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As part of the second annual World Voice Day on April 16, physicians at NewYork-Presbyterian Hospital/Columbia are urging New Yorkers to follow a few simple tips to help them maintain a healthy voice.

You don't have to be a professional singer to need a good voice. From home to work, vocal health is the cornerstone of communication, says Dr. Jonathan Aviv, medical director of the Voice and Swallowing Center at NewYork-Presbyterian Hospital/Columbia and professor of otolaryngology, head and neck surgery at Columbia University College of Physicians Surgeons. People tend not to pay attention to how they sound, but when something goes wrong, it becomes noticeable and often very uncomfortable. And voice problems can lead to bigger problems including difficulty swallowing, he adds.

The larynx, or voice box, is the primary organ responsible for voice production and for normal swallowing, explains Thomas Murry, Ph.D., the Center's clinical director and professor of clinical speech-pathology in otolaryngology at Columbia University College of Physicians Surgeons. Although it's a small organ, there are a number of things that can 'go wrong' with the voice.

While usually not life-threatening, voice problems can have a severe impact on income and lifestyle for those who need their voice for their profession. But voice problems can have a detrimental effect on those who don't rely on the quality of their voice to earn a living. Pain, discomfort and hoarseness can make social interaction difficult. Minor voice problems may lead to changes in social situations or career opportunities where speaking is mandatory, notes Dr. Murry. Voice problems can be the result of a variety of conditions. These include vocal polyps, cysts, nodules, paralysis, and misuse of the voice. It should be remembered that two weeks of hoarseness should alert someone to the possibility of a serious disease such as throat cancer.

Patients are evaluated by a thorough history and a variety of tests. These can include acoustic analysis, vocal performance evaluation, aerodynamic evaluation, video strobolaryngoscopy, and a voice handicap survey. Treatment consists of behavioral voice therapy, medications, phonosurgery, botulinum (Botox®) injections, laryngeal reconstruction or framework surgery, or post-cancer voice rehabilitation.

Too many people have been told that there isn't any help for them or that their problem isn't that significant and they try to make adjustments. But that's not the case. Swallowing and voice problems are often serious. There is help for them, for their swallowing problems, for their voice problems. Just say the word. We're here to help, concludes Dr. Aviv.

Dr. Aviv and Dr. Murry recommend the following tips for vocal health:

• Drink six to eight glasses of water every day
• Avoid yelling, screaming, shouting, and throat-clearing
• Don't smoke and avoid secondhand smoke or other noxious environments
• Rest the voice when fatigued
• Curtail vigorous exercises, especially weightlifting
• Seek help if hoarseness persists more than two weeks
• If hoarseness persists more than two weeks, it should be checked by a specialist

The NewYork-Presbyterian/Columbia Voice and Swallowing Center, unique to New York City, is dedicated to the evaluation and treatment of voice and swallowing conditions. For more information, visit the NewYork-Presbyterian Web site at http://www.nyp.org.