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Other Voice Disorders 

Dr. Grillone also manages a variety of other voice disorders including age-related hoarseness and vocal weakness; vascular lesions of the vocal cords; and, voice disorders related to underlying neurological disorders such as Parkinson’s disease and stroke. He also specializes in voice and airway problems related to Wegener’s granulomatosis and amyloidosis. 


Conservation of the voice means avoiding vocal misuse, allowing the vocal mechanism to be healthy and function with maximum efficiency. Should you find that your voice is impaired, the following suggestions will help undo some of what has been done and avoid circumstances that lead to voice impairments in the future.  

1.  Speak slowly and with mildly exaggerated articulation. 

2.  Keep physically healthy. Get plenty of rest, moderate exercise and eat sensibly. 

3.  Increase your water intake. DRINK at least 64 ounces of water per day. Avoid alcoholic beverages. 

4. Know you’re singing limitations and stay within them. Avoid signing in groups. 

5.  Wear comfortable clothing, so there’s adequate room for expansion of the abdominal, thoracic and neck areas.  

6.  When speaking on the telephone, remember to: 

  • Maintain good posture
  • Don’t talk for an extended period of time while lying down
  • Speak at a comfortable conversational level of loudness
  • Speak slowly
  • If you use the phone extensively, consider obtaining a head set so that you don’t position the receiver between your ear and shoulder, which minimizes breath support

7.  Reduce stress (e.g. personal and job related), which causes tension in the vocal mechanism. 

8.  When you speak under “performance” pressure, check your posture and make sure to use diaphragmatic breathing*. If time permits, do a brief vocal warm-up before you speak. Learn to avoid overusing or straining the voice. 

9.  Avoid yelling, shouting, screaming and/or use of loud talking for extended periods of time. 

10. If you talk in a noisy environment*, make sure to face the person you are communicating with. 

11. Avoid speaking extensively if you are tired or ill (cold, laryngitis, etc). 

12. Avoid whispering. Instead, speak normally but at a low volume or use a safe whisper* 

13. Avoid excessive consumption of aspirin and caffeine. Both substances increase likelihood of acid reflux (GERD).

14. Avoid excessive use of salt, which tends to cause the body to retain fluids and may contribute to swelling of the vocal cords.

15. Do not self-prescribe over-the-counter preparations for “allergies,” such as nasal sprays, cold and congestion medications, especially prior to professional or extended use of the voice. These may dry the vocal tract

16. Use a humidifier to keep moisture in the atmosphere, especially when sleeping.

17. Discontinue use of tobacco and/or recreational drugs. If at all possible, avoid unhealthy atmospheric conditions where environmental irritants are present (e.g. exposure to dust, fumes, chemicals, cigarette smoke, etc).



Diaphragmatic Breathing: Speech-breathing support solely from the diaphragm. Effort should be shifted from chest, neck or head involvement. Focus on deep breathing from your stomach. 

Safe Whisper: Effortless, breathy voice. You should feel no strain from your voice box (larynx) while practicing a safe whisper. 

Noisy Environments: Any situation in which you need to increase your voice loudness level in order to compete with environmental sounds. For example, subway stations, automobiles, loud parties, stereos, planes and televisions.


  1. Vocal Warm-Up: Take 1-2 minutes of relaxation and deep breathing to warm-up your voice before professional or extended use.
  1. Diaphragmatic Breathing: To ensure proper technique. Try lying flat on your back and placing a book on your stomach. If the book is rising up and down as you breathe naturally, you are ready to begin practicing in an upright position. Take a few minutes twice a day to practice diaphragmatic breathing. This will help to prevent abuse/misuse of you voice. Diaphragmatic breathing is crucial for adequate breath support during speech production.
  1. East-Onset Sigh: This is the next step after you have mastered diaphragmatic breathing. During exhalation, allow the airflow to produce a soft tone (sigh). Be sure not to use any force to produce a sound. If a soft sigh does not come easily, a ‘loud breath’ is fine. This will teach you how to use your voice gently.
  1. Silent Cough: Use the silent cough instead of clearing your throat. Push as much air from the lungs in short, blast-like bursts, without producing any sound. The only sound should be a quiet rush of air. Next, swallow immediately.
  1. Self-Monitor Loudness: Take note and ask others about your conversational loudness. If you are spending extended periods of time in noisy environments, plan “talking breaks” and limit yelling.