Phoniatrics is the branch of otolaryngology that deals in particular with the production of the voice, that is, phonation or voicing. The subject of interest of the phoniatrist is the emission of sounds to the environment and the way they are produced by the organs of speech, as well as all abnormalities and pathological changes within these issues.
Most often, doctors in this specialization combine it with audiology, which deals with how people hear sounds and with hearing disorders. Both areas are related to the issue of sound, and the problems of the voice and hearing organs are often related (for example, speech disorders are often associated with hearing disorders).
The phoniatrist’s patients are people who work with the voice, so certainly singers and singers, but also teachers and other people whose profession involves emitting voices for a relatively long time during the day. Quite often, phoniatric problems also affect young children, who are just learning to emit sounds, while at the same time strongly exploiting the vocal cords during prolonged bouts of crying. Both adults and children most often visit the phoniatrist with a symptom of persistent hoarseness.
Abnormalities in phonation (the emission of sounds to the environment) can result from many reasons, such as poor structure of the speech organs, congenital and acquired defects, previous infections, operating mode of the voice organs and the formation of growths (nodules) on the vocal folds. In order to assess the size of the problem and learn about its etiology, the phoniatrist has numerous possibilities for measurements and research. Some of them require the use of specialized equipment, others are made without additional equipment.
How does a phoniatrist examine the voice?
For many mothers whose children have been referred to a phoniatrist, such a visit is a matter of concern. Especially when it is necessary to examine the condition of the vocal cords, which activity is most often associated with the presence of a laryngostroboscope (specialized medical equipment) in the throat and larynx. However, the doctor does not always decide to perform this type of examination of the condition of the voice organs – there are many other possible procedures that allow the phoniatrician to find out about the situation without introducing the apparatus inside the patient’s body. Additionally, if it is necessary to have direct insight into the function of the vocal folds, the test is performed under surface anesthesia, and therefore causes, at most, discomfort.
An interesting issue is the very concept of this study: vibrations of the vocal cords are too fast to be captured by the human eye – hence the idea of using stroboscopic lighting, whose flashes at frequencies noticeable to humans illuminate different phases of vibrations, making up a kind of a slowed-down image of the work of the folds voices. The laryngostroboscope itself can be additionally equipped with a magnifying glass. Nowadays, most often the device is connected to the computer and the image can be observed on the monitor. The patient is asked to emit the vowel “a” evenly during the examination.
Non-invasive methods of voice testing are carried out on the basis of sound samples recorded with a microphone, which analyze specialized computer programs, calculating various parameters and determining their position on the scale of standards for a given age and gender. This type of research allows, inter alia, to determine the so-called a voice field that extends between the intensity axis and the frequency axis. This parameter is of great importance for singers who measure their voice capabilities.
Phoniatric exercises and prevention
The final form of treatment of severe disorders may also be surgery, especially in the case of nodules that may pose a threat. However, the most frequently found irregularities are subject to pharmacological treatment and rehabilitation with the use of emission exercises recommended by the phoniatrist. Various dysfunctions will require various forms of therapy, activation of specific parts of muscles and resonators, but you should definitely take to heart the need for proper hydration of the voice organs. During increased phonic activity, it is worth adopting the rule of 1 hour of speaking = 1 glass of water and follow this recommendation also after the rehabilitation process is completed, which will prevent future problems. Cigarettes, alcohol, coffee and – although this may surprise some – tea do not serve the sound system on a daily basis. The temperature of the consumed food also affects the voice – the less it differs from the room temperature, the better.