A school teacher’s toolbox is filled with the necessary equipment, but one such tool – the voice box – sometimes needs sharpening. What is the best way to protect your vocal cords from being overused or damaged? An expert otolaryngologist and a speech therapist from Rambam Health Care Campus (Rambam) in Haifa, Israel, share the primary lessons.
The annual Rambam Summit celebrates the accomplishments of Rambam Health Care Campus and the people who helped make them possible. Held this year from May 30–June 1, friends of Rambam from Israel, the USA, Canada, the UK, Brazil, Bulgaria, and Spain, Rambam executives, including Professor Michael Halberthal, Rambam's director general and CEO, Rambam leadership, other international and local VIP guests, and Rambam employees participated in the historic event.
Like teachers, if your voice is an essential tool in the workplace, and used extensively to communicate with others, your vocal cords could become damaged or injured.
Dr. Nadeem Habashi, attending physician at Rambam’s Department of Otolaryngology-Head & Neck Surgery, a specialist in voice disorders (dysphonia), difficulties in swallowing (dysphagia), and throat cancer, warns, “Constant overuse of the vocal cords has a cumulative damaging effect. Fortunately, we can take steps to minimize or prevent permanent damage.”
According to published studies, about six percent of the general population will develop and suffer dysphonia. However, this number is much higher among teachers and educators. Data also indicates that twenty to thirty percent of school teacher sick days are related to dysphonia and that it is more prevalent in the first five years of employment, with a higher incidence in female educators.
It is easy to understand why. School teachers make prolonged and extensive use of their vocal cords. However, most of them were never taught how to use their voices correctly, of that age and stress affect voice quality – all of which caused dysphonia and vocal cord injury. In fact, while singers usually undergo vocal range tests regularly to determining vocal competency, the educational system has no such service – although a teacher’s voice is tested daily!
Voice timbre – tone, resonance, and articulation – is affected by air passing through the nose, mouth, and tongue structure. Good vocal quality depends on unobstructed airways since obstructions can distort it.
Signs of vocal problems
The salivary glands hydrate the oral cavity and secrete almost a liter and a half of liquid saliva daily. Any disturbance in the oral cavity can hinder sound production and articulation. Hence, the voice can also be distorted by chronic dry mouth, diabetes, or medications that dehydrate the mouth.
Vocal quality, dry mouth, sore throat, vocal fatigue, and neck and head pain are cause for concern and should be investigated. Hoarseness is the most common vocal disorder. Warts, polyps, and cysts can also develop on the vocal cords, and scarring of the vocal cords can result in irreversible damage. Habashi recommends consulting with an otolaryngologist – an ear, nose, and throat specialist. Smokers should seek medical attention after one week and non-smokers after two weeks. Early diagnosis and treatment can prevent complications.
Teachers also experience muscle tension dysphonia (MTD), another common voice disorder, when the muscles around the voice box (larynx) are so tight that the larynx does not work efficiently. This condition is exacerbated in the classroom when a teacher raises their voice to talk above the children’s chatter.
Diagnosing and treating vocal problems
After 15 years of daily strain, an increase in voice-related conditions in teachers is seen. Many think the problem is transient and will disappear independently, but this is not the case. Regular vocal cord examination will identify possible issues, and preventative or curative treatment can commence immediately. Early diagnosis and treatment contribute to a successful outcome.
If experiencing any of the symptoms of vocal problems, Rambam specialists stress the importance of not postponing a visit to a specialist. Waiting too long can lead to significant vocal cord injury could result.
Specialists have several diagnostic tests that are highly effective in determining the cause of the vocal disturbance. One test, a laryngoscopy, provides the otolaryngologist with visualization of the vocal cords, pharynx, and larynx. Another similar test helps the specialist examine vocal cord structure.
Once a diagnosis is made, an individual treatment plan is established. Drug therapies, antibiotics, or steroid-based medication are prescribed if necessary.
A second line of treatment is speech therapy, explains Sigalit Gabai, a senior speech therapist at Rambam. She recommends that patients meet with a speech therapist who will teach correct articulation, balanced and timed breathing, and voice control.
Speech therapy is individualized according to the patient’s needs and abilities. A treatment plan is established emphasizing breathing, voice production, resonance, and eradicating bad habits that could harm the voice.
Surgical treatments for other related conditions, such as polyps, cysts, and suspicious lesions, are performed under general anesthesia.
Preventing vocal problems
Dr. Habashi recommends maintaining a healthy lifestyle.
- Avoiding acidic foods and drinks reduces the acidity of the digestive system. Acid rising into the throat affects the voice.
- Drink plenty of water – it hydrates the oral cavity and larynx.
- Limit caffeine intake.
- Do not raise your voice or shout; avoid whispering; it strains the vocal cords, causing long-term damage.
- Speaking in short sentences and maintaining correct posture helps to regulate breathing.
- Get plenty of fresh air.
- Cold air damages the vocal cords, so limit exposure to air cooling systems.
- If feeling unwell, stay home and rest –viral infections can strain and damage the vocal cords.
- Good quality sleep is essential – aim for at least 6–7 hours per night.
- Stress affects voice health, so take time to relax.
In addition, Gabai suggests doing the 4-7-8 breathing technique: Inhale for four seconds, hold your breath for seven seconds, and slowly release for eight seconds. This exercise reduces stress and tension in the vocal cords and neck muscles.
Rambam hopes that lessons learned here, will aid educators in the school system and the public maintain good vocal cord health.
The hospital’s Department of Otorhinolaryngology-Head and Neck Surgery provides diagnosis and treatment to patients of all ages for problems of the nasal cavity and sinuses, ears, mouth, pharynx, larynx, throat, and benign and malignant tumors of the head, neck and base of the skull. The department carries out the entire range of surgical procedures for these areas using the most advanced and innovative techniques available.