Conflicting Voice Interventions? A patient reading two of your recent voice interest articles would surely raise an eyebrow at opposing intervention strategies for the same pathology (Roy and Tanner, “All Talked Out” and Law, “Healing the Hitmakers”). The protocol Law described for a “top-billed celebrity” presenting with a unilateral true vocal fold polyp ... Inbox
Inbox  |   May 01, 2013
Conflicting Voice Interventions?
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Inbox
Inbox   |   May 01, 2013
Conflicting Voice Interventions?
The ASHA Leader, May 2013, Vol. 18, 3-4. doi:10.1044/leader.IN3.18052013.3
The ASHA Leader, May 2013, Vol. 18, 3-4. doi:10.1044/leader.IN3.18052013.3
A patient reading two of your recent voice interest articles would surely raise an eyebrow at opposing intervention strategies for the same pathology (Roy and Tanner, “All Talked Out” and Law, “Healing the Hitmakers”). The protocol Law described for a “top-billed celebrity” presenting with a unilateral true vocal fold polyp was complete voice rest, polypoid resection and postsurgical voice therapy. In contrast, Roy and Tanner noted successful intervention for a unilateral polyp through voice therapy alone; very small supporting before-and-after endoscopic images were included in the article sidebar. Differential diagnosis for the pictured left TVF lesion could include granuloma, a lesion typically more responsive to voice therapy.
In the same Leader issue, it may be important to note that the oft-quoted recommendation for drinking “(up to) 64 ounces of water per day” is simply not supported by research (Kelchner and Brehm, “Strike the Right Cord”). The National Academy of Science’s Committee and Institute of Medicine stated in 2005 that an estimated average requirement for water intake “based on data is not possible.” Also, “The Role of Hydration in Vocal Fold Physiology” (Sivasankar and Leydon, 2010) noted “these clinical recommendations are based largely on anecdotal reports of the beneficial effects of hydration on voice function.” Other widely publicized myth-busting articles indicate that the seminal, hypothetical, 1945 recommendation for high daily water intake included both liquids and foods. Animals drink only when thirsty, and humans in a “prehydration era” did just fine when following the same instinct.
Martin L. Spencer Columbus, Ohio
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May 2013
Volume 18, Issue 5