Monday, July 30, 2012

Vocal Cord Cyst

7 months ago I had surgery on my voice due to a cyst embedded in my right vocal cord. I started singing again about 3 months later and was back to normal. Recently, I have been losing my voice worse than before and I lost my upper register almost completely. What are the possibilities of why this is happening to me again? Can you tell me what could be wrong?

Melissa Kim M.S., CCC-SLP replies...

When one experiences persistent hoarseness following phonosurgery, the reason may be scarring, recurrence of the lesion or evolution of another traumatic lesion, or underlying hyperfunction of laryngeal musculature. A combination of these contributing factors is also possible. The only way to determine the cause and appropriate treatment is to be re-evaluated.

Good luck to you!

Vocal Difficulties

How do you treat a man 30 years old from having a high voice one minute and a low voice the next -  not settled after puberty?

Melissa Kim M.S., CCC-SLP replies...
I would first suggest that you seek out an evaluation with a laryngologist (an Ear, Nose, and Throat physician with specialized training in voice disorders) in order to determine if there are any anatomic or physiologic factors contributing to your vocal difficulties. If your larynx is determined to be structurally normal, you may be experiencing what is referred to as "puberphonia." Puberphonia is the persistence of abnormally high pitched voice following the onset of puberty, and can often be successfully treated in voice therapy with a speech pathologist.

Best of luck to you.

Voice Projection

I have a muscle disease that makes it hard to project my voice and a lot of times (especially in loud environments, i.e. a car or restaurant) people have a hard time understanding me. I have a couple devices I've tried that kind of work but haven't found a real solution that works all the time. I was wondering if you could give me some help with this

Melissa Kim M.S., CCC-SLP replies...
There are many options for augmentative communication available, but as there are a number of patient variables that would guide a recommendation, only a speech pathologist who has evaluated you thoroughly would be able to suggest an appropriate device. 

Please visit the American Speech-Language-Hearing Association (ASHA) website at to look for a speech pathologist who specializes in the area of augmentative communication.

Good luck!

Sunday, July 15, 2012

Loss of Upper Range

I am 59 years old and have been singing my entire life both professionally and recently semi professionally. I had a 5 year period of time where I rarely sang at all then began to get back into it. I struggled for a while with my upper range then began to see improvement but recently over the past five years have been noticing my voice breaking when I sing in any key and when I get to my upper range it gets raspy and have lost 2 full notes. I no longer have a clear sound in my falsetto either. After having issues with a lot of phlegm to the point I would begin coughing in the middle of speaking or singing on a frequent level, I saw an ENT who scoped me and found some discoloring of the vocal chords and recommended a special diet which I stayed on fairly well for about 5 months. It seemed to help a bit but I still had issues with my upper range. I am now loosing more range and the phlegm is coming back and my voice is breaking again. I have not been staying close to the diet but I don't eat an unhealthy diet. My low and middle range seems to be in control for the most part when I go out to sing in a club or practice, but when I explore my upper range G and above, it goes breathy disappears. What do you suggest?

Melissa Kim M.S., CCC-SLP replies...

If your otolaryngologist described "discoloring" of the vocal folds and recommended specific dietary modifications, I would assume that he or she was suspecting acid reflux to be playing a role in your vocal symptoms. If your symptoms have persisted despite adequate treatment of the acid reflux (which your otolaryngologist or a gastroenterologist would determine), you may be experiencing vocal changes related to muscle tension dysphonia.   

When a singer or speaker encounters an undesirable vocal sound that is the result of any underlying irritation to the larynx (such as acid reflux), the first impulse is to compensate by unknowingly changing the way in which one is singing or speaking. These functionally abusive vocal behaviors, also referred to as muscle tension dysphonia, can exacerbate original vocal symptoms. The treatment for this condition is voice therapy with a speech pathologist who specializes in the treatment of voice disorders; ask your otolaryngologist for a referral.

Good luck!