6 HEALTH & SCIENCE SUNDAY, APRIL 26, 2015 . THE JERUSALEM POST Voice of the people Most people take the sounds that come out of their mouth for granted, but when acute or chronic conditions appear, ear-nose-and-throat and clinical communications specialists should be consulted. Judy Siegel-Itzkovich reports

any teachers suffer from it, as do tele- marketers, sales- persons, aerobic teachers, lawyers, Mactors, stall owners and employees in public markets, Knesset members and maybe a few journalists. And because exuberant, hot-blooded Israelis do a lot of shouting, chronic hoarseness is a widespread condi- tion that requires good habits, guid- ance and sometimes treatment. World Voice Day was marked on April 16 around the globe and in Israel to increase public awareness of throat diseases (dysphonia) such as hoarseness, which affects some six percent of the general population at all ages and 10% or more of people in problematic professions, as well as 30% of children. Other conditions DR. MICHAL ICHT (Courtesy) are throat cancers. The annual event was marked in larynx are much rarer and often con- cialists in Israel, but this may occur various institutions, including Sheba nected to difficulty breathing. Any in the future. It would be a shame Medical Center at Tel Hashomer and problems breathing during an illness for people to study for four years in Ariel University in Samaria, where requires emergency evaluation. the academic field and then find no students produced flyers on vocal A vocal cord can become paralyzed work, she stressed. hygiene that were widely distributed. or weakened (paresis) from a viral Some 45 or so graduate from the Dr. Michal Icht, a clinical commu- infection of the throat, after surgery clinical communications depart- nications specialist teaching at Ariel in the neck or chest, from a tumor or ment at Ariel. The students work University who also has a private growth along the laryngeal nerves or with patients during their studies, practice treating patients in Herzliya, for unknown reasons. and after they graduate they have to gave an interview to The Jerusalem If the vocal cords are spastic or if spend a year under supervision with Post recently to mark the occasion. they have difficulty closing, injec- professionals in hospitals, health There are famous cases of people tions of Botox (botulism toxin) pro- fund clinics, schools, kindergartens whose careers depend on having vide effective although temporary and other locations. healthy voices who have suffered relief. Surgery may be performed to “What limits the number of profes- from hoarseness, such as actress and move a vocal cord to a different place sionals is the number of places where singer Julie Andrews, who had to to be more effective. Fat can also be they can get supervision from a stop singing for years. injected to improve the voice. It there licensed and experienced profession- The late Israeli actor and comedian is no pathological problem, one of al. This is a lot of work and responsi- Sefi Rivlin died last December after a Icht’s main tasks is to teach clients bility. Those who complete the year long struggle with throat cancer; in (TNS) how to breathe properly. have to pass a Health Ministry exam- the earlier stages, he had to use sign ination before getting their license.” language and erasable tablets to com- its fifth year). device, the electro-larynx or a hole larynx – can be caused not only by AS FOR what can help the voice be As Arab-Israeli communications municate. But many ordinary peo- Women constitute the vast major- made in the throat and the speak- viral, fungal or bacterial infection but healthy, one should rest is whenever specialists are too few in number, it ple suffer from throat problems, said ity of practitioners, as it is a “caring” er covering it with a hole to make also by acid reflux disease (in which possible, Icht advised. Inhalation of is fortunate that some attend aca- Icht. There are even politicians, such profession, said Icht, who worked for sound possible from the chest. Better acid from the stomach rises to the water vapor [hydration therapy] is demic institutions in Jordan and as Zionist Union chairman MK Isaac years as a clinician at Maccabi Health still, a hole can be punctured in the throat), excessive coughing and clear- beneficial, “which is probably why return here for work. A number of Herzog, who had to learn to improve Services, but some men entered it neck between the esophagus and tra- ing of the throat, thermal or chemical some people sing in the shower.” Jews who immigrated from the For- their voices so as not to strain them through voice therapy. “It is as much chea and a plastic device inserted to burns, laryngeal trauma and allergy Someone with laryngitis will not mer Soviet Union practice here, but and to earn more public credibility an art as a science,” she noted. make sound possible. to cats, dust or other things. When benefit from swallowing honey or they also need to know Hebrew, she with a lower pitch. The communica- There are famous women, such as “There is no such thing, at least at the two vocal cords are swollen, it is the combination of honey, raw eggs pointed out. tions specialist thinks Prime Minister former minister Limor Livnat and present, as a vocal-cord transplant, always difficult to speak. Polyps in and oil, as these don’t reach the “In Ariel, there are many immi- Benjamin Netanyahu’s natural low Israel Radio military correspondent as the structure is so complex, but the nasal passages can also cause reso- vocal cords or trachea. “If people grants from the FSU. Young children voice accords him, in the ears of the Carmela Menashe, who have low, I’m sure physicians who are ear-nose- nance problems for the voice. think this helps, it is just a placebo are usually taken care of by Rus- public, extra credibility, especially raspy voices, apparently from years and-throat specialists [ENTs] are Chronic laryngitis can also be effect,” she said. If hoarseness con- sian-speaking grandmothers for a few before elections. Icht noted that one of smoking, that sometimes