Answers to Frequently Asked Questions

1. When I get a bad cold, my voice is often the final symptom to recover. What is laryngitis and why does it often occur at the end of a virus?
Laryngitis is the inflammation of the vocal fold tissues. We often get laryngitis at the end of a virus because of irritation of the vocal fold tissue from flu or viral associated coughing and sneezing. Speaking with irritated or swollen vocal folds may prolong the inflammation and feel like the voice is the last to recover after all other cold symptoms are gone.

2. Can exercises increase my singing range? Is it easier to add high notes or low?
Yes, singing exercises can help increase the singing voice range. You can expand both your upper and lower range through developing your technique and vocal flexibility with a trained voice teacher supervising your singing and directing you with specific range-expanding exercises. Your range is somewhat limited to your own laryngeal physiology. You should never try to push your voice to sing higher or lower that what is comfortable.

3. What is the most important preventative measure for having a healthy voice for one's entire life?
Taking care of your voice is the most important preventative measure for having a healthy voice for a lifetime. This involves properly hydrating your body with at least 64 ounces of water a day, using adequate support from your abdominal muscles when you speak or sing, and avoiding vocally abusive behaviors such as throat clearing, coughing, yelling, screaming or prolonged loud talking. You should warm up your voice before you use it, just as you stretch before exercising. You should also speak at a pitch that fits your voice. Listen to where you say "mm-hmm" naturally. If your speaking voice is markedly higher or lower than that, you are not at an optimal pitch and could be straining your voice to maintain that pitch.

Eating a healthy diet, exercising your body and your voice regularly, and getting enough sleep are also important factors in vocal health. Managing your stress level can also help in maintaining vocal health. Be careful of taking over-the-counter medications such as aspirin products (Aleve, Motrin, Advil, Aspirin, and Excedrin) as they are blood thinners and can put you at greater risk for sustaining a vocal fold hemorrhage (bleed). Other medications such as antihistamines can be very drying to the voice. Caffeine and alcohol are diuretics and actually remove fluid from your tissues (including your vocal fold tissue!) Minimize your intake of these beverages, and drink an equal sized glass of water for every caffeinated or alcoholic beverage you drink to counteract the drying effects. (This is in addition to the 64 ounces of water you should already be drinking).

4. Talking and singing sound different from one another, but anatomically, what is really the difference?

Your speaking and singing voice are created from the same exact anatomical structures. The respiratory system (lungs diaphragm and abdominal muscles), laryngeal mechanism (vocal folds, laryngeal cartilages, muscles and nerves) and the supraglottic tract (the spaces above the vocal folds, including the back of your throat, mouth, nasal passages and sinus cavities) all work to produce the beautiful sounds you make. Speaking doesn't require as much airflow (breath) as singing, but you still need to support the speaking voice. Singing involves the utilization of more of the supraglottic spaces for resonance, and the vowels are prolonged. Otherwise…they are almost identical. Just a note…your speaking and singing voice should sound almost identical in your speaking voice pitch range.

5. How come when people with a strong regional accent (i.e., Southern) or stuttering problem don't manifest it when they sing?

When someone speaks with an accent, they produce the vowel sounds differently than the person identifying them as having an accent. When singing, the vowels are prolonged and those differences are minimized.

People who stutter may have an easier time singing because of several possible reasons:

The support required in singing keeps the continuous voicing and airflow components moving easily.
There are no expressive challenges with singing; the words are provided for them.
Some feel that stuttering is a neurological disorder; the neural pathways involved in speech are disrupted somehow. Singing involves more right-hemisphere brain functions vs. speaking, which is left-hemisphere dominated and may be easier to initiate and sustain than speech.

6. If I have a sore throat, is it a good idea to whisper until I'm feeling better?

Actually, you are better off using your normal voice gently and quietly rather than whispering. Whispering alters the manner in which your vocal folds close and vibrate, often compressing the vocal folds in the middle where your tissue is most likely to swell when your are sick. Whenever you have a sore throat, you should minimize your voice use if possible. If you are uncertain whether you are safe to use your voice, it is always best to see an Otolaryngologist who specializes in voice care. If you need help locating a voice specialist in your area, please contact us at the NCVS and we will help find one for you.

7. I have heard that it is a good to do vocal warm-ups before extensive singing or speaking. What exercises do you recommend?

It is always important to warm-up your voice before any kind of singing or speaking. Gentle humming exercises, lip or tongue trills and breath-stimulating exercises like Ya-ha-ha-ha-ha (1-3-5-3-1) with a release in between each note are good for warming up the voice. Your volume should stay around mp (medium soft).

8. Why do male voices "crack" when young men are going through adolescence? How long does this stage last?

The young male voice cracks because of substantial changes occurring in the larynx during adolescence. The vocal folds grow 4-11 mm and the tissue underneath the mucosa of the vocal folds (the lamina propria) develops. This process can begin anytime between the ages of 12 ½ and 14, and is usually complete by age 15.

9. Sometimes I run out of breath when I'm speaking. Can I build in "air reserves"?

Running out of breath when speaking is rarely a symptom of not having enough air in your lungs. It usually indicates that you are not using your breath economically or efficiently as you speak. If this happens to you frequently, you would be wise to have a full voice evaluation to make sure your vocal mechanism is working properly. If your vocal mechanism is functioning normally, you can learn how to support your voice optimally with several sessions of voice therapy and not have this problem in the future.

