Professional Voice Approach to Voice Problems

Professional voice users' problems are first approached by taking a detailed health and voice usage history. Often the voice artist can easily identify the problem, but in some cases the complaints and their causes may not be very clear. Sometimes, performance anxiety combined with nervousness about the illness can make the vocal artist hesitant to share their problems openly. A close relationship between the artist and the voice doctor and voice coach, who know the artist well, often plays an important role in overcoming this problem.

One of our biggest helpers in helping professional voice users overcome acute or chronic voice problems is to take an appropriate history. The voice doctor who has an ongoing relationship with the professional voice user is of course more fortunate. Details about the voice problem, the person's voice training history, frequency and quality of voice use, voice warm-up exercises, habits, a detailed review of personal and family health history, and information about the voice risks they are exposed to are thoroughly examined.

If the voice problem has occurred recently, a recent change in a voice trainer or a new song added to the repertoire could be the cause. Other symptoms accompanying the voice problem should also be carefully evaluated. For example, in a patient with acute laryngitis, increased nasal secretions, headache, muscle pain, and fatigue should be considered. A voice artist visiting the voice doctor for a voice problem might find questions about pharyngitis, nausea, vomiting, or diarrhea irrelevant. However, these questions make sense when considering the importance of the posture, maintained by the musculoskeletal system, for effective voice production.

Particular attention should be given to laryngopharyngeal reflux, which refers to the direct contact of stomach contents with the voice production mechanisms. While it is commonly believed that reflux only involves bitter water coming up into the mouth, silent reflux actually affects many individuals. This condition is especially common in those who frequently consume spicy foods and use tomato-based sauces. Diagnosing reflux can be done without causing any discomfort to the patient using routine voice evaluation tools (videolaryngoscopy). The impact of reflux on voice quality has also been objectively demonstrated through our clinical studies (H Oguz, et al. Journal of Voice). While reflux can have many symptoms, the specific symptoms seen in voice professionals are hoarseness and prolonged voice warm-up time, especially in the mornings.

Many endocrine problems, particularly menstrual period anomalies and pregnancy, can affect a person's voice performance. The effects of oral contraceptives (birth control pills) on the voice have been known for many years. It has been reported that preparations high in progesterone can cause a masculine deepening of the female voice. Although modern oral contraceptives have a balanced estrogen and progesterone ratio, voice problems are still reported in about 5% of users. Therefore, this situation should not be overlooked in female artists.

Similarly, although almost any medication can affect the voice, certain groups of medications have a much more significant effect on the voice. For example, some types of medication used to treat hypertension can thicken or dry out secretions or cause a chronic dry cough. Repeated coughing or poor secretions can cause trauma to the vocal cords, which can lead to treatment-resistant swelling of the vocal cords.

Wishing you a healthy voice.