singing voice

air leak

Question: 
Doc i hope i get an answer..... ok first of all i went to an ent and i have a nodule in my arytenoid the tensors of the vocal chords and he told me that its reflux that made that lump sometimes i feel it... also when i sing i get a white noise in every note low or high and pain in the left side of my neck also i feel the lump in that side, i still have power on my vocals so i dont know if its vocal chord paresis .... also i play with my voice to feel the air leak and i can do a high pitch like a (whisltle or like an harmonic of a guitar) but no power on the voice for that note is like whispering ... please answer me XD
Answer: 
I think that the answer you are looking for requires an accurate examination of the vocal cords. A bump or swelling on the arytenoid cartilage would have nothing to do with the voice. Sound is created by the vocal cords so only problems along the edge of the vocal cord can alter sound production. For a second opinion, I list a number of laryngologists at http://old.voicedoctor.net/Physicians-0/index-000

Vocal issue

Question: 
Hi Dr James! First of all I wanted to thank you for all the exclusive content that you upload in this website. The theory, videos and explanations you give are amazing and have personally given me a much deeper insight and undestanding of the human voice and its hoarsenness. I have been to a lot of doctors but had never seen anyone before with such a deep undestanding of the voice and at the same time explain it so good to normal guys like me who don´t have a clue about how our voices really work. My name is Alvaro, I´m a 21 year old guy, from Spain, and 3 years ago I decided to take some singing lessons. After two months I quitted beacause I felt my voice wasn´t responding as it should be and since then I have had difficulty in speaking and raising my volume a little bit whenever there is some noise in the enviroment. I´ve been to a lot of doctors here in Madrid, the last one I worked with is known as one of the best in the city. However when he sees my endoscope he recognizes redness in my larynx but says he doesn´t know why my larynx is red beacause he doesn´t see any abduction problems of the vocal folds o lessions. During the past 3 years I have been doing a lot of vocal therapy with 3 different speacialists, but I feel the same difficulties when I speak. Please If you could only take a look to my endoscope and tell me what you think about it, if you see something or have any idea on the problem I am willing to travel to the United States to see you and have surgery or whatever would be needed to be done, I just want my voice back more than anything else... Thanx a lot for reading this email and hope the best for you in live P.S.: Could you give me an email to send you the endoscope?
Answer: 
Various options for showing a video include a private channel on YouTube or using Dropbox. You may email me at [email protected]

Singing in Chest Voice

Question: 
Hi Dr. Thomas, thanks so much for such an informative website and the great videos on you tube. I am a voice teacher in Chicago. I have also sung professionally for 20 years. Although I am trained as a classical opera singer (music degrees from Illinois Wesleyan University and Northwestern), my passion has always been rock and pop. I carry a heavy load of voice students (another passion of mine). Quite often I get students who want to sing in bands, or learn to sing quite high in their chest voice for particular musical roles. Usually, teachers refuse to teach students in their chest voice. The classical vocal world does not really allow the use of chest voice. I have always sung in my chest voice, as I have been in musicals and bands and recording studios since I was a kid and I have to believe there is a way to sing high in the chest voice healthily. I have learned to implement my classical training on my chest voice so that it is as forward and clear sounding as possible, a technique that I also teach my students. I know that the classical vocal world says that singing in chest voice will produce nodes, but I was wondering if you have any medical knowledge in the area of chest voice versus head voice and if one can truly cause nodes more frequently than the other, or if the issue is caused by poor technique regardless. I am in the midst of writing a book on the subject as well as trying to get an internship with an ent to learn more of the medical side of the vocal cords. I have extensive knowledge in the are of vocal pedagogy, but would love some medical knwoledge to back it up!! Thanks so much for any help you can give in the area of chest voice. With so many wonderful pop and rock singers of the present and past who have never had vocal problems, it is hard to believe that all use of chest voice could be that dangerous! Thanks again for any help you can give! CK
Answer: 

Changing pitch in chest voice is largely performed by tensioning the thyroarytenoid muscle. This is the muscle within the vocal cord itself. Changing pitch in falsetto is largely from the cricothyroid muscle. This muscle rests outside the larynx and rocks the 2 main cartilages of the larynx producing a change in length of the vocal cord. Consequently, we have 2 sets of muscles to change pitch. They tend to overlap in the middle of our vocal range and we can produce the same note in more than one way. That is, we can sing the note C4 (middle C) primarily by contracting our thyroarytenoid muscle, which would thicken and tighten the vocal cord while it remains the same length. This produces the rather full sound that you describe as chest voice.

