Vocal problems: their prevention and care

  • Meribeth A. Bunch


Speech is such a vital and immediate means of communication that when it is lost, the best of substitutes is found severely wanting, for loss and/or damage to the larynx and absence of powers of vocalisation are major deprivations, even tragedies. Informed singers are acutely aware of the need to prevent vocal damage, however many potential singers are uninformed and unfortunately early warnings are so insidious that they are often overlooked. Hoarseness, even in the absence of discomfort, is nature’s signal to rest the voice, yet unwisely most people tend to force it to function despite this sign of overwork.


Vocal Fold Vocal Tract Vocal Quality Vocal Production Voice Therapy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. Abitbol J, de Brux J, et al (1989) Does a hormonal vocal cord cycle exist in women? Study of vocal premenstrual syndrome in voice performers by videostroboscopy-glottography and cytology on 38 women. J Voice 3(2): 157–162.Google Scholar
  2. Aronson AE (1980) Clinical voice disorders, an interdisciplinary approach. New York: Brian C Decker.Google Scholar
  3. Baker HL jr (1986) The application of magnetic resonance imaging in otolaryngology. Laryngoscope 96(1): 19–26.PubMedGoogle Scholar
  4. Baker DC jr (1962) Laryngeal problems in singers. Laryngoscope 72: 902–908.PubMedGoogle Scholar
  5. Baldwin M (1989) Healthy singing. Seminol Neurol 9(2): 117–118.Google Scholar
  6. Bastian R (1984) Hoarseness in singers. The NATS Bull 40(3): 26–27.Google Scholar
  7. Batza EM (1971) Vocal abuse in the rock-and-roll singer. Cleve Clin Q 38: 35–38.PubMedGoogle Scholar
  8. Bauer H (1968) Die Beziehungen der Phoniatrie zur Endokrinologie. Folia Phoniatr (Basel) 20: 387–393.Google Scholar
  9. Beck J (1961) Beeinflussung des Kehlkopfes durch Hormone. Zschr Laryngol Rhinol Otol 40: 444–446.Google Scholar
  10. Bellussi G (1971) Professional arrangements for medical care of singers and actors in Italy. Folia Phoniatr (Basel) 23: 25–257.Google Scholar
  11. Better NM (1991) What’s in a voice-or, worse, is not? (Voice therapy, drug therapy and surgery may cure vocal ulcers, vocal polyps and laryngitis but preventative meaures are best). The New York Times, June 23.Google Scholar
  12. Bohme G (1975) Gerontologische Untersuchungen über Stimmumfang und Sprechstimmlage. Folia Phoniatr (Basel) 22: 176–184.Google Scholar
  13. Boone DR (1977) The voice and voice therapy. Englewood Cliffs: Prentice-Hall.Google Scholar
  14. Boone DR (1991) Is your voice telling on you? (How to find and use your natural voice). London: Whurr Publishers.Google Scholar
  15. Boone DR, McFarlane SC (1988) The voice and voice disorders, 4th edn, pp 49–75. Englewood Cliffs: PrenticeHall.Google Scholar
  16. Brodnitz F (1954) Voice problems of the actor and singer. J Speech Hear Dis 19: 322–326.Google Scholar
  17. Brodnitz F (1962) The holistic study of the voice. Q J Speech 48: 280–284.Google Scholar
  18. Brodnitz F (1971) Vocal rehabilitation. Rochester: American Academy of Ophthalomology.Google Scholar
  19. Brodnitz F (1988) Keep your voice healthy, 2nd edn. New York: Harper and Row.Google Scholar
  20. Brown WS jr, Hollien H (1982) Effect of menstruation on fundamental frequency. In: Lawrence V (ed) Transcripts of the Xth symposium: care of the professional voice, part I, pp 94–101. New York: The Voice Foundation.Google Scholar
  21. Browne L (1885) Voice use and stimulants. London: Sampson Law, Marston, Searle and Rivington.Google Scholar
  22. Bull T, Cook J (1976) Speech therapy and ENT surgery. Oxford: Blackwell.Google Scholar
  23. Caine A (1991) The voice workbook. Use your voice with confidence. England: Hodder and Stoughton.Google Scholar
  24. Charkhalashvili GE (1989) Significance of relexogenic areas of the larynx in the treatment of professional singers. Vestn Otorinolarigol J 1: 59.Google Scholar
