Patient's Zone

Vern C. Juel, MD

Dr. Juel, in the division of Neurology at Duke, is an essential member of the voice health care team and collaborates with Dr. Witsell on patients with neurological voice disorders.

Appointments

Standard appointments for voice problems can also be scheduled through the otolaryngology clinic.

Voice Video

Voice Patient Testimonial

For 15 years I have struggled with spasmodic abductor dystonia. During those years I have received botox injections which enabled me to finish a 30-year career as a teacher. When I retired in 2003, I ran for my local school board and won. The decision that I made many years ago is that while I do have this disease, it does not have me. Recently I wrote the following poem, which expresses my feelings about SD.

A Voice Found

On the surface I am a person without a voice,
Straining to speak, to communicate, to get people's attention.
It would be easier to retreat into the silence.
But I have a mission in this world which fate will not ignore.

Though the physical is only a whisper,
my spiritual voice is strong.
It speaks for the weak, the disabled, the gifted,
for all the children.
IN ITS SILENCE IS ITS STRENGTH
as it shouts for justice and equality for all.
It is a voice found—a voice for all the people.

I am particularly grateful to have had Dr. Witsell as my physician for the past five years. He has been a real inspiration.

Finally, I would love to correspond with others of you who have SD. My email (what a great invention for us) is LHB1@yadtel.net.

—Linda H. Barnette

Patient's Zone – Voice Patients

When a patient has been diagnosed with a voice disorder, the patient will often work with a voice therapist (a specially trained speech therapist) to identify vocal behaviors that helped cause the problem (loud talking over noise, singing with poor technique, etc). The voice therapist will teach the patient to make subtle changes in the way the patient uses the voice. The voice therapist provides exercises for the patient to rebalance the muscles used to produce voice. The voice therapist also addresses hydration, breathing, and reducing any unnecessary tension in the vocal mechanism. The goal is for the patient to learn how to produce the voice in a way that allows healing of the injury to the vocal folds (voice box), and provides the patient with normal voice use in the future that will not cause further damage to the voice folds.

Patients with voice disorders can be some of the most complicated patients seen in the field of otolaryngology. The complete evaluation of a voice disorder involves taking a thorough medical history, performing a physical examination, and completing a full voice evaluation. An integrated approach involves a team of trained health-care providers, each of whom have their own expertise. The physician evaluates the medical aspects of the voice disorder, and any anatomic abnormalities that may contribute to the voice disorder. A trained speech pathologist provides additional evaluation by taking acoustic measurements of the voice, and performing videostroboscopy. Videostroboscopy involves making a movie of the vocal cords as the patient speaks. This allows for detection of subtle abnormalities that may affect the vibratory characteristics of the vocal cords.

Our goal is to provide you with an integrated approach to your voice problem. Whether you are a professional singer, teacher or student, professional with heavy voice commands, or a person who enjoys socializing and chatting with friends, we will work to give you the best voice that you can have.

Examples of voice problems