makes working on it,” said Icht, who added caused by low-grade infections such tinues for two weeks or more, go to years. Only later are they exposed to scientific study found a connection them sound male. that speech is possible even with a as yeast infections of the vocal cords an ENT or general practitioner. Hebrew in mandatory kindergarten between the baritone voice of a com- “Tobacco causes harm to the vocal single vocal cord. in people using inhalers for asthma. Clinical communications special- and in school. As the parents and pany’s new chief executive officer cords, but one can’t know if some- Speaking is a physical action requir- Chemotherapy patients or others ists work hand in hand with ENTs grandparents may not speak Hebrew and rises in the firm’s stocks. body smokes from his voice. There ing the coordination of breathing by whose immune system is not work- when a patient comes in complain- very well, some children need treat- are other causes – such as polyps or activating several groups of muscles. ing well can get these infections too. ing about his or her voice. ment for speaking problems in two HORMONES AFFECT the voices of cysts on the vocal cords – that can Like in any other physical task, there To take care of one’s voice, one “I will not work with people who languages.” teenage boys bursting with testoster- cause changes as well,” said Icht. are efficient and inefficient ways of should drink a lot of water, avoid come to me unless they have first Cantors, opera singers and popular one (making the pitch deeper); centu- Among her favorite voices in the using your voice. Excessively loud, stress, screaming and whispering gone to a physician, preferably an singers may also initially have voice ries ago, young singers were castrated media are Israel Radio’s Alex Ansky, prolonged, and/or inefficient voice (the latter two are equally hard on ENT, for an examination and assess- problems, she said, but they learn so their sweet, pure voices could be Israel TV’s Haim Yavin and Ya’acov use can lead to vocal difficulties, just the vocal cords), and not constantly ment,” said Icht. “If not, I might mis- very early in the profession how to preserved. Menopausal women and Eilon and Channel 2 TV’s Ilana like improper lifting can lead to back clear one’s throat (because it slams takenly instruct a patient to exercise breathe properly. middle-aged men whose hormone Dayan. Famous singers with hoarse, injuries. Excessive tension in the the cords together). Never smoke, their vocal cords in a way that can “A voice is like a fingerprint – levels change, said Icht, notice their rough voices include Aviv Geffen neck and laryngeal muscles, along and avoid cola, caffeine and salty hurt their voices.” unique because of the structure, voices have altered as well. and Gidi Gov, she added. with a poor breathing technique foods. “Don’t drink very hot or cold “I wanted to become a clinical com- length, position and mass of the Most people take their voice for during speech, leads to vocal fatigue, water,” said Icht. munications specialist,” she recalled, vocal cords and the throat,” said granted – meaning that they don’t THROAT AND vocal cord cancer or increased vocal effort and hoarseness. In general, situations harmful to “because I thought it was a very inter- Icht. “Even in identical twins, voices take care of them – but disorders of the physical trauma to the throat can Voice misuse and overuse puts you at the voice are speaking in noisy situ- esting field with a lot of variety, and are different, because other factors vocal chords and other parts of the cause severe problems. One of the risk for developing benign vocal cord ation, using cellphones too much or I wanted to be in a caring profession can affect them.” She is in awe of throat are numerous and common. six beacon-lighters at the recent lesions or a vocal cord hemorrhage. holding a regular telephone with the to help both children and adults,” actors and comedians working in the Fortunately, for most patients, hoarse- Remembrance Day event could be Others with voice problems handset cradled to the shoulder, not adding, “I have lots of hats.” She stud- satirical Eretz Nehederet show who ness is only temporary, said Icht, who heard only by applying an elec- include sufferers of chronic neuro- using microphones when speaking ied but does not treat stammering or managed to adopt the voices of pol- was born in Tel Aviv, is married and tro-laryx device to his neck; his logical diseases such as Parkinson’s, in public and using a too high or too hearing problems, having decided to iticians and others. But if the voices has four children. She studied clinical voice suffered serious damage when amyotrophic lateral sclerosis, multi- low a pitch when speaking. specialize in speech and voice. were analyzed, she said, even though communications when Tel Aviv Uni- he was subjected to medical experi- ple sclerosis and Guillain-Barre syn- Serious injury to the vocal cords There are probably a couple of they might sound similar they are versity was the only university offer- ments as a young man in a concen- drome. When throat tissue has to be can be caused by strenuous voice use thousand Israeli professionals in her actually very different. ing it. Now there are more, at the Uni- tration camp by the infamous Nazi removed, conventional rather than during an episode of acute laryn- field; “We had a professional confer- “A computer program would easily versity of Haifa, Hadassah Academic physician Dr. Josef Mengele. laser surgery is used because the rays gitis. Since most acute laryngitis is ence not long ago that 900 attend- notice the difference. This and ven- College in Jerusalem, Kiryat Ono (for In such cases, when no voice can cause adhesions, said Icht. caused by a virus, antibiotics are not ed, and not all of them were there.” triloquism are talents that have to be the ultra-Orthodox) and Ariel (now in remains, victims can use a vibrating Laryngitis – inflammation of the effective. Bacterial infections of the There are “not yet” too many spe- learned,” she said. Universality