10. How do I find my natural pitch for speaking?

You can find your natural pitch range for speaking by listening to how you spontaneously say the sound "mm-hmm". The top note of your "hmm" is a good place to start. Try sustaining the pitch of the "hmm" and move into a phrase you'd typically say. For example, "mm-hmm-mm-how are you?" If this pitch range differs substantially from the pitch you typically use when speaking, you are not at an optimal pitch and could be straining your voice to maintain that pitch. Other indicators of natural pitch can be your laugh or cough.

11. What is a nodule? Is it the same thing as a polyp?

A nodule is a benign growth on the vocal fold that usually occurs on both vocal folds and is caused from chronic vocal abuse (kind of like a callus). A polyp is also typically a benign vocal fold growth, although polyps generally occur only on one side and often arise from a traumatic incident to the vocal folds, e.g., after a vocal fold hemorrhage or mucosal tear.

12. Actresses like Demi Moore and Kathleen Turner have gravelly-sounding voices. They can't have laryngitis ALL the time. What gives?

Some actresses are well known for their low-pitched and slightly hoarse vocal quality and want to maintain this quality. This kind of chronic hoarseness or a gravelly-sounding voice quality is often an indication of chronic abuse and/or the presence of a vocal fold mass(es) like a polyp or vocal fold nodules. I have heard anecdotal evidence of an actress screaming daily just to maintain the husky voice and nodules. As a voice pathologist, I do not recommend trying this at home.

13. What is the difference between a vocal fold and a vocal cord?

Over the past decade, we have learned a tremendous amount about the vocal mechanism. This has lead to a greater understanding of the vocal fold anatomy and physiology involved in voice production. We now understand that the "vocal cord" is really made up of muscle, three different layers of tissue in a structure called the 'lamina propria' and a layer of mucosa that moves in a wave-like motion over the lamina propria. This lead to the change of terminology from "vocal cord" to "vocal fold", as the structure is more like a fold of muscle and tissue vibrating in a complex manner rather than a "cord" merely vibrating with air.

14. How can I find a good speech pathologist that can help improve my voice?

You can contact us at the NCVS and we would be happy to help you find a voice pathologist in your area. You may also contact the American Speech-Language Hearing Association and ask them for a list of speech pathologists that are part of the Special Interest Division-3 (Voice). Usually the Otolaryngologist who specializes in voice in your area works closely with a speech pathologist that can help you improve your voice.

15. What changes should an elderly person expect in her voice? His voice?

Several changes can occur in the voice with the aging process. However, just as with the rest of the body, these changes can be stalled with regular exercise (for the most part). Typical changes due to aging include possible:

atrophy (weakening) of muscles and nerve tissues resulting in vocal fold bowing
stiffening or arthritic arytenoid joints, causing incomplete vocal fold closure and subsequent breathy vocal quality
vocal fold tissue can thin and waste and vibrate less, causing hoarse and/or breathy voice
the vocal fold edge can roughen
Other changes can occur due to changes in hormone levels:

Women can have a lowering of their pitch from the loss of estrogen in their body during and after menopause. This can be prevented or reversed with estrogen replacement therapy.
Men's voices tend to get higher as they age, as their level of testosterone drops.

16. I read that clearing your throat too much is bad for your voice. Why? It seems that having excess mucous in your throat makes it harder to speak.

Clearing your throat is very abusive to the vocal fold tissue, as you basically are grinding the vibratory edge of each vocal fold against the other. This causes swelling and irritation of the vocal fold in the middle of the vibratory edge, which then hits first before any other part of the vocal fold. Chronic irritation and swelling in this area can lead to the formation of vocal fold masses such as nodules. The other aspect of the throat clear, as much as it feels like it clears off the mucous, only moves the mucous to the side of the vocal folds, and that mucous eventually makes its way back to the vibratory edge. This begins the viscous cycle of constant throat clearing. There are better alternatives to clearing away the excess mucous:

a silent cough…say the word "huh" with oomph from your belly without voicing followed by a swallow (kind of like coughing, but without voice)
humming can move away the mucous
a sip of water can move away the mucous
a gentle cough with lots of air in front of it is still less abusive than a throat clear.

17. What are some good tips for a pleasant "telephone voice"?

Speak at a comfortable pitch and loudness with appropriate support.
Speak slowly and clearly so people understand you but not unnaturally slow.
Smile! A smile can be detected as pleasantness in your voice

18. What can you do to protect your voice if your job includes extensive speaking (i.e., receptionist)?

Practice good vocal hygiene. (see answer to question #3) If you are using your voice ideally, you should not have a problem with your voice. If you are having difficulties, get some voice training to optimize the way in which you use your voice.

19. I am a 21-year old female. Yet my voice sounds like a little girl. I will be interviewing for jobs right after graduation. What can I do to sound more professional?

My best advice for you would be to work with a voice patholgist (vocologist) on how to utilize your resonant space for a more mature and professional sound. You may also be keeping your larynx at a very high level that limits your vocal flexibility and depth of sound. A few sessions of voice therapy can teach you how to optimize your voice production.

20. Why can some people smoke, drink, stay up all night and yet have a good-sounding voice, and other people seem to have so much trouble?

Not all larynges are created equally. Some people are genetically more prone to injury of the vocal mechanism, as in other parts of the body. Usually, however, that kind of destructive behavior catches up with even the most robust of larynges.


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