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Vocal Abuse and the Results of Surgery, a True Story


patient undergoing vocal cord surgery

Some 20 years ago, I taught voice lessons to a gifted singer who studied with me from sixth grade through the summer before matriculating to music school. This young woman went to obtain her Bachelor of Music and her Master of Music degrees at two well known conservatories. Her mezzo soprano voice was magnificent and she dreamed of performing at the Metropolitan opera in New York.


In order to prepare for auditons and afford transportation to New York or other major cities one has to earn money so she began teaching middle school chorus and general music classes at our local high school. While using her voice all day laong she didn’t realize how much more pressure she would put on her vocal folds by additionally teaching private lessons evenings and on weekends. To add to her vocal stress, she sang in a rock band Friday and Saturday nights. Eventually, her voice had sustained too much abuse with little vocal rest, and she had damaged her vocal cords creating large nodules ( bilateral, benign masses that form in the midpoint on the vocal folds.) This young woman did not respond well to voice therapy as her nodules were too large and she couldn’t speak normally or sing at all so she went for vocal fold ( vocal cord) surgery at a renowned hospital in Boston for this type of surgery. Complications from the surgery forced this young woman to end her vocal career. She returned to school for a doctorate in school administration and today is a middle school principal in Rhode Island and can no longer use her beautiful mezzo soprano voice!


 Phonotrauma and Dysphonia

What happened to this young woman is called phonotrauma. The word phono come from the Greek root for sound or voice. And of course, we all know what trauma means. This type of serious damage usually begins with Dysphonia. Dysphonia means abnormal sound of the voice such as hoarseness, raspiness, sounding strained, weak, breathy , or gravely. Of course, everyone gets hoarse when they have laryngitis or pharyngitis because of the vocal fold swelling which is only temporary. Dysphonia is a chronic vocal issue that must be treated to prevent serious voice damage such as vocal edema ulcers, nodules or polyps.


How the vocal folds work

The voice has many components of use. We use the vocal folds, the lungs and the diaphragm. Once air is pushed out of the lungs by the diaphragm the air vibrates the vocal folds against each other. The vocal folds are shaped like a V. To sing higher, the vocal folds increase their length and tension, thus vibrating faster. Lower pitches are created by shortening the vocal folds and decreasing the tension. One doesn’t normally realize how fast the vocal folds can move; when a band or orchestra tunes their instruments, they tune to the pitch of A 440. That means the strings are vibrating 440 times a second. That doesn’t sound like much until you compare it to hummingbirds who flap their wings between 50 and 200 times per second. Sopranos can sing the note C6 which has a frequency of 1046.502 Hz. That means that we Sopranos vocal fouls are vibrating 1046 times a second! That is two octaves above middle C. Now, if you are singing day after day, slamming those vocal folds together at between 200 Hz and 1046.502 Hz that means that your vocal cords or folds are slamming together millions of times per day. And one wonders why singers suffer from vocal abuse and trauma!


How to prevent vocal abuse

Preventing vocal abuse is vital to a healthy voice singers need to be well hydrated, eat healthy, and get a good amount of sleep. Besides that singer should consider the number of hours they sing every day and try to modify your practice time and strategies and make changes to your speech voice to help prevent more abuse. For these changes you probably will need help from a qualified vocologist such as myself. Vocologists will address changes to address your optimal speech pitch, timbre (the quality of your sound), and resonance (the amplification of your sound.)

By preventing phonotrauma or vocal abuse you will efficiently use your voice performing, speaking, or teaching. If you need help with your voice please contact me or another professionally trained vocologist


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