Ask the BVA...
23rd April 2008
Welcome to “Ask the BVA” webpage. This is a new idea inspired by the many enquiries we receive at the BVA office. Most of these enquiries are from members or from the general public who are worried about their own or a relative/friend’s voice. These enquiries are mainly requests for information or advice however, some have asked if there is a support group available for people suffering from voice disorders. As far as we are aware, no support groups exist for patients whose primary problem is a voice disorder. We are therefore starting “Ask the BVA” so that more BVA members and the general public can benefit from the information and advice provided for common problems/enquiries. We also hope this new webpage will help determine if there is a need for some form of support for those with voice disorders, however, we must stress that the advice given does not necessarily represent the views of the BVA, nor can the BVA be held responsible for it.
Anyone with a voice related query or who would simply like to be in touch with others having similar problems is welcome to contact the BVA. We will post a new enquiry on the website at regular intervals, probably approximately every three months. The enquiry email will be placed on the website anonymously to protect the identity of the enquirer. Anyone wishing to respond to the posted enquiry with information or support from their own experience can do so via the BVA. We will forward these responses to the enquirer who can then choose to make contact or not as they wish. No one will have their enquiry posted on the website without their permission. Anyone wishing to “Ask the BVA” can contact Sara Harris, Communications Officer via the BVA at bva@dircon.co.uk
23rd April 2008
Our first contribution to “Ask the BVA” is from a singer experiencing problems with the upper range of her voice. I am very grateful to her for allowing us to use her enquiry to get this new section off to a good start.
I'd be very grateful for some advice. I'm a 50 year old (amateur) mezzo soprano and have had singing lessons for a number of years. I have reached the point where my teacher felt it unnecessary to have regular lessons but to go to her when I had a concert coming up. However, for almost a year now I have had increasing difficulty with the top end of my voice and have occasionally noticed that at the transition from chest to head voice I almost produce two notes at the same time. I have had laryngoscopic and stroboscopic examinations and consulted with a speech therapist who can find nothing organically wrong. I had to visit my doctor today about something else and asked her what the latest ENT specialist had actually said in his report and when she showed it to me it mentioned 'some vibration of the false vocal cords and vocal constriction at higher pitch'. Can you help me to interpret this? I'm afraid that all the 'experts' I have seen so far have no interest at all in the singing voice which has been very disappointing.
I hope you can help?
Sara Harris replies:
Your query was passed to me as I am a speech and language therapist specializing in voice disorders. Without actually seeing what is actually happening on the stroboscopy I can only make a "best guess". It sounds from the description you have given as though the problems you are suffering are largely due to some muscle fatigue.
Many singers have never been reminded to warm their voices down following singing. As a result, they lose touch with the lower pitch range and the use of chest voice for speech. This is very important, as it relaxes the muscles that lengthen and thin down your vocal folds to raise pitch to reach the upper singing range. You can imagine that if you leave these muscles "switched on" all the time you are using your voice for speaking that it is not surprising that when you try to sing, the muscles can no longer function efficiently. As a result your vocal folds begin to lose their closure in the upper mid and top pitch range. The voice begins to be breathy, unstable, break and give the "two notes" (diplophonia) symptoms you describe.
As the singer begins to struggle with this range they start to recruit other muscles to try and help them maintain the vocal fold closure. The "false folds" are bands of tissue lying above the true vocal folds that normally only close when we seal air in the lungs for effortful activities such as forcing, pushing and straining. When they are recruited into the process of singing it is nearly always a compensation for the fact that the muscles that should be working are "taking a holiday". The squeezing action and muscular effort of closing both the false and true folds is referred at "constriction". Usually the problem can be resolved with voice therapy from an experienced speech/language therapist specializing in voice disorders with singers.
Many speech therapists are now running what we call treatment clinics. In these clinics we use a small camera on a flexible fibrescope which is passed through the nose so that the patient can continue to speak or sing without interfere within the mouth. This allows the therapist to see what happens when the symptoms occur and understand the problem better. If you let me know where you live I can probably tell you where your nearest appropriate voice service can be found.
I hope this explanation helps you and that you can get some appropriate help to resolve the problem. If I can be for further help let me know.
Best wishes, yours sincerely, Sara Harris
Sara Harris can be contacted via the BVA at bva@dircon.co.uk