Professional Voice Disorder
Specialized voice care for singers, actors, teachers, and other professional voice users.
- Evaluation of hoarseness, vocal fatigue, pain, and reduced range.
- Treatment based on the cause of the voice disorder.
- Coordinated ENT and voice therapy support for recovery.
- Same-day or next-day appointments often available.
Important Medical Notice
The information provided below and throughout this website is presented for general educational purposes only and does NOT constitute professional medical advice. This information is NOT a substitute for professional medical advice and NO material on this site is intended to be a substitute for professional medical advice. Always seek the guidance of your doctor or other qualified health professional with any questions you may have regarding a health or a medical condition. Never disregard the advice of a medical professional or delay in seeking it because of something you have read on this website.
Who are Professional Voice Users?
If you are a professional voice user (i.e. you rely on your voice for your living), even a mild voice disorder or change in your voice quality can cause you to experience big challenges in your daily life, both personally and professionally. Because of the nature of their job, professionals need to use their voices a lot on a daily basis for sustainable career success and are thus more prone to developing voice disorders.
The term “professional voice user” can include many different types of work, but some of the most common professions include singers, actors, teachers/professors, voice teachers, attorneys, clergy, telemarketers, physicians, customer service representatives, salespeople, and more. A voice disorder can cause financial and emotional hardship to professionals, such as job loss, lower income, and anxiety.
Common Professional Voice Injuries
At Penn Medicine Becker ENT & Allergy, our team treats the different voice disorders a professional voice user suffers and helps them to have a healthy voice production.
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Vocal Fold Nodules
Vocal Fold Nodules are benign (non-cancerous) lesions, typically found bilaterally (on both vocal folds). Vocal Fold Nodules are most often the result of voice abuse, misuse, or overuse over an extended period of time. The repeated impact on the surface of the vocal folds often results in callous-like lesions. Nodules can vary in size greatly, from pin size to quite large.
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Vocal Fold Hemorrhage
A Vocal Fold Hemorrhage is a bleed into the superficial lamina propria of the vocal cord (the layer that gives the pliability to the vocal fold vibration). This vocal fold lesion is the result of phono trauma (stress or abuse to the surface of the vocal folds or the tiny blood vessels in the vocal cord).
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Vocal Fold Polyp
Vocal Fold Polyps are benign, fluid-filled lesions that can be found unilaterally (one-sided) or bilaterally (two-sided) on the vocal cord. Polyps may appear broad-based and more blister-like (sessile) or may appear to be attached by a stalk (pedunculated). Vocal Fold Polyps are thought to be caused by trauma to the vocal folds (i.e. misuse/abuse of the voice).
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Vocal Fold Scarring
Vocal Fold Scarring of the vocal cord means that the mucosa (covering of the vocal fold) is tethered to the underlying tissue and cannot vibrate freely. Vocal cord sulcus is slightly different, in that the good tissue in Reinke’s space of the vocal folds (or the superficial lamina propria) is missing (or may be filled with scar), and therefore cannot vibrate normally.
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Vocal Cord Dysfunction and Vocal Cord Paralysis
Vocal Cord Dysfunction (VCD) is a medical condition that affects the human voice. It occurs when the vocal cords, which are responsible for producing sound, do not open and close properly. This can cause difficulty in speaking or singing, hoarseness, breathiness, and other vocal issues. VCD can be caused by a variety of factors including allergies, asthma, GERD (gastroesophageal reflux disease), smoking, and even emotional stress. On the other hand, Vocal Cord Paralysis is a condition in which one or both of the vocal cords become paralyzed, resulting in difficulty in speaking and/or breathing. Vocal Fold Paralysis can cause a significant loss of voice and vocal quality. Treatment for this condition may include speech therapy, medications, surgery, or a combination of treatments depending on the severity of the condition.
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Muscle Tension Dysphonia
Muscle Tension Dysphonia is described as dysphonia/hoarseness/voice disruption without any physiologic abnormality found in/on the vocal folds. Often, patients with MTD will report periodic pain in the sites of the larynx, neck, and other areas from the neck up. Patients with MTD may report large variability in their voice, from moments of complete normal voice to moments of aphonia (complete voice loss), but there can be patients with MTD who have more moderate dysphonia at all times. MTD can be present only in the singing voice and not in the speaking voice for some individuals.
