Voice Frequently Asked Questions

Hoarseness is simply a term used to describe a voice that sounds raspy, strained or deeper in pitch. Changes in the voice are usually caused by a swelling, lump or bump on the vocal folds, the sound-producing portion of the larynx (or voice box). The vocal folds remain apart when breathing, but sound is created when the vocal folds vibrate together. Swelling or other conditions which keep the vocal folds from coming together to vibrate properly can cause hoarseness or a change in voice pitch. These vocal fold conditions can be caused by straining the voice or by a relatively benign illness such as laryngitis. However, chronic, prolonged or reoccurring hoarseness may be a symptom of a more serious condition, such as a tumor of the larynx, and should be checked out by an otolaryngologist.

Like any muscle of the body, the voice can be trained for improvement through special exercises and therapies. A speech pathologist is trained to work with patients to strengthen and improve voice quality, whether the patient is a singer, a professional speaker or an average individual.

The Emory Voice Center has a multidisciplinary team of voice specialists including otolaryngologists and speech pathologists. For the professional voice, the Center's staff includes Dr. Bonnie Pomfret, a lyric-coloratura soprano and vocologist who works especially with trained voices.

There are many simple practical techniques that can be applied to take better care of the voice and avoid voice strain. They include:

• No smoking
• Avoid shouting or straining the voice
• Heat stroke
• Drink lots of water to hydrate the voice box
• Schedule periods of the day with no talking to allow the voice to rest
• Sip warm water, tea or juice when possible to soothe the vocal chords
• Swallow carefully and avoid repetitive clearing of the throat
• Treat coughs as soon as possible and try to minimize hacking coughs
• Proper posture

A leading cause of cancer of the larynx is smoking, especially in combination with heavy alcohol consumption. Other causes include exposure to toxic substances such as asbestos. Benign or non-cancerous tumors called vocal nodules can also be caused by these factors, and by excessive voice strain. Another type of tumor, laryngeal papillomatosis is caused by a virus of unknown origin.

Professional singers and speakers must take extra care since their voices represent not only their livelihood, but are often used more than average under conditions that cause additional strain.

Trained singers are usually well versed in how to protect their voices. But many others, including commercial singers and professional speakers may not be caring for their voices to prevent damage or injury that could have long term implications on their voice quality. The Emory Voice Center team has special expertise with voice professionals.

Tips for preserving and protecting the voice:

• Always warm-up before a performance. This can include relaxation techniques and gentle exercise. A singer should then warm-up with singing exercises that are in the mid-range of the voice.
• Rest the voice between performances as much as possible and avoid tension and stress.
• If you have not had formal voice training, learning vocal techniques from a singing coach or vocologist can protect and enhance your voice.
• Avoid smoky rooms, bars and places where the environment can affect voice quality.
• Avoid pitching your voice at a lower or unnatural level.
• Use alcohol moderately, if at all.
• Keep the voice hydrated by drinking lots of water — at least eight, eight ounce glasses each day, or more for those who are heavier.
• If throat dryness is experienced, sleeping with a humidifier is recommended.
• Practice a healthy lifestyle with aerobic exercise and a nutritious diet.