Well Tuned: Maintenance of the Professional Voice: Part 1 of 2

Frank Sinatra purportedly said of Rosemary Clooney that she was able to hit a note right in its center.1 Repeatedly hitting the notes right to a singer is what repeatedly achieving successful suturing and splicing is to a surgeon-both exemplify expertise in a given craft long honed through hours of training, practice, and performance. Critical to such talent is maintenance of the instrument on which that talent relies-for the surgeon, the hands; for the singer, the voice.

For people who rely on their voice for their craft and profession-such as singers, actors, politicians, teachers, and preachers-maintenance of vocal quality is fundamental to a successful and enduring career. The issues of how to maintain good voice quality and how to prevent and treat vocal problems in the professional voice user have given rise to a virtual cottage industry within the otolaryngological profession. Several centers are now available that are devoted to professional voice care. Since 1972 the Voice Foundation (www.voicefoundation.org ), the oldest organization in the world devoted to medical research and education on the voice, has held an annual symposium on the care of the professional voice.

Common Problems for the Professional Voice

Answering your question about common voice problems [in the professional voice] is not as easy as you may think, said Robert T. Sataloff, MD, Chairman of the Philadelphia Voice Center (www.phillyent.com/practice/voicecenter.php ), one of the first centers dedicated to care of the professional voice. Professional voice users, such as singers and actors, are professional athletes. They place great demand not only on their voices, but also their bodies, he continued.

According to Dr. Sataloff-who is also Chairman of the Department of Otolaryngology-Head and Neck Surgery and Associate Dean at Drexel University College of Medicine, a leading expert in caring for the professional voice who has written extensively on the topic, as well as a trained professional operatic singer-these demands take a toll not only on the voice but also on overall health, making professional voice users predisposed to such voice injuries as vocal fold hemorrhages, tears, cysts, and nodules, as well as a number of health problems. Among these, he said, is the high prevalence of laryngopharyngeal reflux. As many as 80 percent of professional voice patients have reflux in addition to-and possibly aggravating-the primary problem for which they seek medical attention, he said, adding that hormonal imbalances, orthopedic injuries that affect posture, and respiratory conditions such as asthma can undermine effective voice use, limit performance ability, and lead to injury.