During conversational speech and reading passage, throat jaw and tongue tension was evident and placement of the tone was generally posterior. His vocal quality was slightly hoarse. He successfully progressed for 60 repetitions daily with 6 ounce resistance to 300 repetitions daily with 8 ounce resistance during the study period. At the completion of the therapy course both the patient and the therapist noted complete resolution of the asymmetric left facial weakness and of the cheek and neck spasms. The patient has had improvement in vocal quality, strength stamina, pitch range and ease of use.
Voice disorders result from a variety of local and systemic conditions.
Some patients have poor vocal quality or strength due to lesions such as a laryngeal neoplasm or injury, neuromuscular weakness, voice abuse or psychological stress. Diseases of neuromuscular weakness, abnormal muscle motion and disorders of central neurologic control can cause poor speech articulation and weak voice quality. Many voice disorders are associated with a weakness, incoordination or abnormal use of facial and cervical muscles. Normal voice production requires movement and stabilization of the larynx by the extrinsic laryngeal muscles in the neck. The facial musculature is effected as an extension of the cervical muscles and is a primary component in the formation of language.