The National Center for Voice and Speech 27/07/16, 2:46 PM

When I get a bad cold, my voice is often the final symptom to

Q recover. What is laryngitis and why does it often occur at the
end of a virus?

A Laryngitis is the inflammation of the vocal fold tissues. We often get

laryngitis at the end of a virus because of irritation of vocal fold tissue from
flu symptoms or viral-associated coughing and sneezing. Speaking with
irritated or swollen vocal folds may prolong the inflammation, so it may feel
like the voice is the last to recover after all other cold symptoms are gone.

Another aspect of slow recovery has to do with the body's natural healing
process, which involves the removal of dead cells. While vocal tissues are
undertaking this "clean up" task, the tissues are more viscous (thicker)
than normal.

Can exercises increase my singing range? Is it easier to add high

Q notes or low?

A Yes, singing exercises can help increase the singing voice range. You can
expand both your upper and lower range through developing your technique
and vocal flexibility with a trained voice teacher supervising your singing
and directing you with specific range-expanding exercises.

Generally, it is easier to add high notes. Singers may be able to add as

much as an octave to the upper range, while usually only 3-4 notes can be
added to the lower range.
Your range is somewhat limited by your own laryngeal physiology. Singers
should be cautious about pushing the voice higher or lower that what is
comfortable.

What is the most important preventative measure for having a

Q healthy voice for one's entire life?

A Many behaviors recommended for maintaining overall health also help

ensure a lifetime of good vocalization. This involves properly hydrating your
body with at least 64 ounces of water a day, using adequate support from
your abdominal muscles when you speak or sing, and avoiding vocally
abusive behaviors such as throat clearing, coughing, yelling, screaming or
prolonged loud talking. You should warm up your voice before you use it,
just as you stretch before exercising. You should also habitually speak at a
pitch that fits your voice.

Eating a healthy diet, exercising your body and your voice regularly, and
getting enough sleep are also important factors in vocal health. Managing
your stress level can also help. Be careful when taking over-the-counter
medications such as aspirin products (Aleve, Motrin, Advil, Aspirin, and
Excedrin) as they are blood thinners and can put you at greater risk for
sustaining a vocal fold hemorrhage (bleed).

Other medications such as antihistamines can be very drying to the voice.

Caffeine and alcohol are diuretics and actually remove fluid from your
tissues (including your vocal fold tissue!) Minimize your intake of these

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beverages, and drink an equal-sized glass of water for every caffeinated or

alcoholic beverage you drink to counteract the drying effects. [This is in
addition to the 64 ounces of water you should already be drinking.]

Q How do I find my natural pitch for speaking?

You can find your natural pitch range for speaking by listening to how you
A spontaneously say the sound "mm-hmm". The top note of your "hmm" is a
good place to start. Try sustaining the pitch of the "hmm" and move into a
phrase you'd typically say. For example, "mm-hmm-mm-how are you?" If
this pitch range differs substantially from the pitch you typically use when
speaking, you are not at an optimal pitch and could be straining your voice
to maintain that pitch. Other indicators of natural pitch can be your laugh
or cough.

Talking and singing sound different from one another, but

Q anatomically, what is really the difference?

A Your speaking and singing voice are created from the same exact
anatomical structures. The respiratory system (lungs diaphragm and
abdominal muscles), laryngeal mechanism (vocal folds, laryngeal cartilages,
muscles and nerves) and the supraglottic tract (the spaces above the vocal
folds, including the back of your throat, mouth, nasal passages and sinus
cavities) all work to produce the beautiful sounds you make.

Speaking doesn't require as much lung pressure as singing - particularly in

classical singing - but you still need to support the speaking voice. Singing
involves the utilization of more of the supraglottic spaces for resonance,
and the vowels are prolonged. Otherwisethey are almost identical. Just a
note: your speaking and singing voice should sound almost identical in your
speaking voice pitch range.

How come when people with a strong regional accent (i.e.,

Q Southern) or stuttering problem don't manifest it when they
sing?