  25. Chernobelskii SI (1985) Hormonal contraceptives and singers’ voices. Vestn Otorinolaringol 5: 62–63.Google Scholar
  26. Coleman RF (1987) Performance demands and the performer’s vocal capabilities. J Voice 1: 209–216.Google Scholar
  27. Colton RH, Casper JK, (1990) Understanding voice problems: a physiological perspective for diagnosis and treatment, pp 310–311. Baltimore: Williams & Wilkins.Google Scholar
  28. Cooper M (1973) Modern techniques of vocal rehabilitation. Springfield: Charles C Thomas.Google Scholar
  29. Cooper M (1982) The tired speaking voice and the negative effect on the singing voice. The NATS Bull 39(2): 11–14.Google Scholar
  30. Cornut G, Bouchayer M (1972) Apport de la microchirurgie laryngee dans le traitement du nodule de la corde vocale. Folia Phoniatr (Basel) 24: 431–437.Google Scholar
  31. D’Orsay C (1895) Correct voice use as a preventative to throat diseases. London: The Dore Press.Google Scholar
  32. Damsté, PH (1964) Virilization of the voice due to anabolic steroids. Folia Phoniatr (Basel) 16: 10–18.Google Scholar
  33. Damsté PH (1967) Voice change in adult women caused by virilizing agents. J Sp Dis 32: 126–132.Google Scholar
  34. Damsté PH, Lerman JW (1975) An introduction to voice pathology: functional and organic. Springfield: Charles C Thomas.Google Scholar
  35. Dordain M (1972) Etude statistique de l’influence des contraceptifs hormonaux sur la voix. Premiers resultats. Folia Phoniatr 24: 86–96.Google Scholar
  36. Duffy M (1991) Why golden voices fade. Restraint is the key to a long reign at the top. Time 6: 74.Google Scholar
  37. English GM (1976) Otolaryngology. New York: Harper and Row.Google Scholar
  38. Eremenko VN, Shkoba IV, Manzhura NP, Makukha AL (1990) Singer’s nodes. Vrach Delo 3: 104–105.PubMedGoogle Scholar
  39. Filter MD (1974) Proprioceptive-tactile-kinesthetic feedback in voice therapy. Lang Sp Hear Serv 5: 149–151.Google Scholar
  40. Finney G (1977) Vocal exercise and nineteenth century hygiene in France. Clio Med 12: 147–171.PubMedGoogle Scholar
  41. Flach M, Schwickardi H, Simon R (1969) Welchen Einfluß haben Menstruation und Schwangerschaft auf die ausgebildete Gesangsstimme? Folia Phoniatr (Basel) 21: 199–210.Google Scholar
  42. Formby C, Thomas RG, Halsey JH jr (1989) Regional cerebral blood flow for singers and non-singers while speaking, singing and humming a rote passage. Brain Lang 36(4): 690–698.PubMedGoogle Scholar
  43. Froeschels E (1952) Chewing method as therapy. Arch Otolarlyngol 56: 427–434.Google Scholar
  44. Fukuda H, Kawaida M, Oki K, et al (1990) Laryngostrobovideography using a flexible laryngofiberscope performed in conjunction with the phonatory examination. Keido J Med 39(2) 102–105.Google Scholar
  45. Gould WJ, Lawrence V (1984) Surgical care of voice disorders. New York: Springer.Google Scholar
  46. Green M, Mathieson L (1989) Voice and its disorders, 5th edn. London: Whurr Publishers.Google Scholar
  47. Greene HP (1924) Interpretation in song. London: Macmillan.Google Scholar
  48. Griffiths C, Bough D jr (1989) Neurologic diseases and their effect on voice. J Voice 3(2): 148–156.Google Scholar
  49. Guillemin M, Cohn T, Melnechuck (eds) (1985) Neural modulation of immunity. New York: Raven Press.Google Scholar
  50. Habermann G (1971) Vocal diseases of singers. HNO 19: 129–137.PubMedGoogle Scholar
  51. Harma R, Sonninen A, Vartiainen E (1975) Vocal polyps and nodules. Folia Phoniatr (Basel) 27: 19–25.Google Scholar
  52. Hirano M, Hibi S, Yoshida T, et al (1988) Acoustic analysis of pathological voice. Some results of clinical application. Acta Otolaryngol (Stockh) 105(5-6): 432–438.Google Scholar
  53. Hollien H (1980) Vocal indicators of psychological stress. Ann NY Acad Sci 347: 47–72.PubMedGoogle Scholar
