Listen to What Your Voice Is Telling You

Ask the Experts

Melissa M. Mortensen, MD Melissa M. Mortensen, MD
Otolaryngologist/Laryngologist
Division of Otolaryngology 
Head and Neck Surgery
Department of Surgery
Stony Brook Medicine
Elliot Regenbogen, MD Elliot Regenbogen, MD
Otolaryngologist/Laryngologist
Division of Otolaryngology
Head and Neck Surgery
Department of Surgery
Stony Brook Medicine
Marilyn D. Baricevac, MS, CCC-SLP Marilyn D. Baricevac, MS, CCC-SLP
Speech-Language Pathologist
Division of Otolaryngology
Head and Neck Surgery
Department of Speech and Hearing
Stony Brook Medicine
Your voice is invaluable — to basic communication, to your occupation, to self-expression, to your identity. You can help keep this vital gift in good health by treating your voice kindly and staying alert to changes that may signal a problem. Here are suggestions from voice specialists Melissa M. Mortensen, MD, Elliot Regenbogen, MD, and Marilyn D. Baricevac, MS, CCC-SLP.

What are the signs of a voice problem — and what can cause this?
Hoarseness, roughness, raspiness, breathiness, instability (tremor or changes in pitch or volume) or reduced voice endurance are among the first signs of a voice problem. Such changes are related to disorders in the sound-producing parts (vocal folds) of the voice box (larynx). When you speak or sing, the folds come together and, as air leaves the lungs, they vibrate, producing sound. Swelling or lumps on the vocal folds may hinder vibration, altering voice quality, volume and pitch. Voice problems can arise from voice overuse or misuse, cancer, infection or injury. 

When is it time to see a doctor about a voice problem?
Please see a laryngologist if you experience hoarseness lasting longer than two weeks, especially if you smoke; or if you’re a vocal performer and unable to perform; or if you do not have a cold or flu, and experience:
• coughing up blood
• difficulty swallowing
• a lump in the neck
• loss or severe changes in voice lasting longer than a few days
• pain when speaking or swallowing
• difficulty breathing accompanying your voice change
• hoarseness interfering with your livelihood

How can I prevent voice problems and maintain a healthy voice?
Use your voice wisely. Avoid habitual yelling, screaming or cheering. Be aware of background noise — when it becomes loud, your voice volume rises. Try using non-vocal or visual cues, such as a whistle, clap or hand signal to attract attention, especially with children. If you routinely need to use a loud voice, especially in an outdoor setting, use a voice amplification system. Try not to speak in an unnaturally low pitch or high pitch — it can cause injury to the vocal cords with subsequent hoarseness and a variety of problems. If you feel like your throat is dry, tired, or becoming hoarse, stop talking.
Moderate your voice use when sick. Reduce your vocal demands as much as possible when your voice is hoarse due to excessive use or an upper respiratory infection (cold). Singers should exhibit extra caution. Permanent and serious injury to the vocal cords are more likely when the vocal cords are swollen or irritated.
Minimize throat clearing. Clearing your throat can be compared to slapping or slamming the vocal cords together — and can cause vocal cord injury. Habitual throat clearing may be due to an unrecognized medical condition. Talk to your doctor about seeking treatment if chronic throat clearing is the result of gastroesophageal reflux (GERD), laryngopharyngeal reflux disease, sinus and/or allergic disease.
Drink water. The vocal cords vibrate extremely fast even with the most simple sound production; remaining hydrated by drinking water aids vocal cord lubrication. 
Do not smoke. In addition to increasing the risk of throat and lung cancer, primary and secondhand smoke passes by the vocal cords causing significant irritation and swelling. As a result, vocal quality, nature and capabilities can change permanently.

What voice services are available at Stony Brook Medicine?
The voice specialists of Stony Brook’s Division of Otolaryngology – Head and Neck Surgery provide a complete range of services aimed at vocal health and wellness: from advanced diagnostics to laser therapy for voice and throat to laryngeal reconstructive procedures and voice rehabilitation.

Grateful acknowledgement is made to the American Academy of Otolaryngology – Head and Neck Surgery for its contribution to promoting voice health.

For a consultation with one of our voice specialists call (631) 444-4121.

All health and health-related information contained in this article is intended to be general and/or educational in nature and should not be used as a substitute for a visit with a healthcare professional for help, diagnosis, guidance, and treatment. The information is intended to offer only general information for individuals to discuss with their healthcare provider. It is not intended to constitute a medical diagnosis or treatment or endorsement of any particular test, treatment, procedure, service, etc. Reliance on information provided is at the user's risk. Your healthcare provider should be consulted regarding matters concerning the medical condition, treatment, and needs of you and your family. Stony Brook University/SUNY is an affirmative action, equal opportunity educator and employer.