Voice, Resonance, &
Upper Airway Disorders

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Voice, Resonance & Upper Airway Disorder Evaluation and Therapy Services in the Black Hills

The voice is a complex system that relies on coordination between breathing, the vocal folds, resonance spaces, posture, and the muscles of the head, neck, and throat. When these systems are not functioning efficiently, individuals may experience changes in vocal quality, breathing difficulty, reduced vocal endurance, or discomfort during communication and physical activity.

At DSSC, we provide comprehensive evaluation and individualized treatment for voice, resonance, and upper airway disorders across the lifespan. Our approach considers the connection between respiration, phonation, resonance, muscle function, and nervous system regulation to help individuals improve vocal quality, breathing efficiency, and overall communication.

Services are available in person at our Rapid City clinic and through telehealth options when appropriate.

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Common Signs of Voice, Resonance & Upper Airway Disorders

Individuals may benefit from evaluation if they experience:

  • Persistent hoarseness or voice changes

  • Vocal fatigue

  • Difficulty projecting the voice

  • Throat tension or discomfort

  • Frequent throat clearing

  • Breathing difficulty during exercise

  • Noisy breathing episodes

  • Changes in resonance

  • Reduced vocal endurance

  • Difficulty coordinating breathing and speech

  • Voice concerns affecting work, school, sports, or daily communication

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Evaluations to Get to the Root of the Issue

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Our Process

Every treatment plan begins with a comprehensive evaluation to understand how the breathing, voice, and upper airway systems are functioning together.

Our evaluation may include assessment of:

  • Voice quality, pitch, loudness, and vocal endurance

  • Breathing patterns and respiratory support for speech

  • Vocal habits and behaviors that may contribute to strain or fatigue

  • Resonance patterns, including nasal and oral resonance

  • Vocal hygiene and lifestyle factors impacting the voice

  • Muscle tension patterns involving the jaw, neck, shoulders, and throat

  • Coordination between breathing, voicing, and movement

  • Symptoms related to exercise, stress, or specific environments

  • Functional impact on communication, work, school, sports, or daily activities

Following evaluation, we develop an individualized treatment plan based on the underlying contributors to each person’s concerns. Treatment may include voice therapy techniques, breathing retraining, resonance strategies, vocal function exercises, relaxation and tension reduction techniques, and collaboration with medical providers when appropriate.

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Voice, Resonance & Upper Airway Concerns
We Evaluate & Treat

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Dysphonia, Functional Voice Disorders & Vocal Fold Concerns

Voice disorders can affect vocal quality, strength, endurance, and comfort. Dysphonia refers to changes in vocal function that may result from inefficient voice use, muscle tension, vocal fold changes, neurological conditions, or other factors affecting the voice system.

We evaluate and treat concerns related to:

  • Hoarseness or rough vocal quality

  • Breathiness or weak voice

  • Vocal fatigue or reduced endurance

  • Difficulty projecting the voice

  • Changes in pitch or vocal range

  • Increased effort or discomfort with speaking

  • Functional voice disorders

  • Muscle tension patterns impacting voice

  • Vocal fold nodules, polyps, cysts, lesions, or paresis (in collaboration with ENT providers)

Treatment focuses on improving vocal efficiency, reducing strain, and developing sustainable voice patterns that support each person’s communication goals.

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Inducible Laryngeal Obstruction (ILO) & Exercise-Induced Laryngeal Obstruction (EILO)

Inducible laryngeal obstruction (ILO), sometimes referred to as vocal cord dysfunction (VCD), occurs when the upper airway narrows inappropriately during breathing. When symptoms occur primarily during exercise, it is often referred to as exercise-induced laryngeal obstruction (EILO).

Individuals with ILO/EILO may experience:

  • Difficulty breathing in

  • Noisy breathing or stridor during episodes

  • Chest or throat tightness

  • Shortness of breath during exercise

  • Feeling unable to get enough air

  • Anxiety or fear related to breathing episodes

  • Difficulty returning to activity after symptoms occur

Treatment focuses on improving breathing awareness, respiratory coordination, and strategies to manage symptoms during exercise and daily activities. Collaboration with medical providers is recommended for diagnosis and comprehensive management.

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Upper Airway & Voice-Breath Coordination Disorders

Breathing provides the foundation for efficient voice production. When breathing patterns, posture, or muscle coordination are disrupted, individuals may experience difficulty supporting speech, maintaining vocal endurance, or using their voice comfortably.

We evaluate functional concerns related to:

  • Inefficient breathing patterns

  • Poor respiratory support for speech

  • Difficulty coordinating breathing and voicing

  • Mouth breathing and altered respiratory patterns

  • Upper airway tension

  • Reduced vocal stamina

  • Breathlessness during communication

Treatment may incorporate breathing retraining, coordination strategies, and functional voice techniques to support efficient communication.

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Resonance Disorders

Resonance refers to how sound travels through the throat, mouth, and nasal passages to create the quality and tone of the voice. Changes in resonance may occur when airflow, oral structures, or velopharyngeal function are not working efficiently.

We evaluate and treat resonance concerns including:

  • Hypernasality (excessive nasal resonance)

  • Hyponasality (reduced nasal resonance)

  • Velopharyngeal dysfunction patterns

  • Resonance differences related to structural or functional differences

Treatment may focus on airflow management, speech coordination, resonance balance, and communication strategies.

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Muscle Tension Dysphonia (MTD) & Hyperfunctional Voice Disorders

Muscle tension dysphonia occurs when excessive tension or inefficient coordination of the muscles involved in voice production contributes to changes in vocal quality, discomfort, or vocal fatigue. It may occur independently or develop as a compensatory response to another voice concern.

Individuals with MTD may experience:

  • Strained, tight, or effortful voice quality

  • Vocal fatigue after speaking

  • Throat discomfort or pressure

  • Neck, jaw, or shoulder tension

  • Reduced vocal range

  • Difficulty projecting the voice

  • Frequent need to clear the throat

  • Symptoms that worsen with increased voice use

Voice therapy for MTD focuses on identifying contributing factors, reducing unnecessary muscle tension, improving breath-voice coordination, and establishing more efficient and comfortable voice production.

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Professional Voice, Communication & Vocal Performance

Individuals who rely heavily on their voice may experience fatigue, strain, or difficulty maintaining vocal quality throughout their day. Voice therapy can support both professional voice users and individuals seeking personalized communication goals.

Services may support:

  • Teachers, coaches, healthcare professionals, performers, and public speakers

  • Vocal endurance and efficiency

  • Projection without strain

  • Speaking confidence

  • Vocal flexibility and control

  • Communication goals related to gender expression or gender affirmation

  • Development of a voice that feels authentic, functional, and sustainable

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Chronic Cough, Throat Clearing & Laryngeal Sensitivity

Persistent coughing, throat clearing, or throat discomfort may occur when the upper airway becomes hypersensitive or when behaviors develop that continue to irritate the voice system.

Common concerns include:

  • Chronic cough

  • Frequent throat clearing

  • Globus sensation (“lump in throat” feeling)

  • Throat irritation

  • Vocal fatigue

  • Sensation of throat tightness

Treatment may include education, behavioral strategies, vocal hygiene, breathing techniques, and approaches to reduce irritation and improve comfort.

We’re accepting new clients for speech therapy in Rapid City, SD

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