  54. Horii Y, Fuller BF (1990) Selected acoustic characteristics of voices before intubation and after extubation. J Speech Hear Res 33(3): 505–510.PubMedGoogle Scholar
  55. Isshiki N, Yanagihara N, Morimoto M (1966) Approach to the objective diagnosis of hoarseness. Folia Phoniatr (Basel) 18: 393–400.Google Scholar
  56. Jackson MC (1982) The voice of the young singer. Folia Honiatr (Basel) 34(5): 276–280.Google Scholar
  57. Jellinek A (1956) Treatment of vocal disorders with spontaneous imagery. Folia Phoniatr (Basel) 8: 75–85.Google Scholar
  58. Kazhlaev OM, Butusov AD (1983) Determination of the vocal field in singers with laryngeal diseases. Vestn Otorinolaringol 2: 55–59.PubMedGoogle Scholar
  59. Lacina O (1968) The influence of menstruation on the voice of female singers. Premenstrual laryngopathy. Folia Phoniatr (Basel) 20: 13–24.Google Scholar
  60. Lacina O (1970) Die adduktionelle Asymmetrie des Kehlkopfes bei den Sängern (Assymetria Arytaenoidea Cruciata Cantatorum). Folia Phoniatr 22: 100–106.Google Scholar
  61. Lacina O (1972) Das Vorkommen von Stimmlippenknötchen bei den Sängern. Folia Phoniatr (Basel) 24: 345–354.Google Scholar
  62. Laguaite JK (1972) Adult voice screening. J Speech Hear Dis 37: 147–151.Google Scholar
  63. Lawrence JL (1979) Care of the professional voice. Transcripts of the Vlllth symposium. New York: The Voice Foundation.Google Scholar
  64. Lawrence JL (1980) Care of the professional voice. Transcripts of the IXth symposium. New York: The Voice Foundation.Google Scholar
  65. Lawrence JL (1981) Laryngoscope. The NATS Bull 37: 23–25.Google Scholar
  66. Levin NM (1962) Voice and speech disorders: medical aspects. Springfield: Charles C Thomas.Google Scholar
  67. MacKenzie M (1890) The hygiene of the vocal organs. London: Macmillan.Google Scholar
  68. MacKenzie SM (1928) The hygiene of the vocal organs. A practical handbook for singers and speakers. Belmar: Werner.Google Scholar
  69. Martin F (1988) Drugs and vocal function. J Voice 2(4): 338–344.Google Scholar
  70. Moore GP (1977) Have the major issues in voice disorders been answered by research in speech science? J Speech Hear Dis 42: 152–160.Google Scholar
  71. Novak A, Dlouha O, Capkova B, Vohradnik M (1991) Voice fatigue after theater performance in actors. Folia Phoniatr Basel 43(2): 74–78.PubMedGoogle Scholar
  72. Olson N (1983) Effects of stomach acid on the larynx. Proc Am Laryngol Assoc 104: 108–112.Google Scholar
  73. Perkins W (1978) Mechanisms of vocal abuse. In: Weinberg B (ed) Care of the professional voice, pp 106–115. New York: The Voice Foundation.Google Scholar
  74. Perkins WH (1975) Normal vocal tone generation: detection, diagnosis and management of vocal tone generation. In: Tower D (ed) Human communication and its disorders, vol 3: the nervous system, pp 505–514. New York: Raven Press.Google Scholar
  75. Poole JL (1989) Weight and the singing voice (Viewpoint column). Opera News 3: 4.Google Scholar
  76. Punt NA (1979) The singer’s and actor’s throat, 3rd edn. London: Heinemann Medical Books.Google Scholar
  77. Raymond T (1922) Singing for health. London: CW Daniel.Google Scholar
  78. Redenbaugh MA, Reich AR (1989) Surface EMG and related measures in normal and vocally-hyperfunctional speakers. J Speech Hear Dis 2: 68.Google Scholar
  79. Reker U (1990) Measuring the voice field in general ENT practice. How, when why? HNO 38(10): 349–354.PubMedGoogle Scholar
  80. Rodenberg P (1992) The right to speak. Working with the voice. London: Methuen.Google Scholar
  81. Rubin W (1988) Allergic, dietary, chemical, stress, and hormonal influences in voice abnormalities. J Voice 1(4): 378–385.Google Scholar
  82. Sanada T, Tanaka S, Hibi S, et al (1990) Relationships between the degree of lesion and that of vocal dysfunction in vocal fold polyp. Nippon Jibiinkoka Gakkai Kaiho 93(3): 388–392.PubMedGoogle Scholar
