CASE STUDY # 2
SINGER WITH NO FALSETTO/HEAD VOICE
THE STORY
A 32-year-old recording artist states she has not had access to her head voice for years. As her career took off, she gradually lost her falsetto, which she attributed to aging. Singing is also more effortful and she now needs 2 days to recover her voice after a show.
The patient has a polyp of her left vocal fold when she is seen in the office.
NOTES
Loss of falsetto/head voice is not a sign of aging
Voice loss from aging does not happen in your 30s
Prolonged recovery after performance indicates a problem
Success bring higher demand and an increased risk of injury due to lack of care and rest
This singer is a busy, touring recording artist and has not had time to invest in her vocal health. She has never seen a laryngologist, just going to voice doctors/ENTs for crisis care. She began working with a vocal coach who referred her for care. We accommodated an appointment that corresponded to her tour stop in Los Angeles.
She needs an accurate diagnosis and a treatment plan that works with her schedule. She requires privacy as a high-profile performer.
THE BREAKDOWN
Pre-operative stroboscopy
Postoperative stroboscopy
Vocal injury can occur at any time, but the risk is greater with high-impact voice use., such as singing, voiceover, and professional speaking. These are forms of athletic demand. When there is underlying inflammation, such as from illness, back-to-back performance, smoking, etc, the risk of injury is even higher.
Voice injury is most common in vocal athletes and when it sidelines them, it’s difficult to earn a livelihood and create. Treatment may require time-consuming rehabilitation, medication, therapeutic interventions, or surgery. However, the busy performer may struggle to integrate vocal health care into their work schedule. Injury can worsen, making the treatment course prolonged or suboptimal.
Vocal performers require accommodations to their care that honor their complex demands, atypical schedule, and significant athletic challenges. *
*Read more about vocal athletes here
CHALLENGES AND CONSIDERATIONS
COMPLEX TIMING
This artist needed to have surgery but was in the middle of a tour. She was faced with possible tour cancellation, costing her and her band. However, without surgery, she risked permanent injury. A surgeon needs to understand the artist, their vocal needs and type of voice use, the likelihood of progression, and how to implement safeguards to prevent worsening. Surgery was expedited to accommodate her performance schedule. Our protocols can expedite scheduling within days of getting the green light from management and the artist.
REHABILITATION DURING TOUR
It was impossible for this patient to follow a traditional rehabilitation schedule due to voice demands. Rehabilitation needed to be flexible and mobile, with coaching through intense voice use during recovery. The team of professionals at Center for Vocal Health has expertise in pro voice rehabilitation and we adapted our regimen to the specific demands of this patient.
PERFORMANCE REHABILITATION
Rehabilitation of the performing voice is more complex than traditional speech and voice therapy. This performer had intense vocal demand and had to re-learn how to access falsetto after years of compensatory muscle use. This is one of the most complex vocal tasks and re-education and training requires specialists like those we have at the Center for Vocal Health. This patient regained her head voice within 4 weeks of surgery due to expert rehabilitation and training.