Alternatively, we could tighten our cricothyroid muscle until we reached the note C4 and we would stretch the vocal cord longer and thinner until we reached this note. Even though we have 2 discrete ways to produce the same note, and you could do this on a guitar with 2 different size strings, the quality will be different when a thicker string vibrates at a given pitch then when a longer and thinner string vibrates at the same pitch. We could also produce the same pitch with some intermediate tension on each of these 2 muscles. Consequently there are many ways of creating the notes in the mid-range of our voice. A classical singer would typically spend years trying to smooth out this transition between using one muscle and the other. This would create a blend rather than a break as we shift the tension from one muscle to the other gradually.

In my experience, vocal elevations/swellings (nodules, polyps etc.) come from vocal overuse. Very few people sing sufficiently to create vocal swellings solely from singing. However, a great many people are extremely talkative and filled their life with vocal activity, both singing and speaking. The greatest factor for creating a vocal swelling is vocal overuse, talking too much. A person who is very talkative and hoarse has about an 80% chance of having a vocal swelling based solely on this information. The second factor contributing to vocal swelling is vocal volume. The third factor is likely vocal technique.

I think the use of chest voice or head voice (falsetto) plays almost no role in the formation of vocal swellings. Quantity mostly and volume second are the overriding factors creating lesions along the vibrating margin of the vocal cord.

Laryngitis

Question: 
I have been diagnosed with laryngitis. Doctor suggest no talking. I have read and heard that whispering is the same to the vocal chords as yelling. Is this true and could you give any suggestions on how to recover the voice and when it's wise to start speaking or singing again. Sincerely, Ringo Maestro
Answer: 

The word laryngitis means inflammation of the larynx. If your larynx is inflamed, at some point it should become not-inflamed. You and your doctor would need to determine when that point is.

Whispering is much different than yelling. In a true whisper, the airway is narrowed and airflows turbulent leak through this narrow point. This generates white noise which we hear as a whisper. Consequently there is no movement of the edges of the vocal cord. This is in strong contrast to a yell where the vocal cords are hitting each other rather aggressively. There is an in-between sound called a stage whisper where the vocal cords are partially closed and partially allowed to vibrate. There is both a white noise quality and a pitch quality to a stage whisper.

Voice Rest - How long for polyp/hemmoraghing for young singing student?

