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Valentina Carlile Osteopata
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  • Writer's pictureValentina Carlile DO

Voice and Singing Osteopathy: Sjogren's syndrome and hoarseness, story of L.


Voice and Singing Osteopathy: Sjogren's syndrome and hoarseness, story of L.


L., a 54-year-old employee, came to my office sent by her speech therapist and reported that she had started to have hoarseness problems which gradually worsened until they had been continuous for about 6 months.


L. you have Sjogren's syndrome, an autoimmune syndrome that causes dryness in the mouth, eyes, nose and throat. This led her to have long periods of hoarseness after a 'crisis'.

The syndrome was diagnosed after a continuous series of episodes of sinusitis (including infectious), upper respiratory tract infections, pneumonia, reflux episodes (GERD), difficulty swallowing and hoarseness or even actual aphonia.

She was diagnosed with the syndrome in 2003 by a rheumatologist.


Sent to a phoniatrician for the vocal disorder, he carried out a videostrobolaryngoscopy to verify the movements of the vocal cords. Soon after she was prescribed to start some fairly important work with a speech therapist and so did she. In these sessions L. was re-taught how to swallow, how to contract the neck muscles and was assigned vocalization exercises, and each time the vocal peaks were measured via software. She was also given exercises to do at home from time to time.


L. continued with the speech therapist for about 4 years with weekly sessions with mixed results until we reached the moment when she suggested she come to me for a specific osteopathic evaluation.


At the first evaluation I found low cranial vitality associated with poor tissue reactivity. When evaluating the vocal box I found poor inhalation-exhalation excursion with a tendency towards a low position of all the laryngeal components except the hyoid bone which was extremely high, especially on the left. This was associated with reduced lingual fascial mobility on the same side.


The chest was globally positioned in inspiration with poor global costal mobility. I based my treatments on an initial detension of the thoracolumbar, thoracic and deep anterior fascia, liberation of the skull base with relaunch of movement and subsequent mobilization of the shoulder blades, ribs and laryngeal elements. At the end I synchronized the three main diaphragms and the individual laryngeal components and then harmonized everything in correlation with the respiratory acts.


After about 5 sessions L. returned to the speech therapist to resume the exercises. Since then she says she has 'finally found a condition that allows her to lead her life on a regular basis, even in terms of communication.


Currently L. comes to me for rebalancing 2-3 times a year. Since then the sporadic episodes of hoarseness that you have had have lasted a maximum of 2 days but thanks to the speech therapist and some of my suggestions you have a pool of exercises that you can do when the problem arises to control it.

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