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Voice Resource Articles

Voice Case of the Week: Does Smoking Marijuana Affect the Voice?

Osborne Head and Neck Institute Case Presentation:

Figure: Stroboscopy imaging of the larynx demonstrating laryngitis.

Figure: Stroboscopy imaging of the larynx demonstrating laryngitis.

This is a case of a 24 year old male professional singer who has noted gradual loss of vocal range over the past year. He has had increased demands over that period of time but is studying with a vocal coach. He feels that he is technically proficient, and this is reaffirmed by a conversation with the vocal coach. There has been gradual onset of a ‘rattle’ or ‘gravel’ sound in his voice that he cannot avoid. This is now present in his speaking voice in addition to his singing voice. He used to only experience hoarseness after performances or a lengthy studio session but now feels it is more consistent and takes longer to recover. He has no known medical problems but smokes marijuana once a day, in the morning, through a vaporizer. He is fastidious about keeping it clean and is very particular about his diet. He is gluten-free and does not consume any reflux triggers. He has been tested for allergies and is negative.

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

Voice Case of the Week: Vocal Granuloma

Osborne Head and Neck Institute Case Presentation:

Figure: Stroboscopy image of the larynx demonstrating a right vocal process granuloma.

Figure: Stroboscopy image of the larynx demonstrating a right vocal process granuloma.

The patient is a 42 year old director who has noted progressive worsening of his voice over several months. He noted initial onset after a 3 week movie shoot, where he had to use his voice excessively. He went to an ENT who noted the presence of a vocal granuloma. She suggested he have surgery to remove the granuloma as well as reflux medication.

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

Vocal Nodules: Frequently Asked Questions

Vocal nodules are one of the most commonly misunderstood forms of vocal pathology among voice users. These lesions are noncancerous benign reactive growths that develop on the vocal folds after traumatic or forceful voice use. The purpose of the vocal nodule is to protect the delicate vocal folds from continued trauma. Continued use of improper voice technique after nodules have formed can potentially lead to more serious voice disorders and potential vocal deterioration.

Los Angeles laryngologist, Reena Gupta, MD, discusses common questions associated with vocal nodule formation, evaluation, diagnosis, and treatment.

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Vocal Nodules: Treatment

Surgery should be reserved as a measure of last resort for the treatment of vocal nodules. Vocal surgery can result in scarring and a subsequent decrease in vocal quality. This invasive approach to nodule treatment approach should be considered once all other options have been exhausted. In addition, the determination of whether vocal surgery is appropriate or not should only be made by a qualified laryngologist.

Beverly Hills laryngologist, Reena Gupta, MD, discusses the treatment of vocal fold nodules and the unnecessary overuse of surgery.

Beverly Hills laryngologist, Reena Gupta, MD, discusses the treatment of vocal fold nodules and the unnecessary overuse of surgery.

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The Benefits of Voice Therapy

voice-therapist-los-angeles

Proper technique is a crucial component of maintaining and preserving a healthy voice. Often times voice users will seek evaluation for vocal complaints that result in healthy appearing vocal cords on imaging and no clear diagnosis. Issues with proper technique, both spoken and sung, are usually the cause of these complaints. Vocal therapy is a medical discipline that is geared, in part, towards the optimization of voice use, recognition of flawed technique, and treatment of preexisting pathology.

Los Angeles voice therapist, Amy Chapman, discusses the importance of voice therapy in treating common voice disorders and optimizing everyday voice use.

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Voice Case of the Week: Scarring From Surgery

Osborne Head and Neck Institute Case Presentation:

Figure: One vibratory cycle, demonstrating good posterior closure but with mid-vocal fold insufficiency secondary to depression of the edge. This is due to vocal scarring from a loss of superficial lamina propria.

Figure: One vibratory cycle, demonstrating good posterior closure but with mid-vocal fold insufficiency secondary to depression of the edge. This is due to vocal scarring from a loss of superficial lamina propria.

The patient is a 55 year old male who has had significant vocal demands as a teacher for several decades. He had noted sudden voice changes and sought care by an ENT, who informed him that he had a vocal growth. The recommendation was made for surgical excision and the technique that was utilized was laser treatment of the lesion as well as excision.

The patient never noted any significant improvement after surgery and sought a second opinion one year later, after struggling with his voice.

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

Voice Case of the Week: Vocal Folds in a Gospel Singer

Osborne Head and Neck Institute Case Presentation:

Figure: Stroboscopy image of the vocal cords demonstrating formation of vocal fold scarring/sulcus vocalis.

Figure: Stroboscopy image of the vocal cords demonstrating formation of vocal fold scarring/sulcus vocalis.

The patient is a 24 year old female who has noted a 5 year history of progressive worsening of her voice. She was examined by an ENT who told her that she had nodules and that she should rest her voice. She did not notice any improvement but stated that she had to sing and so she continued to use her voice as much as she could. She sings exclusively gospel-style music, but had kept her singing to what she felt was a comfortable range. She presented for a second opinion when she noticed increased difficulty with projection and vocal fatigue.

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

The Dangers of Synthetic Marijuana

marijuana-affect-voice

There is growing concern about the popularization of synthetic marijuana in the US. Also known as fake pot, spice, or herbal incense, this new designer drug carries various health risks including serious injury and death.

Due to lack of regulation and proper dosing safeguards, fake pot has been responsible for several serious overdose reactions and has been associated with various deaths.

Los Angeles laryngologist, Dr. Reena Gupta, MD, discusses the recent popularization and dangers of synthetic marijuana (cannabinoids) usage.

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A Real Explanation for Vocal Fatigue

vocal-fatigue

Vocal fatigue is an often-misdiagnosed condition that is commonly seen in the professional voice user. Because, vocal fatigue can often present with little to no visible vocal pathology, traditional providers have typically provided incorrect diagnoses and temporary stopgap measures.

If left untreated vocal fatigue can ultimately lead to classical voice disorders as well as vocal impairment. Prompt evaluation of suspected vocal disorders or vocal fatigue is recommended to avoid complications.

Los Angeles Voice Therapist, Amy Chapman, discusses the importance of timely evaluation and treatment of voice fatigue by a laryngologist and voice therapist.

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Voice Case of the Week: Lasers in Laryngology (AKA Why we should trust our singing patients)

Osborne Head and Neck Institute Case Presentation:

The patient is a 27-year-old female enrolled in a graduate level vocal performance program. She has had vocal difficulties for many years, including vocal inconsistency, intermittently decreased vocal range, and increased effort of phonation. She has sought evaluation numerous times. Each evaluation has noted the presence of varices (dilated blood vessels) on the left vocal fold but she has been told that varices cannot cause dysphonia (vocal symptoms) unless they rupture, resulting in a hemorrhage. The times that she has been evaluated while symptomatic did not demonstrate a hemorrhage and so she has been told there was nothing that could be done.

Figure: Varices before laser treatment (left). Varices after treatment. Note that the pink hue of the photo is due to a lens filter that protects the surgeon’s eyes from the laser (right).

Figure: Varices before laser treatment (left). Varices after treatment. Note that the pink hue of the photo is due to a lens filter that protects the surgeon’s eyes from the laser (right).

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