Your voice-box
Your voice-box (larynx) sits between the bottom of your tongue and the top of your windpipe. It is made up of muscles, soft tissue and cartilages. The largest cartilage in the voice box is called the thyroid cartilage, also known as the ‘Adam’s apple.’ This can be seen or felt protruding from the front of the neck and is more prominent in men.
Vocal cords
The vocal cords sit behind the Adam’s apple. They are two tiny bands of smooth muscle that lie opposite each other and are stretched across the windpipe from front to back, they are about 1cm long.
At rest when we breathe, our vocal cords are wide apart so air can flow freely through the vocal cords into the windpipe to our lungs.
When we voice, we open and close the vocal cords really quickly. As the air from the windpipe passes through the closed vocal cords, they vibrate, creating sound.
Vocal cords at rest Vocal cords close when we voice
For good vibration of the vocal cords we need to make sure we have:
- Good breath support to power the vibration
- Complete and smooth closure of the vocal cords for clear voice quality
- Relaxed muscles in the voice box to avoid tension and strain
When producing normal voice, it should feel easy, not tight or painful.
What is causing the problems with my voice?
Changes in your voice quality and/or discomfort can be caused by many factors such as:
- Muscle tightness (e.g. due high voice use, shouting, screaming or tension from stress and worry)
- Trauma or injury to the voice box
- Allergies or irritants
- Nerve disorders
- Breathing difficulties
Treatment?
Your ENT specialist will decide the best treatment for your voice problem. Lots of different treatments, including voice therapy, can be helpful.
Please use the following QR code or website link to access the video that accompanies this leaflet:
Voice care
If you have been referred for speech and language therapy, there are a number of things you can do to help your voice while you are waiting for your initial appointment.
Do:
- Try to use your voice quietly and gently, but don’t whisper. If you feel you are starting to “push” or your voice becomes effortful and tired, this is a signal that you should rest it, or have a break from speaking, if possible.
- Avoid talking above background noise – turn down TVs, music. Find a quiet corner to talk in if you are out in a noisy venue. Be aware of the background noise in a car.
- Try to drink plenty of fluids, particularly water. Avoid too much caffeine (tea, coffee, coke)
- Use regular steam inhalations (hot water in a bowl + towel; “steam cup”) as this can be very soothing.
- Try to avoid reflux (acid). Try to make a note of any foods which give you indigestion, and avoid them. Try not to bend down eg to load the washing machine – kneel down instead. Don’t wear clothes that are too tight around your waist.
- Try to keep a note of when your voice is good/bad as this may provide insight into your problem.
- Be aware of your environment. If it is very hot and dry, place some bowls of water around the room to add some moisture to the atmosphere (plants and opening the window may also help). Air conditioning can have a very negative impact on your voice. If you work in an office near an air conditioning unit, ask if you can move.
Don't:
- Clear your throat. This may feel as if it is helping but is a very harsh action on your vocal folds (muscles which produce your voice) and can be one of the main causes for voice change. Try swallowing instead – it will feel as if it isn’t helping, but persevere!
- Smoke/Vape. Any exercises you are given are much less likely to help your voice if you continue to smoke.
- Suck lozenges etc – they are very unlikely to help, and in some cases can be very drying.
- Try to sing, particularly loudly or across a large range.
Contact details
North Cumbria Adult Speech and Language Therapy Department,
Room 1450, Lower Ground Floor, Cumberland Infirmary, Newtown Road, Carlisle, Cumbria, CA2 7HY
Tel: 01228 608332
Email: VoiceSLT@ncic.nhs.uk
North Cumbria Adult Speech and Language Therapy Department,
Level 4, West Cumberland Hospital, Homewood Road, Hensingham, Whitehaven, Cumbria, CA28 8JG
Tel: 01900 705082 (referral line)
Email: AdultSpeechTherapy-AllerdaleandCopeland@ncic.nhs.uk
Useful websites
If you would like further information about health conditions and treatment options, you may wish to have a look at the NHS website at www.nhs.uk
If you would like to find accessibility information for our hospitals, please visit https://www.ncic.nhs.uk/accessibility
Visit the NCIC Adult Speech and Language Therapy website at https://www.ncic.nhs.uk/services/speech-and-language-therapy
https://www.britishvoiceassociation.org.uk/ has free literature with advice on voice care.
We kindly thank the ENT SLT Team, Newcastle Upon Tyne Hospitals NHS Foundation Trust for permission to reproduce and share this advice sheet and video link.
Disclaimer: This publication is designed for the information of patients. Whilst every effort has been made to ensure accuracy, the information contained may not be comprehensive and patients should not act upon it without seeking professional advice.
Confidentiality
‘The Trust’s vision is to keep your information safe in our hands.’ We promise to use your information fairly and legally, and in-line with local and national policies. You have a right to understand how your information is used and you can request a copy of the information we hold about you at any time.
For further information on confidentiality contact the Information Governance Team:
Information.Governance@ncic.nhs.uk | 01228 603961
Feedback
We appreciate and encourage feedback, which helps us to improve our services. If you have any comments, compliments or concerns to make about your care, please contact the Patient, Advice & Liaison Service:
pals@ncic.nhs.uk | 01228 814008 or 01946 523818
If you would like to raise a complaint regarding your care, please contact the Complaints Department:
complaints@ncic.nhs.uk | 01228 936302