Skip to main content

Featured post

"Exploring Post-Grommet Complications: What You Need to Know"

 Navigating Postoperative Complications of Grommet Insertion: A Comprehensive Guide Grommet insertion, a standard surgical procedure to alleviate symptoms of middle ear disorders, can sometimes be accompanied by postoperative complications. Among these, one of the most frequently encountered issues is otorrhea or ear discharge. Understanding the nature of postoperative complications and their management is crucial for patients and healthcare providers. Types of Otorrhea Postoperative otorrhea manifests in various forms, including early, delayed, chronic, and recurrent. Early otorrhea occurs within four weeks of surgery, while delayed otorrhea surfaces four or more weeks post-surgery. Chronic otorrhea persists for three months or longer, while recurrent otorrhea involves three or more discrete episodes. Studies suggest that ear discharge after grommet insertion affects a significant proportion of patients, with rates varying from 16% to as high as 80%. Prophylactic Measures and Treatmen



LAX VOX is a vocal therapy technique that can help improve voice quality, relaxation, and overall vocal health. It involves using a unique tube to create bubbling sounds while phonating. 

Here are the steps for practising LAX VOX:

Relax and Focus on Posture and Breathing:

    • Maintain a good posture with a long spine.
    • Relax your face, neck, upper back, and chest muscles, allowing them to release toward gravity.

Preparing for Bubbling with Phonation:

    • Place a silicone tube (about 35 cm long and 9-12 mm in diameter) between or in front of your incisor teeth and above your tongue.
    • Keep your tongue relaxed (imagine it as a piece of steak) and slightly touch the tube.
    • Hold the water-filled bottle near your body to avoid using shoulder muscles.
    • Inhale through your nose as if you’re yawning with your mouth closed.
    • Prepare for phonation during exhalation, focusing on abdominal and lower back muscles.

Finding the Target Voice:

    • Create bubbling sounds with your voice: //hhhooooo// (both short and long).
    • Repeat with variations: /hhoo hoo hooo/.
    • Increase your awareness of the process within your body.

Advanced Techniques:

    • Try pitch gliding (melodies on //hhoooo//).
    • Glide pitches up and down.
    • Experiment with different water depths in the tube to observe changes.
    • Practice without the tube: Open your lips and produce /hhoooo/ and /hhmmm/.

Incorporate LAX VOX into Daily Life:

    • Use correct syllables, words, and sentences (e.g., greetings, good morning).
    • Engage in conversational speech (remember to inhale nasally before speaking).
    • Read books or newspapers aloud in various ways.

Remember that LAX VOX can be a valuable addition to voice therapy, especially for individuals seeking improved vocal function and relaxation.

How often should I practice LAX VOX exercises?

LAX VOX exercises can be beneficial for your vocal health and relaxation. The frequency of practice depends on your individual needs and goals. Here are some general guidelines:

Consistency: Regular practice is essential. Aim for at least 5-10 minutes of LAX VOX exercises daily.

Listen to Your Body:

    • Pay attention to how your voice feels during and after the exercises.
    • If you experience any discomfort or strain, reduce the duration or intensity.

Integration into Daily Routine:

  • Incorporate LAX VOX into your daily activities:
      • Practice while showering (the steam can enhance the effect).
      • Use it during your commute or while doing household chores.
    • Include it in your warm-up routine before speaking or singing.

Quality Over Quantity:

    • Focus on proper technique rather than just the duration.
    • Ensure relaxed breathing, gentle bubbling, and a comfortable posture.

Consult a Professional:

    • Consult a speech therapist or voice coach if you have specific voice-related concerns or are recovering from vocal strain.
    • They can tailor recommendations based on your unique needs.

Remember that individual responses may vary, so adjust the frequency based on your comfort level and progress. Happy vocal bubbling! πŸŽΆπŸ—£️


Can I combine LAX VOX with other vocal warm-up techniques?

Combining LAX VOX with other vocal warm-up techniques can enhance your overall vocal preparation. 

Here are some ways to integrate it into a comprehensive warm-up routine:

LAX VOX + Lip Trills (Brrrr):

    • Start with LAX VOX to relax your vocal folds and improve resonance.
    • Then transition to lip trills (brrrr sound) by blowing air through your closed lips.
    • Lip trills engage the lips, tongue, and airflow, promoting flexibility and warming up the vocal tract.

LAX VOX + Humming:

    • After LAX VOX, switch to humming.
    • Humming helps activate the vocal folds, improve breath control, and warm up the resonating spaces in your head.

