Talking up a storm? Featured

4:33am EDT March 31, 2006
Having a functional voice is like having an operable computer. That is, you take it for granted until it’s taken away. Our thoughts, views and ambitions are all communicated to others via the power of language.

And in Los Angeles, Hollywood types aren’t the only people who are deeply impacted by voice problems or disorders.

“It isn’t just singers, actors and high-level businessmen, but also teachers and lawyers,” says Dr. Gerald Berke, chief of the Division of Head and Neck Surgery at the UCLA Medical Center. “These are people who rely day in and day out on their ability to communicate.”

Smart Business spoke with Berke about the UCLA Voice Center (which was established under his direction) about the causes of voice disorders and how you can keep your keep voice healthy.

How common are diseases or disorders of the voice?

The larynx is a very robust organ, so we kind of take it for granted. It’s really only when we lose our ability to communicate that we realize how much of our self-identity is built around the way that we present our voice and our language to the external world. The problems that occur are fairly frequent, especially in people who use their voices in their profession.

What are some of the causes of voice disorders?

They range from rare to common. Some patients have neurological voice disorders that can accompany strokes or other degenerative diseases. Others have mass lesions on the vocal cords. There are people who just start using their voice improperly because they develop bad habits. There are people who abuse their voices and abuse their intake.

A very common [problem] is acid coming up in the back of the throat and bathing the vocal cords for a length of time. Oftentimes, this is silent, and patients don’t even recognize that it’s happening. That is probably the most common cause of voice disorders, and it can lead to a lot of problems in individuals if it’s not recognized and taken care of.

For many business executives, public speaking is a vital function. How can they keep their voices healthy?

Steps to take include getting enough rest, eating the proper diet, not drinking wine late at night and avoiding smoking. Also, rest your voice when you’re not giving a public presentation so that you’re not over-using it.

What steps do patients go through when they visit the Voice Center?

Most patients are either referred by a singing coach, a voice therapist or a physician. But, certainly, we’re willing to see anybody.

When patients come in, they first get a complete history and physical examination of their head and neck area. Then we usually perform an analysis of what their voices are like and how they sound. Then we take photographs with high-speed cameras or stroboscopy. These are analyzed, and we come up with diagnoses and treatment plans.

The Voice Center is composed of a multidisciplinary team of experts. How do team members work as a cohesive unit to provide expert care?

[An examination] usually involves an evaluation by at least one physician, a speech therapist and possibly a vocal coach as well. We have the most modern analysis equipment available, and we see things that other doctors have failed to recognize just because our ability to capture the anatomy of the larynx is so much better than other places.

What challenges have you faced in getting funding for the center?

The center was created by the generosity of two UCLA donors who recognized the importance of having a place like this on the West Coast and in Los Angeles. Through their generosity and philanthropy, we have been able to bring this center into fruition. We always had a small voice center, but we’ve never had it in a localized area where everybody could be with the most modern equipment.

In addition to analysis equipment, we’ve been able to purchase some of the most up-to-date treatment equipment, which allows us to do many things right in the office. Heretofore, patients had to go to sleep with general anesthesia in a hospital setting. Oftentimes, we can now just treat them in the clinic, and they can go home immediately. This has really changed the way that we’re able to take care of a lot of patients.

DR. GERALD BERKE is chief of the Division of Head and Neck Surgery at the UCLA Medical Center. Reach him at