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Vocal Fold Cyst
Vocal Fold Cysts are benign (non-cancerous), fluid-filled growths that can be present congenitally (since birth) or can be acquired later in life. Cysts typically occur unilaterally on the vocal folds (one-sided), but can occur bilaterally (both sides). Cysts occur under the mucosa of the vocal fold and cause the vocal fold to be stiff in the area of the cyst.
Our Voice Specialist
At Penn Medicine Becker ENT & Allergy, not only do we have a group of excellent physicians who understand your concerns, but we also have a team of highly specialized speech-language pathologists with extensive training in the particular areas of speaking voice and singing voice disorders. Our lead Speech Pathologist, for instance, Carly Schiff, has worked with and rehabilitated hundreds of professional voice users from CEOs to teachers to Broadway performers. She not only has a background in treating and rehabilitating these professionals, but she was also one herself as a previous performer and went through a vocal injury with vocal rehab.
With this specialized team, Penn Medicine Becker ENT & Allergy has the unique ability to understand the urgency and magnitude of your voice problem and the way it can and likely is impacting your daily life. Our goal is to help you through your vocal recovery as seamlessly and efficiently as possible with as little impact on you emotionally and financially.
When to Seek out Evaluation from a Voice Team
If you are experiencing a minor voice change that has lasted for two or more weeks, you should seek out an evaluation with a multidisciplinary team, regardless of your profession. However, if you are a professional voice user and rely on your voice daily for your income and success, you should seek out an evaluation with a voice team within two days if you experience sudden changes in any of the following areas:
- Sudden onset of hoarseness, raspiness, or breathiness in the speaking and/or singing
- Abrupt changes to voice sound quality in speaking and/or singing voice (breathy, raspy, pitch breaks or cracks)
- Significant changes to your vocal range (i.e. loss of high notes, loss of low notes, loss of mid-range)
- Increased warm-up time
- Straining or increased effort when talking and/or singing
- Throat pain or discomfort with speaking and/or singing
- Decreased ability to control dynamics in the singing voice
- Increased effort in specific styles of singing (i.e. belting, classical singing, etc)
- Increased vocal fatigue
Diagnosis of Voice Injuries
When it comes to the diagnosis of voice injuries, vocal professionals such as otolaryngologists and speech-language pathologists are the best people to consult. They will assess the vocal cords and other related structures to determine the cause of the problem, and once a diagnosis is made, our experts can provide medical care and treatment options that are tailored to each patient’s needs.
Treatment of Voice Disorders
Vocal hygiene includes avoiding activities that can damage the vocal cords, such as smoking, drinking alcohol, and shouting or screaming. Additionally, it is important to practice good vocal hygiene habits such as drinking plenty of water, avoiding caffeine and dairy products, and using a humidifier in dry environments.
Lee Silverman Voice Therapy
Voice therapy and neck surgery are two of the most common treatments for voice disorders. Lee Silverman Voice Therapy (LSVT) is a speech-language therapy program that focuses on improving vocal loudness, pitch, and quality. This type of therapy involves vocal exercises such as sustained phonation, breath support, and resonance exercises.
Resonant Voice Therapy
Resonant Voice Therapy (RVT) is another form of speech-language therapy that focuses on improving vocal health and quality by using techniques such as vocal warm-ups, relaxation techniques, and breathing exercises.
Both LSVT and RVT can be used in conjunction with other treatments, such as neck surgery or medication, to help improve the patient’s overall voice quality. A Speech Therapist can provide guidance on which treatment option best suits each patient’s needs.
Risk of Untreated Voice Injuries
Voice disorders can have serious consequences if left untreated. Without proper diagnosis and treatment, voice injuries can lead to permanent damage to the vocal cords, resulting in a permanently hoarse or breathy voice. Untreated voice injuries can lead to chronic pain and discomfort in the throat and neck area, as well as difficulty in speaking or singing for long periods of time. Furthermore, if left untreated, voice injuries can cause significant psychological distress due to the inability to communicate effectively with others.
Schedule an appointment with our voice experts!
If you are experiencing any voice disorder symptoms, don’t hesitate to schedule an appointment with the vocal specialists at Penn Medicine Becker ENT & Allergy Center. Our experts provide comprehensive care and treatment options tailored to each patient’s individual needs. With our expert care, we can help you get back to speaking and singing with ease. Book an appointment to start your journey toward better vocal health!
*Note: It is absolutely crucial that you seek out care from a team with experience in care for professional voice users. Not all Ear, Nose, and Throat Doctors specialize in care for professional voice users. When you get an exam of your voice, it should be a video stroboscopic examination, which is an exam performed with slow-motion imaging, recorded on a screen, and played back for you and explained in detail. If you do not receive this comprehensive care and evaluation level, you should seek a second opinion.
