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Voice Changes

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Dr. Amanda Salvado  is board certified by the American Board of Otolaryngology as an Ear Nose Throat Specialist, and has also completed a Fellowship in Laryngology at UCLA, where she is currently an Assistant Clinical Professor.   In March 2014, Dr. Salvado was asked to be a guest speaker at The Vocal Masterclass designed for professional voice users, held at Pepperdine University.  This 2 day seminar, whose sponsors included SAG-AFTRA and the West Coast Chapter of The Recording Academy, was attended by actors, singers, students of voice, voice therapists, voice coaches, and laryngologists.   Dr. Salvado spoke on the topic of the dangers of an incorrect diagnosis for professional voice users.

What is Voice?

“Voice” is the sound made by vibration of the vocal cords caused by air passing out through the larynx bringing the cords closer together. Your voice is an extremely valuable resource and is the most commonly used form of communication. Our voice is invaluable for both our social interaction as well as for most people’s occupation​s​. Proper care and use of your voice ​will provide a healthy voice for your entire lifetime​!

Why Is the Voice Important?

Voice is something that is often taken for granted. Many people, including many occupational voice users, don’t pay attention to their voice until they develop a significant problem with it. These voice problems then have an adverse effect upon their ability to do their job. Consider, for example, a school teacher. Arguably, this is the most vocally demanding profession. Teachers are using their voices constantly, often in noisy rooms with poor acoustics. One recent 2004 research article found that 11 percent of teachers participating in the study reported a current voice problem.

​Only​ 6.2 percent of the participants were not teachers​.

A similar ratio was evident when participants were asked about ever having a voice disorder in their lifetime. Teachers reported an incidence of 57.7 percent, while non-teachers reported a 28.8 percent incident rate.  It is clear from the medical literature that high voice demands in the workplace have health consequences for the individual​.

How do I know I have a Voice Problem?

Voice problems are detected by a change in the sound or feel of the​ voice, often described as hoarseness, roughness, or a raspy quality. People with voice problems often complain about or notice changes in pitch, loss of voice, loss of endurance, and sometimes a sharp or dull pain associated with voice use. ​There may also be a change in singing ability most often and notable in the upper singing range or register​.

What is the most common cause of a change in voice?

Voice changes sometimes follow an upper respiratory infection​, and these problems may​ last up to two weeks. Typically the upper respiratory infection (common  cold or flu)​ causes swelling of the vocal cords and changes their vibration​,​ resulting in an abnormal voice. Reduced voice use (voice rest) typically improves the voice after an upper respiratory infection or bronchitis. If ​the ​voice does not return to its normal characteristics and capabilities within two weeks​ after a cold, a medical evaluation by an ear, nose, and throat specialist who is specially trained in Laryngology ​

What Can Be done About These Issues?

As with many ailments, awareness is key. First, people must be made aware of voice-related occupations. A person may not know that they are in such a profession until a voice problem brings the issue to the forefront.Do not accept hoarseness as part of the job. Be aware that there are steps you can take to help prevent voice problems. (For more information, see Maintaining a Healthy Voice Fact Sheet.)

Finally, know that proper evaluation and treatment can take care of most voice-related problems and can set you up to succeed ​in even the most demanding voice-related occupation. If you notice a problem with your voice that lasts more than two weeks, schedule an appointment with one of our Laryngologists or Otolaryngologists for an evaluation and treatment recommendations. 

The Voice and Aging

As we age, our voices change. The most dramatic voice changes are those during childhood and adolescence. The larynx (or voice box) and vocal cord tissues do not fully mature until late teenage years. Hormone-related changes during adolescence are particularly noticeable among boys. The rapid changes in the size and character of the larynx causes characteristic pitch breaks and voice “cracking” during puberty as we learn to use our rapidly changing voice instruments.

After several decades of relatively stable voice, noticeable change can ​again ​occur in the later years of life. As our bodies age, we lose muscle mass, our mucous membranes thin and become more dry, and we lose some of the fine coordination that we had in younger years. It is no surprise that these changes occur in the larynx as well, and this leads to changes in our voice. Your doctor may call these changes vocal cord atrophy or bowing, presbyphonia, or presbylaryngis.

HERE is a link to an article discussing the aging voice.



Changes in the Voice as We Age

Below is a list of commonly reported voice changes as we age:

  • Reduced volume and projection of the voice (or “thin” voice)
  • Reduced vocal endurance
  • Difficulty being heard in noisy situations
  • Tremor or shakiness in the voice
  • Higher pitch voice in men
  • Lower pitch voice in women

These symptoms are amplified by the reduced hearing ability that commonly occurs in our peers as we age.

NOTE: Much of the time, hoarseness and vocal difficulties are not simply age​-​related change​s​. Any change that you notice in your voice should be a warning sign that ​there may be a problem​. Please call to schedule an evaluation by one of our Laryngologists or Otolaryngologists. Almost all voice problems are treatable.

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What Can Be Done About Age-Related Voice Change?

If you are bothered by your voice, take action today.  First, visit your ENT physician for an evaluation.  With simple techniques that are not painful,  she can evaluate your vocal fold anatomy and make most diagnoses and treatment plans at your first visit.

​A vocal fitness program (i.e. voice therapy) may be indicated​, as healthy voice use is key to voice preservation. Under the guidance of a speech-language pathologist, a vocal fitness program can make a big difference. ​ Laryngologists (ENT’s specializing in the voice) work closely with voice therapists to create and deliver the best regimen for you.  ​

​​S​ome people are candidates for medical or surgical treatment to improve the steadiness, strength, or endurance of the voice. Of note, many procedures can be done in-office without need for general​ anesthesia.  ​