Sound advice about exercises to promote overall ear, nose, and throat health from otolaryngologist Dr. Richard Vivero.
Shelby Stockton (00:00):
Welcome to the South Florida ENT audio blog. I'm Shelby Stockton, and today I spoke with otolaryngologist Dr. Richard Vivero about aging. We discussed lifestyle changes we can implement to promote overall ear, nose, and throat health; how aging affects the vocal cords' and common throat conditions that can happen as we age. Dr. Vivero gives some sound advice about exercises to maintain strong swallowing muscles, and some signs that might indicate a swallowing issue in older adults.
Dr. Vivero, thanks so much for your time today. I really appreciate it.
Dr. Richard Vivero (00:37):
Thanks, Shelby, for having me. Good to be here.
Shelby Stockton (00:39):
Fantastic. I have a few questions for you about aging and our voice, our ear, nose, and throat. My first one for you is, are there specific lifestyle changes that can promote overall ear, nose, and throat health as we age?
Dr. Richard Vivero (00:54):
Absolutely. We think of the ears, nose, and throat. I mean, there are a couple of different things you can consider for each of them. For the ears, obviously, you want to protect your ears from loud noises, and the oxidative stress of free radicals, which happens with age. We all hear about that damaging other parts of the body, the brain, so good vitamins, antioxidants can help in that regard. Regards to the nose and the throat, I always recommend getting away from inflammatory things, like managing your allergies, your reflux, trying to avoid vocal abuse or irritant exposure to minimize the irritation of those areas.
Shelby Stockton (01:27):
Great. How does aging affect the voice and vocal cords?
Dr. Richard Vivero (01:32):
Great question. Aging has multiple impacts on both. As we age, the body tends to have more atrophy, as you'll see in an old person, has atrophy in their hands or in their facial musculature. So, and those muscles get thinner, the voice will become more gravelly, more raspy. The, quote, old person's voice, as we call it. Also as you age, there's usually a re-distribution of fat. So some of the fat that goes around the vocal cords can go to other parts of the body, and that combination can make the vocal cords much thinner. And so as you age, you'll find that a woman's voice will become a little bit deeper from both this and being postmenopausal, and a man's voice will oftentimes actually get a little bit higher or feminine. And so as we age, the woman's voice and the man's voice come closer together.
Shelby Stockton (02:20):
That's so interesting. Are there common throat conditions that can happen as we age?
Dr. Richard Vivero (02:27):
Yes. As we age, in addition to the atrophy we talked about, I mean, there's a decreased muscle tone and sensation that comes with the aging of the nerves themselves that increases your risk of having not only other vocal disorders, but can also impact your swallowing.
Shelby Stockton (02:46):
What can a person do to manage or prevent chronic sore throat or hoarseness as they age?
Dr. Richard Vivero (02:51):
Great question as well. Sore throat is always a concern for me. Usually, it's indicative of either inflammation, which could be from allergies, reflux, but always you have to be concerned about something a little bit more concerning such as a cancer. So if you have sore throat or hoarseness lasting more than two weeks, I recommend seeing an ENT to have that carefully evaluated with a camera through the nose or mouth, to look at the throat in the vocal cords.
If it's something benign like reflux or allergies that can be treated with medicine, which can be very helpful. As far as the voice goes, something I like to maintain the voice is you got to use it. Like most things in the human body, if you don't use it, you'll lose it. So I think remaining vocally active is very important. Additional things you can consider would be voice therapy, like you would rehabilitate an arm or a leg, you can rehabilitate the voice for strength. And then there are also other procedures, almost like a facelift for the vocal cords where you can inject material to augment or supplement the vocal cords to improve the quality.
Shelby Stockton (03:56):
Wow. A facelift for the vocal cords. I love that. Are there exercises or strategies to maintain strong swallowing muscles?
Dr. Richard Vivero (04:04):
Yes, much like voice therapy, there is also swallow therapy, which there are various exercises that can be done such as trying to swallow with an empty throat, practicing that, but there are a lot of techniques that a speech and language pathologist can use to help strengthen the swallowing function. There's even some type of electrical feedback systems that can be used to encourage swallowing if necessary. So we should always think of the throat and voice as we think of every other part of the body, where there are muscles and coordination involved that, with good rehabilitation, they can oftentimes be improved.
Shelby Stockton (04:39):
What are some signs that might indicate a swallowing issue in older adults?
Dr. Richard Vivero (04:44):
Some things I look for are coughing after you eat, that may suggest that food is going down the wrong way, or liquid for that matter. Also, if you end up having increased phlegm or feeling of something getting stuck, those are probably the most common things. Usually liquids are harder to swallow, oddly enough than solids because of the fact that they are liquids. They can move around much faster than our muscles can sometimes control or our nerves can feel. So I always feel, if you have a problem with liquids, definitely that needs to be checked out soon.
Shelby Stockton (05:19):
Well, Dr. Vivero, this was very educational. I really appreciate it. Thanks for your time. I know you're busy.
Dr. Richard Vivero (05:25):
No, my pleasure. Thanks for having me.
