People who overuse their voice, risk straining the muscles in the larynx. The discomfort causes speaking difficulties. Instead of delivering a solid tone, the voice is lower, raspy, and strained.
Teacher Jing Burias was alarmed when she could not pronounce certain consonants. Working as an English teacher overseas, her work routine involved eight hours of nonstop talking, five days a week. She taught a class of 40 students, which required her to raise her voice all the time. \
“After two years, I noticed my voice was getting worse. I started using a lapel microphone until it was no longer useful. We resorted to zoom classes.”
Her condition got so worse that she could hardly talk, and needed a writing tablet to convey what she needs to say.
Teacher Jing was diagnosed with Spasmodic Dysphonia a voice disorder that involves involuntary spasms in the voice box muscles, causing a tight, strained, or strangled sound. The neurological speech disorder changes the vocal performance of the spoken sound. The change can happen with certain consonants or words. In severe cases, voice deterioration can post make a person difficult to understand.
When teacher Jing joined a support group for Spasmodic Dysphonia patients on Facebook learned about the Isshiki Thyroplaty procedure at Isshiki Memorial Voice Center, Manila (IMVC).
Also known as phono surgery, Isshiki thyroplasty is a voice alteration procedure pioneered by Japanese surgeon Nobohiki Isshiki.
“Dr. Isshiki has been performing the procedure in Japan for decades. People all over the world would troop to Kyoto, Japan, to have the surgery,” shared IMVC surgeon Dr. John Espina.
The idea for the procedure started when a patient consulted with Dr. Isshiki about the change in his voice. During a karate class, the opponent kicked the patient’s neck right where the larynx is located.
“The voice did not change but the Adam’s apple was dislocated. Dr. Isshiki manually brought it back to its original position, however, but the voice turned bad. He moved it back to the deformed location, and then shaved the laryngeal framework structure (cartilage only). The patient’s voice was back to normal. Dr. Isshiki realized that by manipulating the Laryngeal Framework, voice can change and even improve disorders,” explained IMVC surgeon Dr. Shamylle Quinto.
The procedure manipulates the laryngeal structure to improve voice quality. Up until recently, Dr. Nobuhiko Isshiki himself would perform the surgery at the Isshiki Memorial Medical Center (IMVC) located in Kyoto, Japan. The 92-year-old doctor passed away last August 2022.
IMVC Manila at Centuria Medical Makati is the first clinic outside Japan. Drs. Quinto and Espina trained under Dr. Isshiki in Kyoto, Japan back in 2016. Both are ear, nose, throat—head, and neck surgeons, with subspecialties in Laryngology and Phonosurgery.
The patient is conscious during the two-hour Thyroplasty procedure. Once fully recovered, the patient is advised to undergo speech therapy. Three weeks after the Thyroplasty procedure Teacher Jing’s speaking voice was back to normal. She even posted a video singing “Top of the World.”
Aside from spasmodic dysphonia, IMVC addresses vocal problems which include hoarseness, vocal cord paralysis, and voice change (both feminization and masculinization). Transgender flight attendant Mikee Vitug posted about her voice feminization procedure at IMVC.
With IMVC Manila, the surgeons hope to raise awareness of spasmodic dysphonia.
“That’s the goal of our mentors in Japan. ‘Pag may nauutal-utal akala natin joke’, but it’s a serious neurological disorder,“ Dr. Quinto said. She added that just like Nihongo, the languages spoken in the Philippines are glottal. The words are structured in syllables there are pauses or airflow interruptions in between, which can lead to spasms. Vocal overdoers like teachers, announcers, and call center agents are prone to develop Spasmodic Dysphonia.
