Poor Hearing Impacts Speech

Team approach improves communication.

Patricia “Pat” Yount enjoys dining out with friends. But with everyone at her table talking and laughing, she had difficulty following conversations.

Photo by Nerissa Johnson.

Cell phone conversations are no longer a trial for Pat.

Speaking loud enough to be heard became problematic, too. Her voice had grown deep and raspy, and she suffered from a worsening sore throat.
“I didn’t want to do what my mother did, which was to withdraw,” Pat remembers. “My mother had hearing loss. My brother has hearing loss. I could see where this was going.”
Pat’s primary care physician referred her to Atlantic Ear, Nose & Throat in Orange City, where ear, nose and throat surgeon Devang Shah, MD, performed a videostroboscopy. He describes it as a camera with a strobe light that magnifies a view of the vocal cords in motion.
Dr. Shah found no lesions or growths that would indicate a serious disease. However, the videostroboscopy revealed her vocal folds weren’t vibrating correctly or completely coming together during voice production.
While Pat’s vocal folds had the ability to assume the correct position, they did not because they were pulling against one another inefficiently. The abductor (or opening) muscles prevented the vocal folds from closing completely. Until those muscles stopped competing with the closing muscles, her voice would remain impaired.
The gap in the folds could eventually close naturally after Pat began using strategies to improve her vocal efficiency, taught to her by speech language pathologists at Atlantic Ear, Nose & Throat.
During her videostroboscopy appointment, further examination and a hearing test uncovered a hearing loss that likely caused Pat to strain her voice.
Dana H. Jickell, AuD, a licensed audiologist at Atlantic Ear, Nose & Throat, determined Pat had a moderate hearing deficiency that was more severe in the higher frequencies. This common impairment results from damage to tiny hair cells in the inner ear caused by age, noise or disease.
Dr. Jickell fitted Pat with a pair of behind-the-ear hearing aids.
“I discussed with her the different levels of technology that we offer, the prices and what those hearing aids can do for her,” Dr. Jickell explains. “Because she’s in multiple listening environments throughout her day, she needed a high-technology hearing aid so she could understand and communicate without struggling. We programmed them just right for her, and she loves them.”
“You pick up sounds you never knew were there,” marvels Pat.
One welcome change was she could hear her husband again when he was speaking to her.

Reducing Vocal Strain

As part of Atlantic Ear, Nose & Throat’s multidisciplinary team approach, Pat also had six sessions with licensed speech-language pathologist Carinda Stout, MA, CCC-SLP.
She taught Pat such techniques as breathing from the diaphragm, taking more breaths instead of pushing out the last few words, trying to lift the voice up into the mouth and into the nose instead of speaking down in the throat, and not dropping the word endings.
“Most of our patients have great success when they work with our audiologists and speech-language pathologists to find the right hearing aids, as well as learn strategies to modulate their voice while speaking,” Carinda explains. “People are surprised at what a difference it makes.”
As Pat practiced pronouncing and enunciating specific words and phrases, “I could hear myself getting better,” she relates. “Every time I went back, Carinda was very encouraging. The results, I think, are pretty good.”
Pat calls her treatment at Atlantic Ear, Nose & Throat “a very good experience,” adding, “They were understanding and patient and professional.”

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    • Atlantic Ear, Nose and Throat, P.A.

      Atlantic Ear, Nose & Throat is a comprehensive, full-service otolaryngology practice with offices in both Seminole and Volusia counties. In the practice, Devang Shah, MD, and Daniel Rothbaum, MD, combine surgical excellence with a compassion... Read More

    • Devang Shah, MD

      Devang M. Shah, MD, is board certified in otolaryngology. After receiving his medical degree with honors from Robert Wood Johnson Medical School, New Brunswick, NJ, he completed his surgical internship and residency at Johns Hopkins Hosp... Read More