LAX VOX + Tongue Exercises:

    • Perform tongue exercises (e.g., tongue stretches, side-to-side movements).
    • These enhance tongue flexibility, crucial for clear articulation during speech or singing.

LAX VOX + Yawn-Sigh:

    • Yawn deeply to open up the throat and stretch the vocal folds.
    • Follow the yawn with a gentle sigh (sustain an “ah” sound).
    • This combination helps release tension and encourages relaxed phonation.

LAX VOX + Vocal Range Exploration:

    • Use LAX VOX to transition smoothly between different pitch ranges.
    • Glide from low to high notes and vice versa.
    • Explore your full vocal range while maintaining a relaxed throat.

LAX VOX + Resonance Exercises:

  • Combine LAX VOX with resonance-focused exercises:
    • Nasal Resonance: Produce LAX VOX sounds while focusing on nasal resonance.
  •             Oral Resonance: Shift the resonance to the mouth and oral cavity.

Remember that warming up your voice gradually and gently is essential. Listen to your body, stay hydrated, and adjust the warm-up routine based on your needs. Happy vocalizing! πŸŽ΅πŸ—£️

Can you explain more about resonance exercises for the voice?

Voice resonance exercises are essential for improving your voice's quality, projection, and overall effectiveness. 

Let’s explore some techniques:


    • Yawning helps open up the back of the throat, adding warmth and loudness to your voice.          Try this:
      • Breathe deeply as if about to yawn.
      • Sing with that same feeling, lifting the soft palate and imagining an egg stuck in the back of your throat.
    • Start with lower notes and gradually move to higher ones while maintaining the open feeling.


    • Humming accesses the natural brightness of your voice, contributing to nasopharynx resonance.
    • Focus on singing in the “mask” of your voice (the bridge of your nose).
    • Hum on a pitch that feels comfortable for you, noticing the buzzing feeling on the bridge of your nose.

Sing the Vowel ‘E’:

    • Singing the vowel ‘E’ (or IPA ‘i’ as in “feed”) engages nasal resonance.
    • Listen for the ringing sound of efficient resonance as you sing it on a five-note scale going up and down.
    • Allow yourself to explore different levels of nasal resonance.

Use Plosive Consonants ‘B’ and ‘P’:

    • Plosives (sounds produced by building air pressure behind the lips) can help focus attention forward.
    • Sing notes using ‘p’ or ‘b’ followed by a vowel (e.g., bi, bΙ‘, pi, pΙ‘).
    • This draws emphasis away from throaty singing and encourages forward resonance.

Explore Vibrations in Facial Bones:

    • Humming helps you feel vibrations in your facial bones.
    • Try sirens (sliding your voice up and down through your range) to explore different types of resonance.

Remember to listen to your body, practice consistently, and seek guidance from a voice coach or speech therapist. 

Happy vocal resonance exploration! πŸŽ΅πŸ—£️

What are some common voice problems related to resonance?

Resonance disorders are distinct from voice disorders, although they can impact speech quality. 

Let’s explore common issues related to resonance:


    • Description: Abnormal sound energy in the nasal cavity during production of voiced, oral sounds.
    • Cause: Often related to structural factors (e.g., cleft palate) or functional issues.
  • Symptoms:
      • Speech sounds “nasal” or “muffled.”
      • Too much nasal resonance.
    • It may occur in conditions like cleft lip and palate.


    • Description: Reduced nasal resonance or energy associated with nasal sounds.
    • Cause: Typically due to blockage or obstruction in the nasopharynx or nasal cavity eg nasal septum deviation,nasal polyps
  • Symptoms:
      • Speech lacks expected nasal quality.
      • Too little nasal resonance.
    • Can be related to neurological conditions or structural issues.

Other Resonance Disorders:

    • Mixed Resonance: Combination of hypernasality and hyponasality.
    • Articulation Errors Misinterpreted as Resonance Disorders: Mislearning may lead to misinterpretation.
    • Structural Causes: Cleft palate, submucous cleft palate, enlarged adenoids.
    • Functional Causes: Neurogenic factors, mislearning, or other issues.

Remember that speech-language pathologists (SLPs) use differential diagnosis to determine the underlying cause of resonance issues. Treatment plans vary based on the specific aetiology. If you experience any voice-related concerns, consult a professional for personalized evaluation and guidance.

