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HeadWay - How to Mend a Broken Voice

HeadWay Spring 2010

How to Mend a Broken Voice

Date: May 3, 2010

Lee Akst
Lee Akst believes most patients with voice complaints, including those with phonotraumatic lesions, can be helped.

Most people imagine voice patients as opera singers or actors. But the reality is that most patients with voice complaints work more routine jobs—as lawyers, salesmen, marketing professionals and, says Lee Akst, especially elementary school teachers.

“A classic voice patient is someone who uses their vocal cords so much that they’ve developed a lesion on them that gets in the way of good vocalization,” Akst, a laryngologist, explains.

And elementary school teachers, Akst continues, are especially subject to such injuries. It’s a population—along with the marketers and lawyers and other highly vocal professionals—that he plans to treat as he takes the helm of the Johns Hopkins’ Division of Laryngology.

Akst, who specializes in voice and swallowing problems, joined Hopkins from Chicago’s Loyola University Hospital, where, as director of laryngology, he helped establish a center for voice and esophageal disorders. Now he’s doing the same here, joining together with current otolaryngology faculty and staff and bringing them all under the umbrella of the newly established Johns Hopkins Voice Center, in the outpatient center of the hospital’s East Baltimore campus.

“We really want to expand the variety of specialty services we’re offering patients with these issues,” Akst says.

Those patients can range from television newscasters to the countless number of teachers who have sought Akst’s assistance through the years. People in these professions, he explains, have one major thing in common: They must frequently use—and sometimes strain—their vocal cords.

“Teachers are particularly high risk because they’re constantly talking and projecting their voices to the classroom, and they’re unable to rest their voices when they’re feeling tired or hoarse,” Akst says. “They have to keep pushing through in order to communicate with their students.”

Over time, he continues, their voices—and those of others in vocally demanding jobs—just give out.

Fortunately, he says, most patients with voice complaints can be helped, especially if diagnosis is early and accurate. Patients with phonotraumatic lesions such as nodules, polyps and cysts can benefit from voice therapy and also surgery. Patients with growths on their vocal cords, like cancer or papilloma, can benefit from surgery as well, often through procedures that use advanced pulsed laser technologies to help preserve voice.  For patients with vocal cord paralysis, there are medialization procedures and also injections that can help restore voice.

“There’s always something we can do,” Akst says. “We can always make someone at least a little bit better.”

Info: 410-955-1654 or

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