Question: 
Dear Dr. Thomas, One of my young students (age 12) developed a polyp/hemmoragh in early November from screaming/crying when she fell back and hit her head on the sharp table corner. Her singing up to that point was wonderful, with a 3.5 octave range, clarity, etc. Her singing voice was compromised greatly because of the screaming/crying event. I heard it right away when they called me the day after it happened, - her range was cut in half and the sound was raspy. The doctor to whom she went to, only advised her to be on voice rest for one week. After one week, she came to me for her voice lesson, but it was obvious that she was nowhere near vocal recovery, (so, no voice lesson). She went back to the laryngologist and they/he said to have a second week of voice rest. She did this, and after the second week, her voice was still nowhere near vocal recovery. Yes, I have seen photos at different stages of the recovery. A few days ago, she came in for a voice lesson, this time after about three sessions with a voice therapist working on breathing and airflow with lip trills, sound/no sound airflow exercises, etc., and still, the photo showed a slight swelling on either side of the cords where the polyp had been. Firstly, I do not understand why the doctor would have her receiving voice therapy when her cords are still swollen. Secondly, I do not understand why the doctor would have given her only one week of voice rest, then followed by only a second week of voice rest. In other instances, I am familiar with singers being totally silent for a month or even two, just to give the polyp and bleeding the best possible opportunity to heal completely, before beginning any type of voice therapy. Does voice therapy aide or hinder the recovery of still swollen vocal cords?
Answer: 
Dear voice teacher, When there is a sudden loss of voice, the problem is usually related to blood vessels and hemorrhage. If that was the case with your student, the amount of time for recovery is quite variable, although one week would almost certainly be too little for blood to absorb and a blood vessel which was broken to heal. Secondly, if a blood vessel was involved, it is not clear to me that any type of exercise can promote healing of such a blood vessel. This is in contrast to chronic vocal overuse which tends to produce a thickening of the skin, otherwise known as a vocal nodule(s). Appropriate therapy can be initiated to alter vocal behavior and perhaps diminish vocal trauma, in the long run reducing the size of the vocal swellings. One can still sing with a hemorrhagic polyp, the risk of re-breaking the polyp is just higher and the voice is likely impaired to some degree. Some people are willing to take that risk. Quite frequently hemorrhage will reabsorb into the body. In contrast, once a hemorrhagic polyp is formed, in my experience this usually requires surgery to remove it, along with a number of weeks of recovery afterwards. The good news is that, if a hemorrhagic polyp formed from a vocal accident, there is usually no underlying inappropriate use of the voice so that once healed, no specific therapy is needed to alter voice use. Regular voice lessons can just be resumed. The best way to know what is going on is to have a good close examination, something I talk about in several videos. I have tried to list the physicians I know who are highly interested in the voice elsewhere on this website: http://old.voicedoctor.net/Physicians-0/index-000 .

vocal cord disfunction

Question: 
Good Day Doc, I am a Singer from the Caribbean Island of Grenada. Lately I've noticed that i am not able to hit notes that i am accustom to. I am also hoarse alot of the time. What do you think might be the problem? Nekoyan.
Answer: 
Dear Nekoyan, I would love to hazard a guess, but it would be no more than a guess with so little information. About the best I can suggest is to see an ENT doctor, and I do not know how hard it would be to find one on your island. The other option is to read the various areas of this website and see if anything seems to match up with your symptoms. Ultimately, only a good look of the vocal cords will answer your question precisely.

thick scretions and pitch

Question: 
I have been singing all my life, and told i have an amazing gift. I had the vocal range of mariah carey and barbra strisand.in the last ten years being dianosed with chronic bronchitis i often suffer with thick mucus like scretions that seem to sit at the base of my throat like a pocket. doctors have given me inhailers and say i should try speach. i have a vocal coach and even she says there is something theyer not seeing. when i try to sing i have no pitch in high range.even low vocalizing becomes difficult. I feel i can be helped because there are days when just for a day my voice seems clear. i love to sing and just want to enjoy my gift again, what can be done for me.I am 55 years old. thank you Rose
Answer: 
Dear Rose, An accurate diagnosis would be extremely helpful in resolving your problem. I would suggest that a laryngologist take a close look at your vocal cords while trying to generate sound in the area of your range where you are experiencing problems. With appropriate video equipment, problems with roughness of the voice can be visualized. I do list some specialists at http://old.voicedoctor.net/Physicians-0/index-000 .

what is wrong with my voice?

Question: 
Hey, I have been having all kinds of trouble with my singing voice, I got a cold, in June and my voice got a little hoarse, after this cold my voice was fine again, and I use to sing everyday, all day without any problams, a few weeks later we where rehearsing for 2 diffrent concerts, and I got a little hoarse again, then, just after the 1 concert in August, we got a cat. I'm allergic to cats. I took some allergy pills but they did not work, my throat kept getting soarer and soarer. It started to hurt when I breathe and more when I swallowed, the pain just suddenly stopped after a few weeks. This was when I started to feel a lump in the back of my throat, sometimes completely shutting of my air when I take a fast deep breath. I can't sing the top octave of my natural range without forsing my voice and my valsetto is completely gone. My mouth tastes sour and the back of my throat, mostly in the morning. I constantly cough, I have post nasal drip and when I do cough up something, it is not much. Also my voice feels closed when I sing, it sounds as if I'm singing with a towel or something covering my mouth. Overall it just really affects my singing voice, I feel very uncomfortable when I sing. Overall symptoms: lump in throat, sour taste, hoarseness, coughing, throat clearing, pain in my throat, trouble with singing, post-nasal drip. Please tell me what this is and how I can stop it.
Answer: 
The only way to know what is wrong with the voice is to have a look. I list a number of physicians who can provide this type of examination at http://old.voicedoctor.net/Physicians-0/index-000.