A When people speak with an accent, they produce the vowel sounds
differently than the person identifying them as having an accent. When
singing, the vowels are prolonged and those differences are minimized.

People who stutter may have an easier time singing because of several
possible reasons:

The support required in singing keeps the continuous voicing and

airflow components moving easily.
Words are provided in singing, so the challenge of deciding what
words to say isn't present.
Some feel that stuttering is a neurological disorder; the neural
pathways involved in speech are disrupted somehow. Singing involves
more right-hemisphere brain functions as compared to speaking,
which is left-hemisphere dominated. Thus, singing may be easier to
initiate and sustain than speech.

If I have a sore throat, is it a good idea to whisper until I'm

Q feeling better?
Actually, you may be better off using your normal voice gently and quietly
A rather than whispering. Whispering can alter the manner in which your vocal

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folds come together, often compressing the vocal folds in the middle where
your tissue is most likely to swell when your are sick. Whenever you have a
sore throat, you should minimize your voice use if possible. If you are
uncertain whether you are safe to use your voice, it is always best to see
an otolaryngologist who specializes in voice care.

I have heard that it is a good to do vocal warm-ups before

Q extensive singing or speaking. What exercises do you
recommend?
It is always important to warm-up your voice before any kind of singing or
A speaking. Gentle humming exercises, lip or tongue trills and breath-
stimulating exercises like Ya-ha-ha-ha-ha (1-3-5-3-1) with a release in
between each note are good for warming up the voice. Your volume should
stay around mp (medium soft). You may also want to see Dr. Titze's
webpage, Top Vocal Warm-ups for Singers.

Why do male voices "crack" when young men are going through
Q adolescence? How long does this stage last?

A The young male voice cracks because of substantial changes occurring in

the larynx during adolescence. The vocal folds grow 4-11 mm, and the
tissue underneath the mucosa of the vocal folds (the lamina propria)
develops. This process can begin anytime between the ages of 12 and
14 and is usually complete by age 15.

Sometimes I run out of breath when I'm speaking. Can I build in

Q "air reserves"?
Running out of breath when speaking is rarely a symptom of not having
A enough air in your lungs. It usually indicates that you are not using your
breath economically or efficiently as you speak. If this happens to you
frequently, you would be wise to have a full voice evaluation to make sure
your vocal mechanism is working properly. If your vocal mechanism is
functioning normally, you can learn how to support your voice optimally
with several sessions of voice therapy and not have this problem in the
future.

Q What is a nodule? Is it the same thing as a polyp?

A nodule is a benign growth on the vocal fold that usually occurs on both
vocal folds and is caused from chronic vocal abuse (kind of like a callus). A
polyp is also typically a benign vocal fold growth, although polyps generally
occur only on one side and often arise from a traumatic incident to the
vocal folds, e.g., after a vocal fold hemorrhage or mucosal tear.

Actresses like Demi Moore and Kathleen Turner have gravelly-

Q sounding voices. They can't have laryngitis ALL the time. What
gives?
Some actresses are well known for their low-pitched and slightly hoarse
A vocal quality and want to maintain this quality. This kind of chronic
hoarseness or a gravelly-sounding voice quality is often an indication of
chronic abuse and/or the presence of a vocal fold mass(es) like a polyp or
vocal fold nodules. I have heard anecdotal evidence of an actress screaming
daily just to maintain the husky voice and nodules. As a voice pathologist, I
do not recommend trying this at home.

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Q What is the difference between a vocal fold and a vocal cord?

They are the same thing. However, over the past decade, we have learned a
A tremendous amount about the vocal mechanism. This has led to a greater
understanding of the vocal fold anatomy and physiology involved in voice
production. We now understand that the "vocal cord" is really made up of
muscle, three different layers of tissue in a structure called the 'lamina
propria' and a layer of mucosa that moves in a wave-like motion over the
lamina propria. This led to the change of terminology from "vocal cord" to
"vocal fold", as the structure is more like a fold of muscle and tissue
vibrating in a complex manner (especially at low pitches) rather than a
"cord" merely vibrating with air.

Q How can I find a good medical team to help improve my voice?

