Are voice disorders a hidden threat?

SALT LAKE CITY — Singers who make a living using their voice probably have to worry about straining their muscles and dealing with other voice disorders. Recently, famous musicians like Adele and John Mayer have had to halt tours and concerts to wait for their voices to heal.

For thousands of Americans, losing their voice probably isn't the worst thing that can happen. However, experts have said it can have a profound effect on your physical and emotional well-being. Voice disorders affect 45% of women compared to 37% of men.

"Most problems with the voice can be treated without surgery, but with medical management and therapy," said Dr. Marshall E. Smith, director of the University of Utah Voice Disorders Center.

That wasn't the case for Unified Police Officer Paul Burnett. He needed surgery in addition to therapy to restore full use of his vocal cords. Holding a microphone to his neck and mimicking sounds to Dr. Smith's, Burnett's simple "eeks" during therapy sessions are considered progress.

Twelve years ago, Burnett had parathyroid surgery that paralyzed his voice box and damaged the nerves. "It's a common, well-recognized complication of any type of neck surgery," Smith said.

The surgery paralyzed the right side of Burnett's vocal folds. He had to undergo surgery and therapy at the Center to strengthen the left side of his vocal cord. "It was paralyzed in the open position," Burnett said. "Now the surgeries that Dr. Smith performed allow the left vocal cord to vibrate off the right one."

This is significant, especially because when the vocal cords aren't working properly, it can affect breathing. "When the vocal fold is paralyzed, one side isn't moving, and the vocal folds cannot close," Smith said. "And there's a gap or a space in between them."

Smith said that gap limited Burnett's duties as a police officer. He used to be an active sportsman, but had to be more mindful of his activity level after his vocal cord was damaged.

"If if I were to go sprint somewhere as fast as I could, I'd be out of breath," said Burnett. "Not in the sense that my lungs couldn't take the air, it was fact that I couldn't get the air to my lungs."

Since then, he's had to trade the sirens and chase in his patrol car for telephones and files doing desk duty. The paralysis on his vocal cord took a toll on Burnett's family, social and professional life.

"For the longest time I couldn't speak into the next room. People would have to know that they'd have to come up close to me to hear me. Or if we'd go on a camping trip or something down by the stream or loud noises," Burnett said. "Now it's not quite that severe. But out of doors is still much more difficult than inside an office to speak."

Burnett's voice box is healing well according to Smith.

"As well as we can hope for, given the condition that he has."

However, Burnett's case is more specific. Smith said most people have jobs that demand using their voice three or more hours a day, jobs like teaching, receptionist, sales representatives, and many more.

Even simple things like cold weather and acid reflux can do some damage to your vocal cords.

"I can usually speak better in the warm weather," Burnett said. As for the acid reflux, Burnett told Dr. Smith he eats a few hours before bedtime to avoid potential problems. "I also watch what I eat so it doesn't cause more acid reflux than what I have normally."

Smith said that's excellent advice for any patient, especially since many voice disorders are caused by other things like inflammation, muscle tension in the neck, and allergies. For acid reflux, Smith also recommends taking medications and elevating your bed. Smith said going through voice therapy will help strengthen those voice muscles.

"Just like the athlete who develops a limp, or a strain, or a muscle pull, needs to go to a physical therapist to get the muscles re-balanced and get moving again," Smith said. "Speech pathologists who work with us in our voice clinic get patients voices moving again."

People can experience short term injury to the voice such as after a football game, a soccer match, or a cold or sore throat. Those types of injuries should recover within a month.

"It's when there's repetitive injury that some tissue damage can result," said Smith. These days, Burnett's smooth baritone voice is a little more gravely than he'd like. So he warns others not to take their instrument for granted.

"I had no control over my voice condition but there are a lot of things, such as smoking, that can affect your voice, (like) yelling too much," Burnett said. "If you think you have a problem such as acid reflux that affects not just your throat but your voice, situations you might have the ability to control, I would strongly suggest you have it looked at."

Currently, doctors at the University of Utah Voice Disorders Center are trying new techniques to better heal voice disorders — a surgical procedure that may be available to restore tone to the paralyzed vocal cord.

"We graft in a nerve from another nerve in the neck to the paralyzed nerve to give it more tone," said Smith. "And that procedure is giving good results."

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