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Other Medical Conditions of the Voice 

Patients may experience problems with their voice due to a variety of other medical conditions and side effects from treatment. If you have experienced voice problems due to any of the following, call us at 617-573-3557 to make an appointment or request one online. You can reach the Voice and Speech Laboratory at 617-573-4050.

Neck, spine, thoracic surgery

The nerves that innervate the larynx take a lengthy course from the brain and descend in to the neck and chest before entering the throat. Because the nerves travel such a distance, operations in the brain, skull, neck, spine, and chest, including the heart, esophagus, and lungs, can potentially impact throat function. 

For instance, during cervical spinal surgery, the most common approach is to enter through the front of the neck. In order to get to the spine, the surgeon must pull the larynx and its muscles and nerves to the sides. This can cause stretching of the nerves that control the voice. When this happens, there may be temporary or permanent damage to the nerves. 

Specialized evaluation by our team can ensure recovery and function following such injuries.

Neurological Diseases

Strokes (CVA)
Strokes are caused by sudden loss of blood supply to the brain, often causing a loss of neurologic function. Patients can have various degrees of neurological impairments following a stroke, including motor and/or sensory deficits. Speech, swallow, and movement are frequently affected, and speech pathologists and physical therapists play major roles in the rehabilitation process after stroke. Treatment is based on the nature of neurologic impairment. If you suspect you or a loved one is having or has had a stroke, please seek medical care immediately.

Parkinson’s Disease
Parkinson's disease is a progressive disorder of the nervous system that affects movement. Although Parkinson’s disease is a progressive neurological disease, speech therapy is beneficial in treating the vocal symptoms. In particular, programs that increase the level of effort put into voicing and that help a person maintain a higher level of effort in speaking have been shown to improve voice in people with Parkinson’s Disease. The program we use in our Voice and Speech Laboratory is the Lee Silverman Voice Treatment program (LSVT LOUD).

Amyotrophic Lateral Sclerosis (ALS)
Also known as motor neurone disease (MND) or Lou Gehrig's disease, ALS is a disease of the nervous system that weakens muscles and impacts physical function. Most frequently, the disease affects the limbs, but facial weakness can also occur, leading to tongue dysfunction. Speech and swallow therapy can be beneficial to pronunciation and swallowing. As the disease progresses, gastrostomy tube placement may be necessary for nutrition and reducing aspiration.

Huntington’s Disease
Huntington’s disease is a genetic disorder that kills nerve cells in the brain over time. This disease often leads to involuntary jerking or twitching movements, and affected individuals may have trouble walking, speaking, and swallowing. Speech and swallow therapy can be beneficial to pronunciation and swallowing.

Dystonias
There are many forms of dystonia, but the element that each of them share is involuntary muscle contractions/spasms. These spasms often affect the voice, causing voice breaks and difficulty with speech. Careful assessment of the presenting dystonia and related symptoms is needed to determine the best treatment course.

Hypothyroidism

Thyroid gland function has an impact on many body systems, including the voice. In particular, hypothyroidism can cause a buildup of fluid in the voice box, referred to as myxedema. The symptoms of hypothyroidism in the voice include lowered pitch and hoarseness (though these may also be caused by other voice disorders). Once the thyroid condition is stabilized, these symptoms may be resolved.

Thyroid Surgery

The thyroid gland is found at the front of the neck, wrapping around the base and lower sides of the voice box. The nerves that control voice function run directly through the thyroid gland. These nerves can be stretched or cut in thyroid surgery, which can cause a voice disorder. 

Our specialized voice team assesses the extent of the problem and develops a treatment plan for the best recovery of your voice.

Asthma and Emphysema (COPD or Chronic Obstructive Pulmonary Disease)

Everything we breathe passes through the larynx and over the vocal folds. This includes the inhaled medications used to control asthma and COPD. At times, these substances can prove to be an irritant to the vocal folds. This can negatively impact function if swelling and redness occurs. Inhaled steroids can also result in the onset of a fungal (candida) infection in the larynx. The simultaneous use of a steroidal inhaler and antibiotics can make you more prone to the development of these kinds of infections. 

Treatment will be dependent upon the source of the difficulty. This may include finding different asthma medications to systemic antifungal treatments. Speech therapy may be useful for maximizing voice recovery.