8 tips to take care of the health of the voice and avoid vocal fatigue

The voice is the main tool that human beings have to communicate, it is part of our identity and, in addition, an instrument of work and expression. Each of us has our own voice and it is different from that of anyone else, so the voice of each one is something that distinguishes us.

In 1999, Dr. Nedio Steffen presided over the Brazilian Society of Laryngology and Voice (now the Brazilian Academy of Laryngology and Voice). After having found that many of the people suffering from dysphonia thought this was normal or attributed it to a natural feature of their voice, they decided, together with their colleagues, to organize a national awareness campaign about vocal health care. In this way, they could convey the importance of early diagnosis and prevention of voice pathologies.

The campaign was truly a success and, four years later, the team decided to share their experience and the results achieved with laryngology societies around the world. These entities were invited to join another campaign - now globally - that gave rise to what is now known as World Voice Day, which is celebrated every April 16. .

Professor Mario Andrea, from Portugal, had the mission of taking this initiative to Europe and the United States, and presented it at various international events as a medical necessity as opposed to the responsibility of raising public awareness about voice care.

Each of us has our own voice and it is different from that of anyone else, so the voice of each one is something that distinguishes us. We have the possibility of having it throughout our lives; for this reason, we must be aware of and guide the general population on how to take care of it and the need to consult in the face of any changes that arise.

We must all take care of our vocal health, especially those who work with the voice, broadcasters, singers, speakers, teachers, actors, among others, and at-risk groups (for example, call center workers) who, through their work, can strive for it. These people report vocal fatigue and this is because they do not know how to use the voice.

About 5% of the world's population suffers from some alteration in the voice, the prevalence is highest between the ages of 25 and 45. In these cases, it is necessary to carry out the evaluation and diagnosis by specialists in otolaryngology working in conjunction with speech therapy.

The sound of the voice originates from the vibration of the vocal cords, located in the larynx. The main alterations are dysphonia, aphonia and hyperfunction.

- Dysphonia: is an inflammatory process in the vocal cords, where the normal timbre of the voice is lost. It can be functional or organic. When it is functional it lasts between 7 and 15 days, and when it is organic, the cause should be studied. On the other hand, there is a physiological form of voice change and it is the one that appears between the ages of 12 and 15 in adolescent boys.

- Aphonia: it is the maximum alteration of dysphonia, in which the voice is completely lost.

- Hyperfunction of the voice: this disorder gives rise to nodules or polyps in the vocal cords. Sometimes the treatment is surgical, with removal of polyps and subsequent rehabilitation.

Some recommendations for taking care of the voice:

1 - Ensure adequate hydration, to keep the vocal cords lubricated

2 - Eliminar el tabaquismo

3 - Avoid drinking coffee and mate

4 - Maintain a healthy diet (avoid large meals)

5 - Avoid talking in closed and noisy places

6 - Do not talk excessively

7 - Try to work in humidified environments (watch out for air conditioners!)

8 - Breathing must be correct for the emission of the voice, it must be inspired before starting to speak and take advantage of the pauses for a new inspiration

Abusing the use of the voice can cause serious problems; therefore, at the slightest dysphonia, at first, rest is indicated. If dysphonia exceeds 15 days, a visit to the specialist is suggested

In the case of voice professionals, it is suggested to consider vocal training, just like an athlete. In the event of allergic symptoms, such as a sensation of postnasal mucus, it is suggested to avoid permanent or excessive scraping, as this would also lead to a hoarse voice that is not clear.

The presence of gastroesophageal reflux (burning sensation behind the sternum) or halitosis are signs that should alert, as, over time, they can injure the vocal cords.

Good posture should be maintained when speaking, any slightest pain in any part of the body influences the emission of the voice. Misuse of the cell phone, often resting on the shoulder, can cause cervical contracture and compromise the larynx (it is recommended to always use the speaker).

Children may also have changes in their voice due to birth defects or hyperfunction. In the latter case, they are usually children leaders in their groups, who use the tone of voice very loud, and often scream.

It is also very common to consult older adults due to loss of loudness. This is caused by a decrease in muscle tone throughout the body, including the vocal cords, which affects the sound richness and is a natural deterioration caused by the years. In this age group, there is a decrease in lack of communication due to the fact that they sometimes live alone.

In other cases, dysphonia or the presence of a cascade voice may have a neurological origin. This dysphonia is characterized by spasms in the voice that impede regular vocal flow and is present in diseases such as Parkinson's or myasthenia gravis.

In the context of the pandemic, the mask has also led us to use our voice with overexertion.

The voice can be temporarily affected by cold, flu or laryngitis. In these cases, recovery should occur in about two weeks. If this does not happen, it is important to consult with the otolaryngologist, who will determine the need to form a multidisciplinary team with specialists in speech therapy. There are also professionals dedicated exclusively to the study and treatment of voice disorders.

As with most diseases, consultation should be early to detect the problem and begin with appropriate treatment.

* Dr. Stella Maris Cuevas (MN: 81701) is an otolaryngologist - Expert in smell - Allergist. Former President of the Otolaryngology Association of the City of Buenos Aires (AOCBA)

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