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The Voice – A Reality That’s More Than a Show

When wannabe singing stars appear on the hit TV show The Voice, judges Adam Levine, Blake Shelton, Shakira and Usher evaluate their voices in terms of their entertainment value.

Most of us aren’t singers on TV, yet our voices define, in many ways, our identity.  And when there is a problem with our voices, an evaluation of a different sort may be required.  Just think back to a time when you were sick and lost your voice.  It’s frustrating and reason enough for you to take steps to protect your voice.

Enter Richard Vivero, M.D., [1]a Board-certified Ear, Nose and Throat physician, or otolaryngologist, affiliated with Baptist Health and one of only four fellowship-trained laryngologists in the state of Florida.  Dr. Vivero specializes in voice and airway disorders, and can treat them in different ways, including with surgery.

“Our voices are usually something we don’t think about until we experience a change in them, like when we get sick,” Dr. Vivero said.  “But it’s important to pay closer attention to changes in the quality of our voices and how we use our voices to quickly recognize when there may be a problem.”

Dr. Vivero sees a lot of professional singers, actors, teachers, lawyers and executives in his practice, because these professionals use their voices for long periods at a time without rest.  They are at risk, he says, for developing polyps and nodules within the folds of their vocal cords.  But, he warns, others may experience voice problems due to cysts within the vocal cords, which are usually present at birth and may cause problems when the vocal cords are damaged through overuse or sickness. 

In fact, the National Institute on Deafness and Other Communication Disorders (NIDCD) [2] estimates that approximately 7.5 million Americans have voice problems.

Signs of a Voice Problem

To prevent long-term, irreversible damage, Dr. Vivero recommends people see their doctor when they experience any of the following:

• Hoarseness or raspiness, lasting longer than two weeks.
• Pain with swallowing or talking.
• Throat or ear pain.
• Difficulty swallowing.
• Coughing up blood.

Practice Good Voice Hygiene

But there are ways to protect your voice before you reach the point of needing treatment.  “Practice good voice hygiene,” Dr. Vivero said.  “Our voices need rest, too.”

Among his tips for maintaining a healthy voice, he recommends:

• When speaking for long periods of time to a large crowd, use an amplification tool, such as a microphone or bullhorn.
• Drink plenty of water before, during and after extended speaking engagements.
• Avoid alcohol, which can dehydrate the vocal cords.
• Stop smoking or steer clear of second-hand smoke.
• Keep screaming and cheering to a minimum when attending concerts, sporting events and other social events.

Surgery as a Last Resort

Fortunately, not all voice problems require surgery as an effective treatment.  Dr. Vivero says a diagnostic test called a videostroboscopy [3] done in the doctor’s office usually pinpoints the cause of voice problems.  From there, treatment options range from voice therapy that retrains the voicebox, or larynx, to minimize strain on the vocal cords to laser or microsurgery that removes polyps, nodules or cysts from within the larynx.

Like the judges on The Voice, Dr. Vivero must evaluate the quality of his patients’ voices.  But, unlike Adam, Shakira, Blake and Usher, he can help patients maintain the quality of their voice.

“The goal of therapy is to maximize vocal quality and return individuals to their normal level of function,” he said.