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Special Care for Voice Users

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Dr. Salvado was very kind and professional. I highly recommend her for other singers in search of an ENT. She was so insightful and helpful regarding my concerns! It was obvious that she truly cares about the well being of her patients.

-Catherine S. via

Causes and Effects of Voice Problems

For clinicians and other professionals who help professional voice users-particularly singers-care for their voices, an understanding is needed of the delicate balance between the external and internal factors that allow the voice to function well is essential.

Acid reflux disease can severely impact the vocal quality, range, and endurance of a singer.   Often symptoms, except for the vocal dysfunction, are either slight or nonexistent.  It can be identified with fair ease and treated by a Laryngologist (ENT specializing in voice disorders).

Another common problem among singers is vocal overuse. Singing with bad technique, singing inappropriate material for one’s voice type, and simply overextending the voice can lead to serious physical problems.

The effects of voice overuse and voice abuse, such as excess muscle tension in the throat, vocal fold edema, and nodules, are common in vocalists, especially in those who are inadequately trained or ask their voice to perform tasks for which they were not adequately prepared.

Along with the external factors described above (such as voice abuse and overuse and acid reflux), other external factors that clinicians need to pay attention to are environmental stressors that may impair prime motor control necessary for good singing, such as exposure to smoke, dusty and dry auditoriums, and stage fog, as well as daily demands on the body. Performance schedules and commitments commonly lead to sleep deprivation, often substandard nutrition, and voice overuse,


Who Is an Occupational or Professional Voice User?

An occupational or professional voice user is anyone whose voice is essential to their job. We are all accustomed to thinking of singers, actors, actresses, and broadcast personalities as professional voice users. Indeed, special or unique qualities of the voice are often the essential feature of their careers. But what about other occupational voice users?

Teachers, clergy, salespeople, courtroom attorneys, telemarketers, and receptionists are also people for whom spoken communication is an essential part of what they do, and there are countless other professions that rely heavily on the voice. In spite of this era of email and Internet communications, we can’t really imagine an effective classroom, pulpit, or courtroom without voice. Can you imagine the difficulties of a physician conveying sensitive or complex information to a patient or colleague, or a business executive conducting a meeting without voice? Once you pause to consider a world without voice communications, you realize that voice is crucial to many professions.

Preventing the Failed Note: Voice Maintenance

The best preventive care for voice users is training, along with voice lessons, proper aerobic exercise, and exercise of the abdominal and back muscles for voice support.  Training includes the proper care of the body by giving it sufficient water, nutrition, and sleep. Singers and actors must get a baseline voice/laryngological evaluation with videolaryngostroboscopy when they are healthy.  Abnormalities are often present that have been asymptomatic for years and need not be addressed medically.  However, with this baseline view, the true culprit may be more easily identified when a problem or change occurs. Singers and actors should know their own personal anatomy and physiology.  A recording of the laryngeal exam, easily performed by a Laryngologist, should be available should any problems arise.

Take care of your body, and get to know your body.  Always listen to your body, and listen to your voice.


When to See a Doctor

Good preventive measures that rely on self-care can reduce injuries, but certain signs and symptoms may indicate the need to see a doctor. The most predominant symptom that warrants a call to the doctor is persistent hoarseness. Hoarseness and fatigue that usually follow a performance can be self-treated with rest and good hydration, but if they last for any length of time they should be checked out. Seek medical evaluation by a voice professional if hoarseness persists for longer than 3 days.