Dysphonia (Abnormal Voice)
Treating voice disorders has been a passion for Yonca since graduate school. She brings a unique approach to treating voice disorders. She believes that treating the root cause of the problem is just as important as treating the symptoms. She incorporates manual techniques, such as myofascial release and laryngeal massage alongside breathing and voice therapy techniques. She guides her patients in making lifestyle and dietary changes to help achieve effective, quick, and long-lasting results.
Changes in voice quality, pitch or loudness can occur due to neurological disorders, vocal-cord dysfunction, vocal disuse or abuse, muscle tension, stress/anxiety, medical procedures or aging. The impact of dysphonia can range from mild annoyance to significant impairment of communication, affecting an individual’s personal and professional life. Diagnosis typically involves a thorough voice evaluation by an otolaryngologist and a speech-language pathologist. Treatment approaches vary depending on the cause and may include voice therapy, medication, or surgical intervention.
Lee Silverman Voice Therapy (LSVT-Loud)
Yonca has been Lee Silverman Voice Therapy–certified for 20 years and has successfully treated many patients with Parkinson’s Disease and other movement disorders affecting voice and speech.
Lee Silverman Voice Therapy is an evidence-based, highly effective treatment method especially in the earlier stages of the disease process. LSVT is delivered 4 days a week for 4 weeks for a total of 16 sessions as per protocol. Yonca offers LSVT-Loud both in person and over video/zoom, allowing patients to receive therapy from the comfort of their home. Monthly, unlimited 1-hour group therapy sessions are included upon completion of the 4-week treatment.
For more information on LSVT-Loud please visit www.lsvtglobal.com
Chronic Cough
Patients are often surprised when they are referred to speech therapy for their chronic cough. From a speech therapy perspective, chronic cough is often viewed through the lens of airway protection, vocal health, and the intricate sensorimotor control involved in the cough reflex. Speech/language pathologists recognize that while coughing is a vital protective mechanism, a persistent cough can become maladaptive, leading to a cycle of irritation and further coughing.
The assessment focuses on understanding the patient’s cough triggers, frequency, and the impact on their voice and daily life. Factors like vocal-cord irritation from repeated coughing, muscle tension in the head and neck contributing to the cough, and even learned behaviors that might be perpetuating the cough are considered in each assessment.
Intervention strategies often involve patient education about the cough mechanism and potential irritants, teaching cough-suppression techniques to regain voluntary control, and implementing vocal-hygiene strategies to minimize laryngeal irritation. Therapy may also address breathing patterns and muscle tension through specific exercises and manual techniques. The goal is to help the individual break the chronic cough cycle, reduce its impact on their voice and quality of life, and promote a more balanced and controlled airway response.
Paradoxical Vocal Cord Dysfunction (PVCD)/Exercise Induced Laryngeal Obstruction (EILO)
Yonca often hears her patients say, “I feel like I am breathing through a straw,” “my throat tightens up when I am exercising,” or “every time I smell bleach my throat closes up.” Not being able to take a breath can be a very scary experience.
Therapy focuses on breathing exercises and laryngeal control, relaxation techniques, manual techniques, as well as identifying and managing triggers to improve airflow and reduce episodes of obstruction. Once the patient is comfortable with the use of the breathing strategies and relaxation during an episode, they start seeing a significant decrease in the frequency and the intensity of the PVCD or EILO attacks.
Paradoxical Vocal Fold Dysfunction (PVFD) and Exercise-Induced Laryngeal Obstruction (EILO) are conditions that can significantly impact breathing, often mimicking asthma but stemming from inappropriate vocal cord movement. In PVFD, the vocal cords narrow and close during inhalation, instead of opening—leading to shortness of breath, stridor, and throat tightness, often triggered by irritants, reflux or stress. EILO, specifically triggered by exercise or exertion, involves a similar narrowing of the larynx, causing breathing difficulties, particularly during intense exertion. Both conditions require careful diagnosis, often requiring a visit to an otolaryngologist and a pulmonologist to differentiate them from asthma or other respiratory issues.