I am a singer and recently began singing a lot more than usual.
I am a 38 year old mezzo soprano but usually sing alto in a choir. Lately I notice that while singing I begin to feel a hoarse, "wad" of cotton" in the throat feeling, affecting only my speaking voice and and notes in my lower register. High notes are unaffected. This is a problem as we have a show coming up and I am to sing 6 Broad- way type songs plus choral parts. My teacher thinks I am just not used to singing so much, but I wonder if my voice is just weak. Is there anything I can do to build endurance in my voice? Which is more dangerous, singing too high or too low? I try to keep a relaxed throat while singing, and do not feel that I am straining, however maybe I do have some bad vocalhabits that I'm unaware of. The hoarseness goes away with rest. Am I hurting my voice?
Answer ----------
There are many factors that affect vocal quality which in the average individual may cause subtle changes which might go unnoticed, whereas in the professional voice the effects may be considerably magnified and problematic. The symptoms described suggest a mucosal abnormality associated with extended use of the voice.
Vocal fatigue is usually manifest by a feeling of hoarseness, loss of range, changes in timbre, breaks into different registers or other haphazard uncontrolled disturbances in vocal quality. The well-trained voice should be capable of singing for several hours without fatigue. The problem is usually associated with improper technique in abdominal and neck muscles. Singing teachers are responsible for the technical and anatomic aspects of voice development and should be able to recognize vocal fatigue by analyzing technique. If you have had several different singing teachers, there may be some technical insecurities induced by different approaches.
Reflux laryngitis is a vocal condition associated with reflux of acidic secretions from the stomach. It is a very common voice disorder especially in singers. Typical symptoms include hoarseness, a sensation of a "lump" in the throat which necessitates frequent clearing of the throat, occasionally a bitter taste in the mouth, and dry cough. In singers it may be associated with prolongation of warm-up time. A physical examination will typically reveal redness and swelling of the posterior (back) portion of the larynx. The condition usually responds to conservative measures including head of bed elevation at night (2 or 3 pillows), antacids, and avoidance of meals within a few hours of retiring at night. Proper vocal hygiene including good hydration (increase water intake) and avoidance of clearing of the throat are necessary. Occasionally prescription medications such as Zantac or Prilosec are necessary short term measures.
Other non-infectious causes of laryngitis include excessive voice use (such as increased duration and frequency of use with pre-performance rehearsals), as well as factors or conditions which cause inflammation of the lining (mucosa) of the vocal cords. Such factors may include allergy, second hand cigarette smoke exposure, dehydration, or use of anti-histamines. Avoidance of mucosal irritants and proper hydration are necessary to avoid this type of laryngitis.
Hypothyroidism (inadequate thyroid hormone production) can also lead to changes in vocal quality. The most common symptoms include voice fatigue, hoarseness, loss of range, and a feeling of a "lump" in the throat. These vocal symptoms can occur even in mild cases of hypothyroidism where other common systemic symptoms may be subtle or absent. A thyroid stimulating hormone (TSH) blood test is the most common method of screening for this disorder.
The assessment of disorders affecting the professional voice require a careful history and physical examination by an otolaryngologist. Ideally, the otolaryngologist should be well-versed in proper voice technique, and the examination should include an assessment of technique. However, this is a fairly esoteric area in medicine. It is often necessary to rely on the combined expertise of an otolaryngologist and a singing teacher to resolve the problem.
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Steve Dankle, MD
Otolaryngology-Head and Neck Surgery
Milwaukee, Wis
NOTICE: OFCN is not engaged in the rendering of professional medical services. The information contained on this system or any other OFCN system should not supplant individual professional consultation. It is offered exclusively as a community education service. Advice on individual problems must be obtained directly from a professional.
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