shown in visual search by fish and humans urprisingly, fish and humans have an important work has been devoted to showing that these specialized indicative property of pop-out. This is the first evidence will substantially advance sea research in Israel,” said brain function in common. Ben-Gurion University brain cells are located in the cortex, which is the largest for pop-out search mode in a non-mammal and in par- university president Amos Shapira. Sof the Negev researchers have shown that the way and most recently evolved area in the mammalian brain. ticular, non-primate. They are cooperating in the framework of the Mediter- fish perform visual searches resembles the way humans At present, most research has focused on monkeys To understand the computation needed for this behav- ranean Sea Research Center of Israel (MERCI), which was do and provides an important insight in to the way the and humans to study visual search. But studying an ani- ior in the archer fish brain, the researchers recorded the established in 2012 and led by the University of Haifa. visual system works. mal that is an earlier evolutionary life form can offer a activity of the brain cells from the optic tectum, which MERCI is a consortium of all of Israel’s research universi- Visual search – the ability to find an object of interest new perspective on understanding the human brain by is the main visual area and one of the largest areas in ties, two government research institutes and an academic against a background – is a task humans encounter on a exploring the evolutionary and developmental perspec- the archer fish brain. This area also exists in primates. college. As part of this new cooperative venture, universi- daily basis. When looking for a car in the parking lot or tives of important behaviors. But due to the massive expansion of the cortex, this ty laboratories are to be built on IOLR grounds to create searching for a key among the many items on a desk, we area comprises a much smaller fraction of the primate’s synergy between the researchers and research equipment rely on visual features that can distinguish the object of NEW WORLDS brain. The new study shows that the activity patterns of at IOLR and the researchers and research equipment that interest from its surroundings. For animals, from detect- the archer fish brain cells are similar to those found in the university will install in the new deep-sea research ing food items to locating lurking predators, this ability • By JUDY SIEGEL-ITZKOVICH the mammalian visual cortex. This implies that the visu- labs, which are being funded by the Leona and Harry has to be accurate and fast to ensure survival. al cortex may not be the crucial component in generat- Helmsley Charitable Trust and other sources. In mammals, including humans, the need for fast In a recent study published in Nature Communications, ing the map of the unique locations in the visual field. The facility will include a lab for unmanned under- visual search led to the development of an important the BGU group followed this approach and focused on The scientists were able to show that the pop-out search water vehicles; an engineering and research pool; an brain capability that enables the scanning of the visual the archer fish, which lacks a fully developed cortex. mode exists in fish – and this could indicate that the par- optics laboratory to develop and test underwater vision scene in a parallel fashion – a concurrent processing of This species of fish exhibits complex visual hunting allel search mode may be a common, and perhaps even systems; an acoustics lab for sonar systems; an under- the entire visual scene as opposed to serial processing of behavior, as it shoots down prey found on foliage above universal, mechanism across vertebrates’ visual systems. water propulsion laboratory to develop underwater object by object. water level and is able to learn to distinguish between propulsion devices and systems; and a marine diving This ability, called “pop-out visual search,” makes it artificial targets presented on a computer monitor in an ‘HISTORIC’ COOPERATIVE AGREEMENT workshop. These will be the first labs of their type in this possible for the observer to rapidly detect the object experimental setting. The BGU researchers headed by A new partnership between the University of Haifa country, and underwater robots, unmanned subma- of interest. Pop-out search is believed to be based on a Prof. Ronen Segev of the life sciences department have and the Israel Oceanographic and Limnological rines, advanced underwater sensing devices and other population of brain cells that together generate a map levered this exceptional visual behavior to study visual Research Institute will advance deep sea research in systems will be purchased. that analyzes every location in the visual scene to deter- search in the lower vertebrate. Israel, according to the two bodies. As part of the MERCI director Prof. Zvi Ben Avraham noted that mine how different it is from its surroundings. This map The archer fish, as this study reveals, exhibits a pop- first cooperative venture of its kind between them, a the combination of a research university and oceano- simplifies the representation of the visual field and high- out visual search mode of moving targets; it was able to cornerstone-laying ceremony was held launching the graphic institute is the world’s leading model for marine lights the location which differs the most from its near- detect a target that moved faster than the other objects construction of the deep-sea research labs for the Harry research. “We will make the research infrastructure we by regions. During casual viewing, the observer’s atten- presented on the screen. Importantly, this detection was and Leona Helmsley Mediterranean Sea Research Cen- are building today available to the entire scientific com- tion is drawn toward this location. Over the years, much not affected by the number of objects in the display, an ter at the university. “This is a historic partnership that munity in Israel and neighboring countries,” he said.