  83. Sataloff RT (1983) Physical examination of the professional singer. J Otolaryngol 12(5): 277–281.PubMedGoogle Scholar
  84. Sataloff R (1981) Professional singers: the science and art of clinical care. Am J Otolaryngol 2: 251–266.PubMedGoogle Scholar
  85. Sataloff R (1987) The professional voice, part I. Anatomy function, and general health. J Voice 1(1): 92–104.Google Scholar
  86. Sataloff R (1987) The professional voice, part II. Physical examination. J Voice 1(2): 191–201.Google Scholar
  87. Sataloff RT (1991) Professional voice: the science and art of clinical care. New York: Raven Press.Google Scholar
  88. Sataloff RT (1987) The professional voice, part III. Common diagnoses and treatments. J Voice 1: 283–292.Google Scholar
  89. Sataloff RT (1990) Medical problems of the aging singer. In: Abstracts, Pacific Voice Conference, San Franscisco.Google Scholar
  90. Schlondorff G (1966) Anabolic hormones and vocal disorders. Dtsch Med Wochenschr 91: 555–557.Google Scholar
  91. Silverman EM, Zimmer LH (1978) Effect of the menstrual cycle on voice quality. Arch Otolaryngol 104: 7–10.PubMedGoogle Scholar
  92. Snyderman C, Weissmann J, Tabor E, Curtin H (1991) Crack cocaine burns of the larynx. Arch Otolaryngol Head Neck Surg 11(7): 792–795.Google Scholar
  93. Söderström E (1979) In my own key. London: Hamish Hamilton.Google Scholar
  94. Sonninen A (1970) Phoniatric viewpoints on hoarseness. Acta Otolaryngol 263: 68–81.Google Scholar
  95. Sonninen A, Damsté PH, Jol J, Foktrens J (1972) On vocal strain. Folia Phoniatr (Basel) 24: 321–332.Google Scholar
  96. Subtelny J, Li W, Whitehead R, Subtelny JD (1989) Cephalometric and cineradiographic study of deviant resonance in hearing-impaired speakers. J Speech Hear Disord 54(2): 249–263.PubMedGoogle Scholar
  97. Takahashi H, Koike Y (1975) Some perceptual dimensions and acoustical correlates of pathologic voices. Acta Otolaryngol [Suppl] 338.Google Scholar
  98. Tanaka S, Hirano M, Tanaka Y, Fujita M (1991) Transcutaneous intrafold injection result and its influencing factors. Nippon Jibiinkoka Gakkai Kaiho 94(6): 817–822.PubMedGoogle Scholar
  99. Tarneaud J (1947a) Importance de la constitution anatomique des cordes vocales dans la formation du nodule. Folia Phoniatr (Basel) 1: 63–69.Google Scholar
  100. Tarneaud J (1947b) Une laryngopathie fonctionnelle: la voix aggravee. Folia Phoniatr (Basel) 1: 7–14.Google Scholar
  101. Tomatis A (1974) La reeducation di la voix — les different méthodes de traitment. La Vie Medicale 20: 120–124.Google Scholar
  102. Tomatis A (1960) La voix chantee — sa physiologie — sa pathologie — sa reeducation. Cours dei l’Hopital Bichat, March.Google Scholar
  103. USA Today (1990) Don’t ignore. hoarseness 19: 14–00.Google Scholar
  104. Wasicko MJ, Leiter JC, Erlichman JS, et al (1991) Nasal and pharygeal resistance after topical mucosal vasoconstriction in normal humans. Am Rev Respir Dis 144(5): 1048–1052.PubMedGoogle Scholar
  105. Weiss DA (1951) The chewing approach in speech and voice therapy. New York: S Karger.Google Scholar
  106. Wendler J (1972) Zyklusabhängige Leistungsschwankungen der Stimme und ihre Beeinflussung durch Ovulationshemmer. Folia Phoniatr (Basel) 24: 259–277.Google Scholar
  107. Wilson DK (1979) Voice problems of children. Baltimore: Williams and Wilkins.Google Scholar
  108. Xu JH, Ikeda Y, Komiyama S (1991) Bio-feedback and the yawning breath pattern in voice therapy: a clinical trial. Amis Nasus Larynx 18(1): 67–77.Google Scholar
  109. Yonick TA, Reich AR, Minifie FD, Fink RB (1990) Acoustical effects of endotracheal intubation. J Speech Hear Disord 4: 427.Google Scholar

Copyright information

© Springer-Verlag Wien 1995

Authors and Affiliations

  • Meribeth A. Bunch
    • 1
  1. 1.LondonEngland

Personalised recommendations