The Importance of the Team Approach

Weekly Teaching Tip – Dec. 9, 2013
by Dr. Curt Stock, ENT

I recently had an experience that reinforced  the  importance of the Team Approach to the Singers Voice. One of the most common etiologies of hoarseness I see in my practice is Muscle Tension Dysphonia (MTD). This is an important diagnosis for Singing Teachers to understand. It is usually manifested with hoarseness, strained voice,  use of neck accessory muscles and sometimes pain or discomfort in the neck.  MTD is frequently seen in high stressed individuals and people who try to project and constantly use their voice. On laryngoscopy the false vocal folds are often over active and the larynx is usually high.

This was the case with A 15 year old female was seen by another otolaryngologist and referred to my associate Anna Siciliano,Speech and Language Pathologist at the Voice Center.Anna also identified that she was a “voice over doer”, which further complicated her MTD*.  After several visits with many of the poor speech habits corrected  and massage for the muscle tension she was sent to my wife, Teri Stock for an evaluation on her singing voice and technique.

On the initial “discovery” interview”he patient described her singing experience as becoming more and more painful. She no longer found singing pleasurable  and thought she may never sing again.Teri was expecting to hear someone locked in chest and trying to pull weight. What she found was quite the opposite. She determined she was very airy on the diagnostic 5 tone ah through all her range It was noted that her larynx was very high . It was soon discovered this young lady had never experienced chest voice and was amazed at this new sensation in her chest.Once Teri helped her  discover her chest voice and as the patient carefully monitored her larynx(keeping her finger under her chin) she was able to move through 3 and 1/2 octaves of range with no tension or pain.Even though the patient had worked with a vocal coach for several years, she had grown up and never moved from use of her pre pubertal head voice into use of her head and chest, thus developing problems with her singing and speaking voice as she matured.

* please note my description of Anna’s work is very simplified.

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