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Inefficient voice use can cause throat clearing?

Do you know how voice use and throat clearing are linked?


I’ve seen many patients whose throat clearing is actually directly related to how they us their voice. They typically have a rough voice quality, strain, reduced efficient airflow or little forward focus.

What’s going on here?

The sensation of inefficient phonation at the larynx is recognized and prompts the hypersensitive response cycle of needing the throat clear to remedy that sensation. But we know that throat clearing Will only lead to more throat clearing.


So how do we know if their throat clearing is truly caused by the way that they use their voice?

One key factor that I always note with these patients is if they say that their throat clearing tends to get worse with more speaking or at the end of the day after they’ve been speaking for a longer time. Usually they will not recognize this link until you directly ask these questions. Even then, it will take some education and direct demonstration to get the patients by and that the way they use their voice can actually illuminate their throat clearing.


What do we do?

- Education

- Resonant voice and flow to re-establish efficient phonation patterns

- Work to generalize

- Replace current throat clearing behavior with an alternative behavior (like a swallow)


Case example: I had a lung transplant patient feeling excessive throat clearing and extreme vocal fatigue and discomfort with speaking rough voice and feeling like he needs to stop conversations early. We worked on identifying the cause of his persistent throat clearing: one of them being the way that he is speaking and using his voice with little breath support (not surprising given his history), little forward resonance and low pitch. He also tends to have a pulmonary cough (due to lung fibrosis/transplant hx) and this contributes to stimulation of laryngeal hypersensitivity. We did 15 minutes of education and work on flow and resonant voice and shortly after that he experienced a significant decrease in throat discomfort as well as throat clearing and felt that his voice was so much easier to use in a continued conversation.


WIN, WIN, WIN. I call that a success!

Do you find yourself with patients who frequently throat clear? Do you know the actual origin of this so that you can properly treat them (no, hydration alone likely won't solve the issue for these patients!). Contact me to get on the waitlist for my soon to come mini-course on throat clearing and chronic cough.



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