Vocal nodules - is surgery an option for a singer?

Question: 
Hello Doctor Thomas, I am a rock and metal singer from Germany. Four weeks ago I continued singing tracks for my solo album despite having a cold, because I told the label I'd be done by the end of this year. To make matters worse, I decided to yell some parts of the chorus in a way a doc barks (only longer), forcing my voice to sound rough and hoarse while producing the tone. The outcome was great, but I haven't been able to produce a clean, soft sound since then, even my speaking voice sounds hoarse most of the time, and this is four weeks after the recording. My live performance is also far worse than it used to be. So I finally visited a doctor, but he didn't really have time for me, I was in and out within 3 minutes. He said I had vocal nodules and I that needed speech therapy, I could look it up. When I asked the doctor if that would get rid of my nodules, he said I should think of them as chicken eyes on my vocal cords, which didn't answer my question. Nevertheless, I've cancelled all live appearances and informed my management I couldn't sing for the next couple of weeks. I've already made an appointment with another ENT (hopefully one with more time to explain stuff), but as I was browsing the web for vocal nodules I came across your website and thought: This site is brilliant, maybe Dr. Thomas can answer my questions. Which are those: Firstly, will speech therapy make my vocal nodules go away? And if not: Will it only help my speaking voice or will it improve my singing voice as well? Secondly: Is surgery an option for a singer? I read about Bonnie Tyler and Julie Andrews, and I wouldn't want my voice to be different after the nodules are removed. And finally: I've done the soft singing test from your website (and obviously failed), but I also noticed that there is a section in the middle, that I have failed to produce for over ten years, which leads me to believe I already had nodules before, but never noticed them. Are there non-surgical ways to get rid of old nodules or have they already turned into scar tissue? Thank you so much for your time and thanks in advance for your answer. Keep up the brilliant work.
Answer: 
Dear rock 'n roller, I believe that accurate diagnosis is the most important element of treatment. With a general ENT exam, it may be difficult to distinguish between vocal nodules, vocal polyps, hemorrhagic polyps and small ectasias. I do list the number of physicians around the world, including some in Germany who specialize in voice disorders. You may be more likely to get an accurate diagnosis from one of them - http://old.voicedoctor.net/Physicians-0/index-000. Anyway, I couldn't comment on the appropriateness of surgery without knowing exactly what the problem is.

Regarding voice depth/tone

Question: 
Hi Dr, My name is Sarah, 20 years old female and a very passionate singer. I don't have any vocal cord "problems" as i have a very clean and loud voice, but i am desperate to lower my tone and pitch (singing and speaking lower notes with more depth) and i was wondering if the CaHA injection would be the solution to my problem? Could you please give me your oppinion? Kind Regards, Sarah.
Answer: 
Dear Sarah, Pitch is a result of how thick the vocal cords are, although it is the edge of the vocal cord that vibrates more then the body or deep portion of the vocal cord. In a person with abnormally thin cords, some sort of implant can lower the pitch. Typically with a normal sized vocal cord, it is difficult to lower the pitch very much by increasing the mass of the vocal cord further. Unfortunately, vocal overuse (especially when combined with tobacco consumption) tends to increase the fluid beneath the surface of the vocal cord (in smokers this is called Rienke's edema) and presently I don't know of an injection that can mimic this quality. Otherwise training is the most effective way to lower the pitch as well as to improve the resonance of the lower tones by learning how to expand the size of the pharynx.
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