Professional voice users (PVUs) are defined as individuals whose voice and spoken communication are an essential part of their job. Among PVUs, singers, actors, teachers, public speakers have constant high demands on their phonatory apparatus (i.e. voice box, also known as larynx which houses the vocal folds) consequently, these individuals should take special care of their vocal instrument. It is important to remember that efficient voice production should be achieved with minimum effort and no associated pain.

The aim of this page is to provide a streamlined path from symptoms to treatment in order to inform you of what you should do if you feel that you are having problems with your voice. An additional General Voice Care (aka vocal hygiene) tab provides some tips on how to look after your voice.

If you are a professional voice user, there is a range of measures that you can take advantage of to ensure your voice will remain sounding and feeling healthy (these can be found under general voice care below). If you feel that your voice is not behaving the way it normally does, please read the tips below and make sure to contact a throat doctor as soon as possible. The advice below is not restricted to PVUs. Anyone that may be concerned with their own voice can benefit from it. 

IF YOU ARE EXPERIENCING PROBLEMS WITH YOUR VOICE FOR OVER A WEEK, MAKE SURE TO CONTACT A VOICE SPECIALIST IMMEDIATELY.

Symptoms
Diagnosis
Treatment
General voice care

There are a number of symptoms that suggest you may have a voice disorder. They may be related to something temporary such as a cold or fatigue, to something more concerning such as an organic change in the structure of the vocal folds or problems with the neuronal circuitry that control your vocal folds. It is always important to seek medical advice if you are feeling any of the symptoms below:

  • Difficulty speaking loudly
  • Fatigue after using voice (voice tires easily)
  • Hoarseness, voice sounding breathy, husky, dull or with added noise.
  • Limited pitch range (voice cannot hit high and low notes in the voice range) 
  • Difficulties projecting your voice
  • Pain when speaking or singing.
  • Throat tickling, feeling dry, burning, aching or feeling tight (like you have a lump in the throat).
  • Tremors
  • Voice breaking
  • Swallowing problems, postnasal drip (sticky mucus on the back of your throat)

If you are suffering from any of the above symptoms, you should be evaluated by a voice specialist for diagnosis and treatment (Otorhinolaryngologist also known as an ENT doctor) - in the Czech Republic this professional is also known as a Phoniatrician. Alternatively you can also contact a Speech Pathologist specialized in voice (Logoped in Czech).

See your doctor right away if you think you have an upper respiratory infection (an infection in your nose, throat, sinuses, and ears). The link below provides the contact of some professionals in the Czech Republic.

Asociace klinických logopedů

Diagnosis is the identification of the nature of an illness (or other problem) by examination of the symptoms.

In order to do that, your otolaryngologists will review your medical history and perform a detailed physical exam. This exam can include a range of voice specific assessments such as:

  • Videostroboscopy: Visual inspection of your larynx using a rigid or flexible endoscope
  • Acoustic analysis: Recording of your voice in order to assess the quality of your vocal output, including vocal intensity and range.
  • Aerodynamic analysis: In some cases a further set of tests may be used to better understand how your voice is working. That may include measures of airflow and pressure.

If necessary, after a diagnosis is completed, a personalised treatment plan will be created to improve your voice quality as soon as possible. This can be divided into:

General Voice Care (Vocal Hygiene) and information

Information regarding how you are using your voice and what you can do to prevent vocal damage will be given to you. This may include the administration of voice usage, hydration, reduction of vocal abuses (shouting, clearing your throat, coughing), vocal rest, avoidance of external factors that may impact on your voice such as: exposure to chemicals, management of acid reflux among others.

Voice therapy

Some voice problems may be eliminated with a course of voice therapy that aims to set new sensorimotor patterns that will enable you to produce your voice in a safe manner. 

Medical treatment

A ENT doctor may decide to prescribe you with some medication (e.g. antacid  tablets) or refer you for vocal surgery (when organic changes are detected during the diagnostic phase - including nodules, polyps, edema, and more). 

Below is an advice list that should be used in order to keep your voice healthy. The list of advices below are normally referred to as vocal hygiene and should always be considered in the treatment of voice disorders (If your voice show any of the signs listed under Symptoms, make sure to contact a voice specialist immediately):

The DON'Ts of voice:

  • Do not smoke or be in places where there is smoke.
  • Avoid screaming or yelling.
  • Avoid excessive amounts of alcohol and caffeine (coffee, caffeinated tea and fizzy drinks) as they dehydrate you.
  • Avoid inhaling chemicals such as paint solvents, cleaning material and any other toxins that may irritate the mucosa of your vocal tract.
  • Do not clear your throat or cough unnecessarily. Instead, drink small sips of water to help keep you from doing such things.
  • Avoid spicy, acidic and fatty foods (e.g. deep fried food, citric fruits, tomato based sauces) as they promote the reflux of stomach acid into your larynx which burns the vocal folds. 
  • Avoid pushing your voice against loud background noise and excessive whispering, as it can cause tension in the larynx.
  • Avoid speaking or singing outside your natural vocal range.
  • Women should avoid excessive vocal usage before and during the menstrual cycle.

The DO's of voice:

  • Drink plenty of water (approx 2L/day). Unlike other "instruments", your vocal folds are made of living biological material that needs a good level of hydration to function normally.
  • Rest your voice from time to time (especially after excessive use e.g. performance) and make sure to get a good night’s sleep (about 8 hours/night).
  • Warm up and cool down your voice:
    • Warm up examples: musical scale, humming, straw phonation.
    • Cool down examples: descending scales, general relaxation, gentle humming and neck massage.
  • Always consult your doctor and avoid self-medication as many drugs have the potential for affecting the voice. For example, anti-histamines, decongestants and antidepressants tend to dry your vocal folds. Anesthetics such as paracetamol may mask signs of pain and strain leading to excessive vocal abuse.
  • Use a humidifier in your room (making sure to avoid excessive condensation in the room that may cause mold to grow).
  • Make use of steam inhalation in order to deliver humid and warm steam straight into your vocal folds (do not add anything to water when steaming and make sure to use sterile water).
  • Use a microphone, whenever possible, to avoid straining the voice.
  • If you need to use your voice professionally for long periods of time, make sure to undergo proper training with a vocal coach, singing teacher or voice pathologist.
  • Make sure to have a healthy and balanced diet. 

If you require further clarification regarding the information contained on this page, do not hesitate to contact HAMU (pedro.andrade@hamu.cz).

Educational section

Below is a fascinating Youtube video showing the activity of the larynx whilst singing.
Further details about anatomy and physiology of the voice to be added soon.