Mr Gaurav Kumar

Consultant Ear Nose Throat Surgeon

Book Appointment

Call for appointment


Follow on Instagram

Popular Post

Retracted Ear Drum

  What Is a Retracted Eardrum? A retracted eardrum, also known as tympanic membrane retraction, is a condition where the eardrum (tympanic membrane) is pulled inward or drawn backwards from its normal position. The eardrum is a thin, delicate membrane that separates the outer ear from the middle ear. It plays a crucial role in transmitting sound vibrations from the outer ear to the middle ear, where the auditory ossicles (small bones) are located.   Under normal circumstances, the eardrum is slightly concave and positioned at an angle that allows it to respond to changes in air pressure. The Eustachian tube, a tube connecting the middle ear to the back of the throat, helps equalize pressure between the middle ear and the outside environment.   However, in cases of a retracted eardrum, the Eustachian tube might not function correctly or become blocked, leading to an imbalance in pressure. When negative pressure builds up in the middle ear, it causes the eardrum to retract inwa

"Naseptin: Powerful Defence Against Nasal Bacteria!"

  Everything You Need to Know About Using Naseptin Nasal Cream   If you've been dealing with nasal issues, you may have come across Naseptin nasal cream as a potential solution. Whether you suffer from recurrent nasal infections (vestibulitis), nose bleeds or simply need some relief from nasal dryness, Naseptin can be a valuable aid. In this blog, we'll cover everything you need to know about using Naseptin nasal cream to ensure you get the best results from this trusted product.   Unlocking the Power of Naseptin Nasal Cream: A Guide to Its Versatile Uses   Naseptin nasal cream, a powerful ally in nasal health, holds the key to treating infections caused by staphylococcal bacteria. This versatile cream offers much more than meets the eye, and we're here to shed light on its incredible benefits! 🌟 πŸ‘ƒ Kicking Nose Infections to the Curb: Say goodbye to those troublesome nose infections! Naseptin comes to the rescue, targeting staphylococcal bacteria and effect

Boil in the Ear canal can be very painful...

How do I know I have boil in the ear canal? The ear canal is lined by skin up to the eardrum. Skin in the outer third of the ear canal has hair follicles. Hair follicles can get infected with bacteria and can form boil or furunculosis. It is challenging to look in our own ear canal. You can only feel a bump in the ear canal entrance which is tender to touch. Why is so painful when we have boil in the ear? Ear canal skin is very tightly attached to underlying cartilage. So any swelling in the skin stretches it and makes it very sore to touch. How do we get boil in the ear canal?  Most common causes of boil in the canal is dryness of the skin and trauma. Dry skin leads to cracks and these cracks can get infected. People who use dry earbuds, fingers, towel edges or pens and traumatise ear canal skin, which can get infected with bacteria. How do I release the temptation of using earbuds? Some people can get very dry skin due to sensitivity to soup, shampoo or dy

Tonsil Stones or Tonsilloliths

Where do Tonsil Stones come from? Tonsil stones or tonsillolith are formed in the tiny crevices on the tonsil surface. Tonsils are present at the back of the throat. Two large tonsils on each side can catch food particles when we eat. This food debris can accumulate bacteria and give a bad smell. This mixture of bacteria and food debris can become solid to form tonsil stones. Can Tonsil Stones go away on their own? Tonsil stones form due to food particle and bacteria. You can prevent stone formation by regularly rinsing mouth after every meal, good oral hygiene and dental care. Gargling with salt water and gentle use of bud to deliver the stones can help in some cases. Soft water floss can help keep tonsil surface clean. If you have, post nasal drip due to sinusitis, seeking treatment advice from ENT surgeon can help. You should not use sharp objects to clean tonsil stones or make tonsil surface bleed. What symptoms do tonsil stones cause? Tonsil ston

Vertigo and Dizziness..

Are labyrinthitis and vertigo the same? The ear has three main parts: the outer ear, the middle ear, with small bones of hearing, and the inner ear, consisting of the labyrinth. The labyrinth has two parts as well, hearing processing part and balance part. When you get an infection in the inner ear, it is often called labyrinthitis. Common symptoms for Labyrinthitis are hearing loss or vertigo, however, there are also other causes for vertigo as well. What is the most important thing to remember when you have labyrinthitis symptoms? In the first few hours of symptoms, it is difficult to know between stroke and labyrinthitis. If you have vertigo and notice one side of your face becoming droopy, your arms or leg become weak and speech becomes slurred, you should call for urgent help. What is the difference between labyrinthitis and vestibular neuritis? If you only have vertigo symptoms, then it is due to vestibular neuritis. Vestibular neuritis oc

