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VOICE AND SINGING OSTEOPATHY
- PHONIATRICS -


Defining a "Phoniatric" Osteopathy does not mean creating a new system of care or going beyond what is the global approach to the individual, which is the prerogative of Osteopathy,

but simply  apply its principles at the service of patients with ENT and Voice disorders in complete interdisciplinarity with the professional figures already existing in the sector, such as ENT professionals, phonologists, speech therapists, singing teachers.

Many symptoms such as pain in the throat, feeling of lump in the throat, recurrent loss of voice, lack of vocal resistance, vocal fatigue, lack of voice upon awakening, dry throat, inability to project the voice, hoarseness and croaking voice, loss of range vocal and many others, can be traced back to laryngeal functional / positional imbalances.

Some of these disorders may occur associated or secondary to organic pathologies affecting the vocal cords, as occurs for example in the case of chordal nodules, while others are related to overuse / misuse without signs of tissue injury, and it is conditions resulting in high muscle tension and / or joint stiffness with loss of flexibility and correct laryngeal function / position, both extrinsic and intrinsic, elements responsible for inflections in the voice even without a videostroboscopic examination revealing real lesions of the vocal cords.

The Specific Treatment

The specific Osteopathic Treatment in this case aims to examine the vocal tract through its peculiar perceptual palpation, then evaluating its global positional / functional state, the intrinsic one and the one in phonatory dynamics, in search of what is the disfunctional functioning in the patient.

Once this pattern has been identified, through specific osteopathic techniques, the osteopathic professional normalizes the correct laryngeal function.

Obviously, the specific osteopathic approach cannot go beyond the evaluation and the overall osteopathic treatment of the patient and clinically the two approaches must always integrate, it being understood that it is unthinkable to be able to act osteopathically in voice without a direct and specific approach on the same, precisely for the complexity of this system.

The larynx is an apparatus largely ignored in the usual osteopathic approach while it is instead a complex mechanism consisting of cartilage complexes, muscles, ligaments, joints 'suspended' in the throat, a crossroads of large fascial chains.
In young subjects it is more elastic and flexible while with age it tends to 'harden'.

It is a very delicate area to manipulate and upon contact it can trigger the most diverse reactions in patients. The throat itself is an area of the body that no one feels comfortable putting their hands on. It is therefore essential to demonstrate safety in the grips, in the tests and in the execution of the correction techniques.  

The phonatory system is also closely related to the emotional sphere and it often happens that some voice disorders are managed simultaneously by an Osteopath and a Psychologist / Psychotherapist.

In this regard, it should be remembered that the biopsychosocial model is one of the 5 osteopathic models.

In the Performer the fact of losing the voice causes further stress which quickly leads to the development of compensatory techniques which however only aggravate the problems.

The constant osteopathic monitoring over the years has proved to be an excellent help in preventing and treating the various phonatory disorders, and fits well into what is the classic healthcare approach of the sector: Phoniatrist, Speech therapist, Psychologist.

The specific osteopathic treatment in ENT and VOICE is useful in cases of:

  • Rhinitis

  • Sinusitis

  • Tinnitus and hearing loss of membranous or chewing origin

  • Functional hypotonia of the velum

  • Hypopharyngeal vellichium

  • Functional articulatory disorders of the velar or of the lingual chain

  • Interincisive diastems

  • Atypical swallowing

  • Respiratory disorders of a functional nature of the splanchocranium

  • Maxillofacial post-surgical (LeFort I - II - III, Markowitz)

  • Laryngitis / Pharyngitis

  • Anterior bite of the arytenoid cartilages (for trauma or intubation)

  • Dislocations of arytenoid cartilages

  • Functional disorders of resonators

  • Otitis media

  • Acute pharyngeal pains selective from constrictors of the pharynx

  • Bruxism

  • Disorders affecting the temporomandibular joint (TMJ)

  • Rebalancing tongue and lingual/laeyngeal chain / post frenulotomy

  • Rebalancing of the tongue and lingual chain in post-surgical outcomes from mass removal and synthesis processes

  • Dyslalias from morphological changes (palatal vault, mandibular structure, sinus structure)

  • Malocclusion dyslalias (especially in the age of development)

  • Functional disorder of the lingual frenulum

  • Compression syndromes of the recurrent laryngeal nerve

  • Organic Dysphonies Secondary to Minor gastrointestinal disorders (alteration of the intestinal regularity with constipation, gastroesophageal reflux)

  • Functional dysphonies or aphonies deriving from an incorrect use of the vocal apparatus both for excess and for misuse of the voice.

  • Post-surgical laryngeal positional / functional correction from the outcome of thyroid gland surgery, cervical discopathies with anterior access, direct interventions on the vocal cords (varices, polyps, lipofilling, Reinke's edema , etc.)

  • Pre and post surgical laryngeal rebalancing in Phono surgery

  • Specific post-surgical rebalancing of neoplasms and pathologies of the oral cavity, tongue and larynx

  • Disorders structure function in syndromic pictures (eg. Pierre Robin)

  • Psychogenic - Traumatic Dysphonies or Aphonies

  • Functional dysphonies or aphonies related to Premenstrual Syndrome and Menopause.

What can it be useful for?

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