Medical Considerations in Treatment of The Young Voice: An Otolaryngologists Point of View As an otolaryngologist with a large voice practice located in an area with a busy entertainment sector, I am often called upon to evaluate and treat young vocal performers who are experiencing a problem. While behavioral vocal factors often play a significant role and are addressed in a multidisciplinary ... Article
Article  |   July 01, 2002
Medical Considerations in Treatment of The Young Voice: An Otolaryngologists Point of View
Author Affiliations & Notes
  • Jeffrey Lehman, MD
    Ear, Nose, Throat and Plastic Surgery Associates, Department of Communicative Disorders, University of Central Florida, Orlando, FL
Article Information
Speech, Voice & Prosodic Disorders / Voice Disorders / Speech, Voice & Prosody / Articles
Article   |   July 01, 2002
Medical Considerations in Treatment of The Young Voice: An Otolaryngologists Point of View
SIG 3 Perspectives on Voice and Voice Disorders, July 2002, Vol. 12, 5-6. doi:10.1044/vvd12.2.5
SIG 3 Perspectives on Voice and Voice Disorders, July 2002, Vol. 12, 5-6. doi:10.1044/vvd12.2.5
As an otolaryngologist with a large voice practice located in an area with a busy entertainment sector, I am often called upon to evaluate and treat young vocal performers who are experiencing a problem. While behavioral vocal factors often play a significant role and are addressed in a multidisciplinary approach to the patient, there are usually medical considerations that must be addressed in the comprehensive care of the patient. This paper presents the medical context that I most often encounter in dealing with these young vocal performers.
Problems associated with the tonsils are often the subject of pediatric visits to the otolaryngologist, and the young vocal patient is affected as often as the general population. Tonsillitis can be viral or bacterial, and the pediatrician or family practice doctor has often dealt with the acute isolated event successfully. I tend to see the patient who has experienced a persistent infection, or one who has frequently recurrent episodes. Inflamed tonsils not only cause significant discomfort for the young vocal performer, but the inflammation can extend to the larynx, affecting the vocal folds, and enlargement of the tonsils associated with inflammation affect resonant characteristics of the vocal tract. I usually will treat the acute episode with appropriate antibiotics, liberal hydration, scaling back of vocal activities, and sometimes oral steroids. The bacteria causing persistent or recurrent acute tonsillitis can be located deep within the tonsillar crypts, which are passages that penetrate beneath the surface of the tonsil. Throat cultures are often not helpful in this context, and I tend to treat without them.
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