Cholesteatoma Ear Surgery

What is a Cholesteatoma? The ear has three parts outer ear (ear lobe and ear canal), the middle ear ( eardrum and bones of hearing) and inner ear. Cholesteatoma is skin from ear canal migrating into the middle ear. Like the skin on head keeps shedding and can cause dandruff. Similarly, skin in the middle ear can cause cholesteatoma, which can form a gradually expanding sac and can damage structures in the middle ear to give deafness, inner ear to give permanent deafness, nerve to the face to give a facial weakness or rarely give infection of the lining of the brain to cause meningitis Is cholesteatoma surgery or mastoidectomy done under general anaesthetic? Cholesteatoma is a surgical problem. Unfortunately, no medications work on it. Cholesteatoma surgery is called mastoidectomy, i.e. clearing cholesteatoma infection from the mastoid bone (the hard bone behind your ear). The procedure is done under general, i.e. you will be sleeping while the procedure is don

Eustachian Tube Dysfunction

Are you unable to pop your ears or feeling pressure in your ears? Eustachian tube dysfunction is a very common problem after flu or cold or even after long haul flight when you feel hearing is muffled, feel pressure around the ears and sometimes you feel as if you are underwater. Good news is most of the time it is temporary.  If you try decongestants, antihistamine ( hay fever tablets ) and Valsalva (ie try and pop your ears) things should improve after a few days to a week. Why do we have symptoms of Eustachian tube dysfunction? The eustachian tube is present at the back of our nose and connects the nose to the middle ear. It is there to maintain equal pressure on both sides of the eardrum. The eustachian tube also helps in clearing normal mucus from the middle ear.  Hence opening and closing of this ventilation tube are very important for hearing. Normally every time we yawn and chew this tube opens and closes without us noticing it. So, if this opening of ventilation tube

Pharyngeal Pouch

  What is a pharyngeal pouch? When we eat food, it passes through the mouth, into the pharynx (the space behind our oral cavity) and then into the oesophagus (food pipe). In some patients, the lower part of the pharynx can bulge or form a pocket that can collect food and become large enough to compress on the food pipe. This 'hernia' is commonly known as the   pharyngeal pouch   or   Zenker's diverticulum. Is a pharyngeal pouch serious? A pharyngeal pouch is an uncommon condition presenting predominantly in males than females, usually showing after the age of seventy or later. If the pharyngeal pouch is left untreated, it can become more prominent, and the regurgitation of food into the windpipe can lead to chest infections. In sporadic cases, cancer can form in the pouch.  What are the symptoms of a pharyngeal pouch? Symptoms of pharyngeal pouch depend on the size. A small pharyngeal pouch mainly presents as a feeling of something stuck in the throat or choking on food, an

Superior Canal Dehiscence Syndrome (SCDS)

πŸ” Unlocking the Mystery of Superior Canal Dehiscence Syndrome (SCDS) πŸŒ€✨ It's a rare condition that affects the inner ear, and here's the lowdown:   Cause: SCDS occurs when one of the bony canals in the inner ear, particularly the uppermost semicircular canal, doesn't close or thicken properly during fetal development.   Symptoms:   Hearing Loss: It's a common symptom of SCDS. Sound Distortion: Ever feel like sounds aren't quite right? That could be SCDS at play. Balance Problems: SCDS can throw your balance off, making you feel unsteady. Autophony: Imagine hearing your own heartbeat or breathing louder than usual. That's autophony. World Tumbling Sensation: Loud noises or pressure changes might make you feel like the world is spinning. Diagnosis and Treatment:   CT Scans: A specialist might use these to spot SCDS, but other tests are crucial too. Hearing Tests: Essential for accurate diagnosis. Treatment: Surgery may be necessary for severe symptoms.

Bleeding From Ears

  Why is my Q-tip bleeding from my ear?   It can be alarming if you've ever noticed blood on your Q-tip after cleaning your ears. Here are a few reasons why this might happen:   🚫 Avoid Inserting Q-tips Too Deep: The most common cause of bleeding is inserting Q-tips too far into the ear canal. This can lead to irritation, scratches, or even damage to the delicate ear tissues.   🩹 Ear Injuries or Scratches: Vigorous or improper cleaning can cause small injuries or scratches inside the ear canal. These injuries may result in bleeding when you use a Q-tip.   🩸 Ear Infections: Infections like otitis externa or swimmer's ear can make the ear canal more sensitive. Cleaning during an active infection can cause bleeding.   πŸ”„ Wax Impaction: Excessive earwax can cause blockages, leading to a feeling of fullness and impaired hearing. Attempting to clean it out with a Q-tip may cause bleeding, especially if the wax is impacted.   πŸ‘‚ What to Do:   Stop Q-tip Use: Refr