A There is a voice team locator in the Nurse's Office at the Voice Academy
website (www.voiceacademy.org). Otolaryngologists (ear-nose-throat
doctors) specializing in voice are listed by city and state. Ideally, these
otolaryngologists work closely with speech-language pathologists and
advocate a team approach to voice care.

You may contact the American Speech-Language-Hearing Association and

ask for a list of speech-language pathologists that are part of the Special
Interest Division-3 (Voice). ASHA's telephone number is 301/897-5700.

You may also contact us the National Center for Voice and Speech, and we
will attempt to find a voice pathologist/vocologist in your geographic area.
E-mail the NCVS.

What changes should an elderly person expect in her voice? His

Q voice?

A Several changes can occur in the voice with the aging process. However,
just as with the rest of the body, many changes can be stalled with regular
exercise and overall healthy lifestyle choices (such as adequate hydration, a
nutritious diet, and avoidance of vocal irritants such as cigarette smoke).
Typical changes due to aging include possible:

atrophy (weakening) of muscles and nerve tissues resulting in vocal

fold bowing;
stiffening or arthritic arytenoid joints, causing incomplete vocal fold
closure and subsequent breathy vocal quality;
vocal fold tissue thinning and wasting with lesser vibration, causing
hoarse and/or breathy voice;
roughening of the vocal fold edge, perhaps caused by depletion of
the mucosal layer.

Other changes can occur due to changes in hormone levels:

Women can have a lowering of pitch from the loss of estrogen in

their bodies during and after menopause. This can be prevented or
reversed with estrogen replacement therapy.
Men's voices tend to get higher as they age, as their levels of
testosterone drop.

I am a 21-year old female. Yet my voice sounds like a little girl. I

Q will be interviewing for jobs right after graduation. What can I do
to sound more professional?

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My best advice for you would be to work with a voice pathologist

A (vocologist) on how to utilize your resonant space for a more mature and
professional sound. You may also be keeping your larynx at a very high level
that limits your vocal flexibility and depth of sound. A few sessions of voice
therapy can teach you how to optimize your voice production.

I read that clearing your throat too much is bad for your voice.
Q Why? It seems that having excess mucous in your throat makes it
harder to speak.

A Clearing your throat is very abusive to the vocal fold tissue, as you basically
are grinding the vibratory edge of each vocal fold against the other. This
causes swelling and irritation of the vocal fold in the middle of the vibratory
edge, which then hits first before any other part of the vocal fold. Chronic
irritation and swelling in this area can lead to the formation of vocal fold
masses such as nodules.

The other aspect of the throat clear, as much as it feels like it clears off the
mucous, only moves the mucous to the side of the vocal folds, and that
mucous eventually makes its way back to the vibratory edge. This begins
the viscous cycle of constant throat clearing.

There are better alternatives to clearing away the excess mucous:

a silent coughsay the word "huh" with oomph from your belly
without voicing followed by a swallow (kind of like coughing, but
without voice)
humming can move away the mucous
a sip of water can move away the mucous
a gentle cough with lots of air in front of it is still less abusive than a
throat clear.

Q What are some good tips for a pleasant "telephone voice"?

A Speak at a comfortable pitch and loudness with appropriate support.

Speak slowly and clearly so people understand you but not
unnaturally slow.
Smile! A smile can be detected as pleasantness in your voice.

What can you do to protect your voice if your job includes

Q extensive speaking (for example, a receptionist)?
Practice good vocal hygiene, as described above. If you are using your voice
A optimally, you should not have a problem with your voice. If you are having
difficulties, get some voice training to optimize the way in which you use
your voice.

Why can some people smoke, drink, stay up all night and yet have
Q a good-sounding voice, and other people seem to have so much
trouble?
Not all larynges are created equally. Some people are genetically more
A prone to injury of the vocal mechanism, as in other parts of the body.
Usually, however, that kind of destructive behavior eventually catches up
with even the most robust of larynges.

Do you have a question for the NCVS? Contact us. We will do our best to respond quickly to inquiries and post questions
and answers which would be of interest to many.

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