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Voice Resource Articles

What to Expect at the Voice Doctor

laryngology

Figure: Quick reference to a comprehensive evaluation by a voice doctor.

It is often very difficult for a voice user to find a qualified physician. This is because there are many physicians who call themselves “voice doctors” without the expertise and training to support this. This has resulted in patients having different experiences with each doctor, which produces uncertainty and a diminishing confidence in voice medicine. Up until recently, voice professionals have had to rely on word of mouth or their own impressions to validate their physician.

Los Angeles laryngologist, Reena Gupta, MD, discusses the components of a comprehensive voice evaluation, including stroboscopy and voice therapy.

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The Misdiagnosis of Vocal Nodules

Vocal nodules are commonly misdiagnosed due to the limitations of traditional examination equipment. Until recently flexible fiberoptic laryngoscopy (FFL) has been the industry standard in examination of the larynx and vocal folds. Due to recent technological advances, video stroboscopy has surpassed FFL as the gold standard for visualization of laryngeal pathology. Stroboscopy has drastically decreased the rate of misdiagnosis and has improved the detection of potentially harmful vocal pathology.

Beverly Hills laryngologist, Reena Gupta, MD, discusses the misdiagnosis of vocal fold nodules, the limitations of traditional diagnostic procedures, and stroboscopy.

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Voice Case of the Week: Hoarseness after Voice Use

Osborne Head and Neck Institute Case Presentation:

The patient is a 31-year-old talent agent who noted severe hoarseness after a networking event. He saw a local ENT who said he had the beginnings of nodules. He was prescribed steroids. The patient did not improve and on subsequent follow up was told that he had developed nodules. He presented for a second opinion.

Figure 1: Incision made to the vocal fold to visualize fibrotic mass

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

Voice Case of the Week: Loss of Vocal Range

Osborne Head and Neck Institute Case Presentation:

The patient is a 34 year old female who has had a several month history of decreased range.  She has lost 2-3 notes off the top of her vocal range.  This has occurred gradually but she is currently unable to access her upper range.  Her history is only significant for a motor vehicle accident around the time of onset, but evaluation at that time did not demonstrate any vocal injury.  Other symptoms include vocal fatigue and mild neck discomfort in the anterior neck.

Figure 1: Muscle tension dysphonia.

Figure 1: Muscle tension dysphonia.

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

Voice Case of the Week: A Hoarse Singer

Osborne Head and Neck Institute Case Presentation:

A 21 year old female singer presented with a 5 week history of intermittent hoarseness. She noted that if she would rest for one day, it would significantly improve but that her hoarseness would return with voice use. She has lost half an octave of her vocal range and feels vocally inconsistent. She does not smoke or drink and has no medical problems.

Figure 1: Vocal cord nodules.

Figure 1: Vocal cord nodules.

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

Top Tips for a Healthy & Powerful Voice #2

[fancy_box]This is the second chapter of a series of helpful information geared towards professional voice users, presented by Otolaryngologist Dr. Reena Gupta, Director of the Voice and Swallowing Division of the Osborne Head & Neck Institute.[/fancy_box]

Tip # 2: Understanding Your Instrument

Voice Specialist Doctor

OHNI Voice Specialist, Dr. Reena Gupta

Dr. Reena Gupta, the laryngologist in OHNI’s Voice Division, lectured at Pepperdine University, as a part of Songfest. Songfest is an intensive performing workshop designed to give singers, pianists, singing teachers and coaches the opportunity to work with distinguished faculty and develop their craft. Melanie Emilio, the director of the program, noted an absence of information about voice and singing anatomy. She invited OHNI to lecture about voice anatomy and Dr. Gupta accepted.

No matter how advanced a singer is, they may not have ever learned how the voice works. Dr. Gupta’s lectures don’t force every detail of voice anatomy into a singer’s brain. However, her audience gets a general overview of how the voice works and the interplay of the various muscles that produce voice.

Students who are struggling with a certain element of their performance may completely turn around once they understand how things work. Some people think very abstractly and others concretely and physically. This latter group can use anatomic information to translate what their teachers mean when they say “relax your tongue” or “raise your palate.” It suddenly makes sense, whereas before they understood how these muscles play into voice, they were helplessly tweaking things to try to comply with their vocal coach’s suggestions.

Everyone can benefit from learning how their voices work. There may be something huge that clicks for you when you see the muscles and their contribution to sound. Or it may be something small, like seeing the relationship between your throat and your sinuses that makes “singing in the mask” make sense.

Some key points about singing and voice anatomy:

  • Your lungs are you power source, producing strong sound
  • A critical component are the two vocal folds (or cords), which make the air column from your lungs vibrate
  • Smooth vocal fold vibration is the key to smooth sound
  • Everything above your vocal folds (lips, tongue, sinuses) are resonators, shaping sound and giving it color

A message from Dr. Reena Gupta, laryngologist at OHNI’s Division of Voice

I’ve come to understand that vocal students can be amazing technicians but they have never been taught how their voices work. But when they learn this information, they start to ask questions because various problems they had with their singing suddenly make sense.

Whatever you take from learning about how your voice is produced, it will inevitably translate to better technique and safer voice production.

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Top Tips for a Healthy & Powerful Voice

This is the first chapter of a series of helpful information geared towards professional voice users, presented by Otolaryngologist Dr. Reena Gupta, Director of the Voice and Swallowing Division of the Osborne Head & Neck Institute.

Tip # 1: The Importance of Preventative Voice Care

Dr. Reena Gupta gives a vocal screening exam.

Osborne Head and Neck Institute (OHNI) recently sponsored one of the largest international conferences for voiceover artists, VOICE 2010. This meeting has traditionally been a place for voiceover artists to meet each other and get tips and tricks to advance their careers.

A patient first brought this to the attention of OHNI’s voice doctor, Dr. Reena Gupta. The patient was expressing his frustrations about the lack of good vocal care available to voiceover artists. Further investigation confirmed that no physician had ever lectured or presented at this meeting. How can a whole community that relies on their voice for their livelihood not know about preventative care?

OHNI saw a clear link between the voiceover community and OHNI’s Voice Division, headed by Dr. Reena Gupta, which promotes the care of the professional voice, and became premier sponsors.

At the event, Los Angeles laryngologist, Dr. Reena Gupta, from the Voice Division of OHNI did free vocal screening exams. The booth was inundated by artists who had never had their voice evaluated. Dr. Gupta was pleased to be able to help these artists, but found it troubling that people who rely on their voices for their livelihood don’t take better care of their voices.

Dr. Reena Gupta at VOICE 2010

What is preventative voice care?
• Establishing a relationship with a professional voice doctor before you have problems
• Maintaining that relationship with regular check-ups to ensure your voice is healthy
• Setting up a program for healthy voice maintenance
• Checking in before major performances to ensure you’re clear to perform

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A message from Dr. Reena Gupta, laryngologist at OHNI’s Division of Voice:

If you are a vocal professional, specifically someone who relies on voice for your living, see a laryngologist regularly. There is no better cure than prevention.

VOICE 2010 was a great opportunity for me to see the challenges to good vocal health among performers. If there is one thing I’d love for these artists to take home, it would be to have their vocal health evaluated regularly. This means seeing a qualified voice physician (called a laryngologist). I saw so many examples of easily remedied vocal problems at this event, and I know that these artists will implement the advice and have better vocal performance because of it.

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