**Additionally, if you are a professional voice user and rely on your voice for a living, we recommend you consider getting a baseline exam. This means you come for a video stroboscopic examination when feeling 100% vocally and physically healthy. Not everyone’s vocal folds appear anatomically normal, and that is okay. When you are feeling vocally normal, we can assess the structure and function of your vocal folds and know what your baseline looks like. Therefore, if you ever encounter a symptomatic problem in the future, you will know what your baseline is to compare to and ensure no findings are incidental. You can take a video of your stroboscopic video on a phone or smart device and have it with you indefinitely.
“When it comes to vocal health, Carly Schiff absolutely changed the game for me. Her vast knowledge, skillful care and warm bedside manner made my post-injury healing process a breeze. Don’t even think twice, call her up and get your voice stronger than you ever thought it could be.”
“My experience with Dr.Lupa was fantastic… he was knowledgeable and patient with me while talking me through my exam. He then referred me to Carly Schiff to ensure that his findings were conclusive with hers and the end result is I will be having vocal cord surgery. I feel I am in good hands with both great bed side manner as well as the ENT Dr that could be performing my surgery. He has made me feel confident with this procedure and it has made me feel comfortable with the necessity to move forward to heal from this constant I have had for a while. I highly recommend this practice as well as Dr. Lupa and Carly Schiff, vocal therapist. Thank you… and for the great staff that also was very nice.”
“Finished a series of extraordinarily helpful therapy sessions with Speech-Language Pathologist Carly Schiff, following a superb test/evaluation visit that I have reviewed separately. Each therapy session focused on particular aspects of my condition (speech, swallowing and associated breathing), and was a truly educational experience. She really took the time for the exercises to be clearly explained and practiced, providing me with good understanding of their rationale and function in my recovery. In addition to being an extremely talented and caring professional, she has a great friendly and helpful attitude.”
— RIM
convenient locations in NJ & PA
Frequently Asked Questions
About Professional Voice Disorders
What does an ENT do for voice disorders?
An ENT (ear, nose and throat specialist) can diagnose and treat voice disorders involving vocal cord lesions. They (or the speech language pathologist team member) will evaluate the condition of the vocal cords using a strobe light and laryngoscope to determine if there is any damage. Based on this evaluation, they will create a personalized treatment plan which may include medical treatment, such as speech therapy or medications, or even surgical interventions if necessary.
What voice disorder do professional singers have?
Professional singers commonly suffer from a voice disorder known as laryngopharyngeal reflux, which is caused by the backflow of stomach acid into the throat and vocal cords. This can cause irritation, inflammation, and damage to the delicate vocal tissues. Symptoms include hoarseness, throat clearing, and a feeling of something stuck in the throat.
Does an ENT treat vocal cord dysfunction?
Yes, an ENT can treat vocal cord dysfunction, though treatment often depends on the severity and cause of the disorder. Treatment may include medications to reduce inflammation or pain, changes in lifestyle habits (such as avoiding smoking or drinking alcohol), speech therapy, and in some cases, surgery to repair damaged tissue.
Is there surgery to improve voice?
Yes, there are surgical treatments available to improve voice. Professional voice care can help diagnose and treat any issues with the vocal cords. Treatment may include medications to reduce inflammation or pain, changes in lifestyle habits (such as avoiding smoking or drinking alcohol), speech therapy, and in some cases, surgery to repair damaged tissue of the vocal cords.
When should you see an ENT for vocal cords?
When you have a chronic cough, vocal tremor, hoarseness, or difficulty speaking that does not improve with time, it is important to see an ENT for an evaluation. An ENT will be able to diagnose the cause of your symptoms and develop a treatment plan to help correct any underlying conditions that may be causing your voice disorder. This might include medication, changes in lifestyle habits (such as avoiding smoking or drinking alcohol), speech therapy, and in some cases, surgery to repair damaged tissue.
How can voice disorders be corrected?
Voice disorders can be corrected with a comprehensive care plan tailored to the individual. This might include medication, changes in lifestyle habits (such as avoiding smoking or drinking alcohol), speech therapy, and in some cases, surgery to repair damaged tissue. For more complex conditions, an ENT may recommend a multidisciplinary approach involving other professionals such as speech-language pathologists and laryngologists. Treatment plans should be regularly reviewed and modified as necessary to meet the individual’s changing vocal needs.