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Care of the Professional Voice

It is a good idea for all performers to have a complete voice evaluation. This includes a complete medical history, endoscopic evaluation of the vocal folds under stroboscopic light, and assessment of the speaking and/or singing voice when the voice is healthy. The laryngeal exam is captured either on video or digitally, and provides a legal documentation of vocal health. This information becomes particularly useful if an injury is ever sustained during a professional contract (worker's compensation). It is also wise to know the health of one's vocal folds (including voice use/technique) if using the voice professionally or avocationally. If you are experiencing voice difficulties, this evaluation is imperative to your vocal career.


Medical History

Any time you see a laryngologist or voice specialist (an otolaryngologist or ENT who has been fellowship-trained in voice care), they will ask about your medical health, daily habits, medications you take (including herbal supplements and over-the-counter), allergies, voice use, eating habits, sleep, upcoming performances, voice concerns, vocal hygiene (water, caffeine, alcohol, tobacco use), phonotraumatic behaviors (throat clearing, coughing, yelling, prolonged loud talking, etc), voice training, stress issues, etc. It is so important that they take a good history, as so many systems in the body can have a negative effect on the voice, and they need to make sure nothing subtle is affecting the voice. A good example of this is gastroesophageal reflux. Many performers have voice difficulties from stomach acid coming up the esophagus and burning the tissue in the back of the throat and larynx.


What is Videostroboscopy?

Videostroboscopy is a method of examining the vocal folds under two types of light; halogen (a bright, static light) and xenon (strobe light). The halogen light is most useful to see the true color of the vocal fold and surrounding tissues. The strobe light allows an averaging of the vocal fold cycles so the naked eye can visualize vibration and tissue health. A comprehensive examination includes two different endoscopes, a flexible fiberoptic laryngoscope and a rigid telescopic laryngoscope. The flexible scope is inserted into the nose and allows visualization of the vocal folds from above without any restriction of voice use or articulation. This scope gives us information about vocal fold function in a dynamic sense; we can watch you whistle, speak and sing. The rigid scope is placed in your mouth (about to the back of your tongue) and has a light source and considerable magnification to allow greater detail of the vocal fold tissue health.

 

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