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Voice Resource Articles

Voice Case of the Week: When Nodules Need Surgery

Osborne Head and Neck Institute Case Presentation:

vocal-nodules-surgery

The patient is a 32 year old singer who presented with significant worsening of her voice over a 3 month period. She is in meetings most of the day and this involves significant voice use, including occasional loud voice use. She then is in rehearsals or in the studio in the evenings. She now is having discomfort associated with voice use and difficulty projecting her voice without significant effort. Her vocal range is also decreased, but she is able to push to access her full voice. She is a non-smoker and rarely drinks alcohol. She is not on any prescription or non-prescription medications or supplements.

Click here for Los Angeles, laryngologist, Dr. Reena Gupta, MD’s diagnosis.

Voice Case of the Week: Who Needs a Laryngeal Surgeon?

Osborne Head and Neck Institute Case Presentation:

The patient is a 34 year old male professional singer who presented with difficulty in his vocal break. His speaking voice sounded slightly raspy to him but more troublesome was that he could not do his vocal exercises as easily as he used to be able to. He noted the onset of his symptoms after a cold. During his illness, he had an important gig and so he did the show but had to push through it to perform.

Click here for Los Angeles, laryngologist, Dr. Reena Gupta, MD’s diagnosis.

Voice case of the Week: Prolonged Vocal Hemorrhage from Herbals

Osborne Head and Neck Institute Case Presentation:

The patient is a 43 year old female who presented with occasional hoarseness for the past year. She noted her voice was normal at times. Her most recent episode of hoarseness, however, started 3 weeks ago and had not improved at all. She denied any associated symptoms, such as would be consistent with an illness. The patient is a lawyer and uses her voice frequently at work but does not shout or use her voice forcefully. She has no known medical problems and does not take any medications regularly. She takes an herbal supplement provided by her acupuncturist to promote vocal health.

Click here for Los Angeles, laryngologist, Dr. Reena Gupta, MD’s diagnosis.

Voice Case of the Week: Voice and Emotion

Osborne Head and Neck Institute Case Presentation:

A 23 year old female singer, well-known to the practice, presented with new onset of vocal symptoms. She noted that things had been going well since her last screening visit, which did not demonstrate any abnormalities. However, over the past month she had been having increasing vocal difficulty. She noted pain when she tried to sing, rapid onset of vocal fatigue while singing, and decreased vocal range. She stated her voice would crack and break when she tried to reach notes that were normally comfortable for her.

She denied any precipitating factors and noted no change in her general health since the onset of symptoms.

Click here for Los Angeles, laryngologist, Dr. Reena Gupta, MD’s diagnosis.

Voice Case of the Week: Timeline of Consultation for Hoarseness

Osborne Head and Neck Institute Case Presentation:

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The patient is a 59 year old male who presented with a 10 month history of throat clearing. He noted some mild voice changes approximately 2 months ago but states his voice has always been weak. He went to his primary care physician at the time of onset who felt this was allergies and prescribed him a nasal spray. When his symptoms did not improve one month later, antibiotics were attempted without any improvement.

Click here for Los Angeles, laryngologist, Dr. Reena Gupta, MD’s diagnosis.

Voice Case of the Week: Voice Doctors as Voice Patients

Osborne Head and Neck Institute Case Presentation:

los-angeles-vocal-cords-doctor

This week’s case features a patient you may know: me. I had an experience last weekend that gave me insight into the life of a singer. In medicine, we risk becoming detached from how it feels to be a patient. This is the tale of how I reconnected with that feeling.

Many of you know that I became a laryngologist because of my passion for the voice. This started at a young age, as I studied voice and performed locally. I continued my vocal studies through medical school, where enrollment in the medical school choir led me to discover laryngology. I had to hit the pause button on my voice pursuits during residency (where I also hit the pause button on exercise, eating and sleeping) but resumed singing during fellowship. My fellowship director mandated that fellows join the choir and take voice lessons. All the other fellows dreaded this but I would count down the days to practice with excitement. Voice took a back seat again when I moved to LA to grow my practice and family but last weekend, I was hit with the musical bug and knew I needed to study again.

Click here for Los Angeles, laryngologist, Dr. Reena Gupta, MD’s diagnosis.

Voice Case the Week: Prognosis Hinges on Diagnosis

Osborne Head and Neck Institute Case Presentation:

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The patient is a 40 year old female who has had significant vocal symptoms for several months. She has noted a decrease in her vocal range and increased effort during phonation. She previously saw a laryngologist, who diagnosed her with a vocal polyp. She was referred for voice therapy, but based on her failure to improve, went back to her surgeon for a surgical consultation. She did not feel comfortable with the recommendation and sought a second opinion here at the Osborne Head and Neck Institute.

Click here for Los Angeles, laryngologist, Dr. Reena Gupta, MD’s diagnosis.

Voice Case of the Week: The Value of a (Healthy) Screening Exam

Osborne Head and Neck Institute Case Presentation:

Figure: Videostroboscopy image demonstrating bilateral vocal fold polyps.

Figure: Videostroboscopy image demonstrating bilateral vocal fold polyps.

The patient is a 26 year old professional singer who has noted significant postnasal drip since performing in a smoky venue 3 weeks earlier. She feels that something is “stuck” in her throat and that singing is more fatiguing than usual. She also notes an increasingly frequent need to clear her throat. This temporarily improves her voice, however, the troubling sensation eventually returns. She denies loss of vocal range or change in vocal quality, noting that she has always had a raspy voice. She has no significant medical history and no history of seasonal or perennial allergies.

Her general physical exam was non-contributory and she did not demonstrate any signs of postnasal drip.

Click here for Los Angeles, laryngologist, Dr. Reena Gupta, MD’s diagnosis.

Voice Case of the Week: Do Nodules Need Surgery?

Osborne Head and Neck Institute Case Presentation:

The patient is a 26 year old professional singer who noted an increase in vocal rasp and a decrease in vocal range over a 6-month period. She was performing more than usual during this 6-month period and noted that her symptoms were worse due to the increased voice use. She saw another laryngologist and was told that she had vocal fold nodules. She was referred for voice therapy, but did not have any notable improvement. The patient followed up and was told that she would need surgery because voice therapy failed to resolve her symptoms. She presented to the Osborne Head and Neck Institute, for a second opinion prior to proceeding with surgery.

At the time of presentation, the patient had an 11-note range. She was unable to produce sound above or below this range without becoming louder or forceful.

Click here for Los Angeles, laryngologist, Dr. Reena Gupta, MD’s diagnosis.

Marijuana and Voice Injury

smoking-marijuana-voice

Whether for medicinal purposes or recreational use, marijuana has become a regular part of many people’s lives. The question that arises most often among professional voice users is whether or not marijuana use affects the voice.

Even a single use of marijuana can cause laryngitis, an irritation of the vocal cords and larynx. Unfortunately, irritation does not always stop professional voice users and further stress on the voice leads to progressive vocal damage.

Los Angeles laryngologist Reena Gupta, MD, discusses the effects of marijuana on the voice and the importance of appropriate evaluation and treatment.

Click here to learn more.