But will it always be?
If you've been sounding hoarse for a while, or you have to strain to talk, or your throat often is sore or needs clearing, you may have a problem. And it's better to raise your concern with your doctor now than wait for it to get worse, says a University of Michigan Health System expert who specializes in voice disorders.
That's especially true if you rely on your voice for your work, whether it's teaching, preaching, singing or just leading meetings.
"Early attention to changes in your voice can accelerate the diagnosis and treatment of everything from vocal cord nodules to throat cancer," says Norman D. Hogikyan, M.D., who directs the U-M Vocal Health Center. "And early detection often can mean better chances for recovery — and less time without a healthy voice."
Hogikyan and his fellow voice specialists around the globe are using this week to get attention for voice problems, and have declared Friday, April 16, World Voice Day. But he and his U-M team think about voice problems every day, when they examine and treat people who have voice disorders.
Many times, they see people who have suffered for months or years with disruptions to their voices, and went without an adequate exam to find the root cause. And when laryngeal, or throat, cancer is to blame, delays can be deadly.
That's why Hogikyan wants to spread the word about the importance of recognizing voice problems and getting prompt attention. He emphasizes that effective treatments are available, and range from voice rest and voice therapy to microsurgery and injections of botulinum toxin, or Botox, into the vocal folds.
Hogikyan developed a measuring tool for voice-related quality of life, a questionnaire that assesses how much of a problem a person's voice disorder is causing for them. He uses it in his research and clinic, and it's available online as a "Voice Quiz" through the World Voice Day home page, http://www.entnet.org/news/voiceday.cfm.
That page, sponsored by the American Academy of Otolaryngology − Head and Neck Surgery, also contains helpful information on recognizing and understanding common voice problems and their treatment.
"The bottom line is, if you've had a change in your voice that lasts a while, especially if you smoke or use your voice professionally, see a doctor immediately," he says. "Listen carefully to your voice if it's complaining to you: it may save your voice or even your life."
Hogikyan, an associate professor in the Department of Otolaryngology at the U-M Medical School and in the Division of Vocal Arts at the U-M School of Music, explains that a few questions can help.
Ask yourself:o Has your voice become hoarse or raspy? Or low and gravelly? Or airy and breathy?o Does your throat often feel raw, achy or strained?o Has it become an effort to talk?o Is your voice unreliable, or "hard to find" ?o Does your voice get "tired" easily? o Do you repeatedly clear your throat?o Do people regularly ask you if you have a cold when you do not?o Have you lost your ability to hit some high notes when singing?o Do you have difficulty swallowing, or persistent sore throat or pain with swallowing? o Do you have difficulty breathing, pain in your ear or a lump in your neck?
The cause of these symptoms could be one of many possibilities " some benign, some dangerous. For example, it could be a side effect of acid reflux, which can harm your vocal cords with acid from your stomach. Or it could be a polyp or nodule on your vocal cords, caused by over-using your voice or using it when you have an infection that causes temporary laryngitis.
Or, the nerves that connect to your larynx (voice box) could have been damaged during an operation, a fall, an accident or an infection " a condition called vocal cord paresis or paralysis.
If you're a smoker or a heavy drinker, it could be laryngeal cancer. That's a serious diagnosis, and treatment options include radiation, surgery and/or chemotherapy, but survival rates are excellent if it is caught early.
Less commonly, you could have a condition called spasmodic dysphonia, which results from spasms in the muscles that open or close the vocal cords when you speak. This condition can be treated with repeated Botox injections that prevent the spasms and improve voice quality.
"In order to determine the cause, your doctor may refer you to an ear, nose and throat specialist, or otolaryngologist, who can perform thorough exams using tools such as a tiny camera that films video of your vocal cords and larynx in action," says Hogikyan.
For people whose voices are central to their work, a multidisciplinary evaluation can be very helpful. At the U-M Vocal Health Center, this type of assessment includes a physician examination, plus evaluations by a speech pathologist and voice training specialist. The Vocal Health Center clinical staff includes experts from the U-M Health System and the U-M School of Music. Freda Herseth, D.M., chair of the Voice Department at the U-M School of Music, works with such patients at the U-M Vocal Health Center to help them adopt healthy speaking and singing habits.
Hogikyan and Herseth have also teamed up to produce an educational video, "The Living Voice" , which actually shows their own vocal tracts during singing and speaking, and teaches students about how the voice works. Many music educators have used it in class, with students from grade school through college. More information on the video, and how to order it, is available on the Vocal Health Center's web site.
To learn more about the U-M Vocal Health Center, or the Living Voice video, visit http://www.med.umich.edu/oto/vocalhealthcenter or call 734-432-7666.
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