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Acute Voice Injury Treatment

January 24, 2021

The treatment of vocal injuries, both acute and chronic, is fraught with many home remedies, “magic” formulas passed down through the ages, and personal anecdotal “success” stories – most of which lack evidence, science, and a proper diagnosis. 

Here are some key points to consider on treating acute voice injuries:


1. If you are a singer, teach singers, or care for singers, you must associate with a laryngologist – an ENT who has had specialty training and lots of experience treating any professional voice user (singers, singing teachers, and teachers are my largest groups of patients). You should not simply go to your neighborhood ENT for a scope. 


2. Stroboscopy is the gold standard diagnostic tool to evaluate the larynx. Most regular ENTs do not have this nor have training using this tool. Regular “white light” scopes cannot evaluate fine details of the vocal folds: subtle asymmetries in motion, closure patterns, and areas of stiffness. More importantly, experience with interpreting these findings is far more important than the tool itself! Thus without a proper diagnosis a proper treatment protocol cannot be created.


3. All Laryngologists are affiliated and work with specially trained and experienced speech pathologists (SLP) who work with our professional voice users. These Voice Therapists are a must when caring for the professional voice. This team approach will allow for the best possible outcome for the professional voice user.

4. Lastly, with regards to acute voice loss, rest is the most important treatment. Singing with an injured voice will lead to pathological changes. Viral upper respiratory infections are the most common causes of acute voice loss and rest and support are the only treatments required: confidential voice, no singing, hydration: copious water (pee should be clear), Entertainer’s secret (found online), humidification, steam inhalation. Your larynx will tell you when it is ready: if you can speak/sing effortlessly, without discomfort or strain, without post-singing difficulties, without change in quality, you are good to go! Otherwise, there could be an underlying reason why you have lost your voice. Importantly, if you frequently lose (or even a subtle change) your voice, you must see a laryngologist to ensure there is no underlying cause.


5. Reflux – Laryngopharyngeal reflux – is another common factor in recurrent vocal issues. I do not believe reflux causes voice problems but reflux can exacerbate another underlying cause. The answer is not proton pump inhibitors (omeprazole, pantoprazole, etc.. – which have been associated with increased risks of heart attack, stroke, dementia,…). The answer is again, a proper diagnosis and treatment: diet – plant based diet and alkaline water works as well if not better than PPI. See my article in JAMA.


6. Lastly and most importantly: teach all of your students these general rules. All singers should find the local laryngologist and SLP team. All singers should have a baseline stroboscopy. All singers should be aware of how to prevent injury.

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