From the Guidelines
For a singer experiencing loss of voice, the most effective treatment approach should include voice therapy, as it has been shown to reduce dysphonia and improve voice-related quality of life 1.
Key Considerations
- Voice therapy should be advocated for patients diagnosed with hoarseness (dysphonia) that reduces voice-related quality of life, as stated in the clinical practice guideline: hoarseness (dysphonia) 1.
- The therapy program is designed to reduce dysphonia through guided change in vocal behaviors and lifestyle changes, and typically consists of 1 or 2 therapy sessions each week for 4 to 8 weeks 1.
- Clinicians should inform patients with dysphonia about control/preventive measures, such as proper vocal warm-ups, technique training, avoiding vocal strain, and maintaining good overall vocal hygiene 1.
Treatment Approach
- Complete voice rest for 24-48 hours may be recommended to allow the vocal cords to recover from inflammation or strain.
- Staying well-hydrated with 8-10 glasses of water daily and using steam inhalation for 10-15 minutes several times daily can help to keep the vocal cords moist and reduce inflammation.
- Over-the-counter medications like acetaminophen can help with pain, while avoiding aspirin and NSAIDs which may increase bleeding risk.
- If the voice loss is due to laryngitis, a short course of oral corticosteroids like prednisone may be prescribed by a physician.
- For acid reflux-related voice issues, proton pump inhibitors such as omeprazole or pantoprazole may be prescribed for 2-4 weeks.
Importance of Professional Consultation
- Professional singers should consult an ENT specialist or laryngologist promptly if symptoms persist beyond a few days, as chronic voice problems can lead to vocal nodules or polyps requiring specialized treatment.
- A thorough evaluation by an ENT surgeon (otolaryngologist) prior to voice therapy is necessary to identify any underlying disease or pathology that may not be amenable to voice therapy 1.
From the Research
Treatment Options for Loss of Voice in Singers
- Voice rest is a widely accepted first-line treatment for singers with loss of voice, especially when obvious laryngeal pathology is not apparent 2
- Voice therapy is an integral part of conservative treatment for voice disorders, including those caused by unilateral vocal cord paresis 3
- Assistive techniques, such as digital compression of the larynx, can be useful in vocal rehabilitation of patients with unilateral vocal cord paresis 3
- Management of dysphonia, a common cause of loss of voice, is directed at the underlying etiology and may include vocal hygiene, voice therapy, pharmacotherapy, and surgery 4
- A combination of voice rest and steroids can help clarify ambiguous diagnoses in singers with phonotraumatic vocal fold lesions and improve diagnostic clarity 5
Considerations for Singers with Specific Conditions
- Singers with Hypermobility Spectrum Disorders (HSD) or hypermobile Ehlers-Danlos Syndrome (h-EDS) may experience voice difficulties and require acknowledgment and support to manage their condition 6
- Voice difficulties in singers with HSD/h-EDS can worsen over time and affect their professional and personal opportunities, communication, relationships, and wellbeing 6
Evaluation and Diagnosis
- Evaluation of loss of voice in singers should include a history, physical examination, and laryngoscopy, especially if symptoms do not resolve or improve within 4 weeks 4
- Videostroboscopy examinations can be used to assess the effect of treatment regimens, such as voice rest and steroids, on phonotraumatic vocal fold lesions 5