Vocal Cord Diseases
VOICE CLINIC
Nodules, polyps, edema, dysphonia: vocal cord diseases, a singer's nightmare. The team at the Centre d'Art Lyrique de Paris offers a unique solution.
Nodules, polyps, edema, dysphonia: vocal cord diseases, a singer's nightmare
Who hasn't heard of these famous vocal cord diseases — benign pathologies that, while not life-threatening, are often synonymous with a temporary career halt?
Even though you won't often hear singers and actors talk about their voice problems, judging by the number of operations performed worldwide, their prevalence is far higher than we are led to believe...
And above all, singers are not the only ones affected! Among those suffering are also children and people who use their voice intensively every day: schoolteachers, business executives, foremen, lecturers, journalists, lawyers, presenters, sales representatives, receptionists...
SYMPTOMS
Symptoms of a vocal cord lesion and/or disease
The onset of a lesion (such as nodules, a polyp, or edema) is characterised by fairly recognisable symptoms:
- Reduced vocal range
- Decreased volume
- Difficulty vibrating the vocal cords when speaking and/or singing
- A different timbre than before
- And above all: failure to return to normal after vocal rest
Singers often only become aware of a pathology such as vocal cord nodules, edema, or a polyp once it has become established. Inflammations such as laryngitis are more common, more quickly identified and treated, but they should not occur repeatedly.
The singing teacher's approach to voice problems and/or vocal cord disease
It is the responsibility of the vocal coach and/or singing teacher to ensure that the technique being taught conforms to how the phonatory system works.
We have observed that very often the singer is abandoned by their entourage at the time of diagnosis. If they are a professional, their teachers — fearing blame — shift their own responsibility onto the singer.
Indeed, poor vocal habits for professionals can lead to lesions (nodules, polyps, edema) on the vocal cords: singing too loudly or in an unsuitable repertoire, for example.
At the risk of causing displeasure, a teacher's role is to warn the singer that their vocal habits — if inadequate or even dangerous — can lead to a complete halt of vocal practice and the need for surgical intervention.
DIAGNOSIS
The vocal assessment: an essential examination to prevent vocal cord disease
It is therefore essential that teachers send their students for regular check-ups with a specialist.
However, the appearance of a vocal cord nodule or polyp does not signal the end of a career. These pathologies, however unpleasant, can be treated through vocal rehabilitation and an appropriate support protocol, possibly following surgical intervention.
The real challenge is the post-operative phase: how can one avoid reverting to the forced vocal gesture that caused the vocal cord disease in the first place?
Some surgeons, such as Dr. Perouse, Dr. Coulombeau, Dr. Malitchenko, and Dr. Jacobs, prescribe vocal rehabilitation before the operation to prepare the patient to review and correct their vocal gesture.
Vocal rehabilitation: from the speaking voice to the singing voice
While speech therapists are trained to address speaking voice problems, it is often difficult for them to resolve issues with singing vocal technique.
After numerous discussions with renowned surgeons, we clearly understand that working with a speech therapist is fundamental, but that very often the problem arises from inadequate or even dangerous vocal gestures in singing practice, which lead to lesions (nodules, polyps, edema) on the vocal cords.
This is followed by a kind of psychological trauma that prevents the singer from returning to the stage and their career under good conditions.
EXPERT CARE
The Centre d'Art Lyrique de Paris team: a unique response to voice problems and vocal cord diseases
At the Centre d'Art Lyrique de Paris, we have brought together several medical specialists who, driven by a shared goal — to offer solutions to people suffering from vocal cord pathologies — work together to cure vocal cord diseases: nodules, polyps, edema, dysphonia...
Medical management of voice disorders involves consulting specialists (ENT surgeon, phoniatrist), complemented by other disciplines: psychological support, speech therapy, vocal technique lessons, osteopathic and physiotherapy support, etc.
You can view the list of specialists who are members of CALYP — Centre d'Art Lyrique de Paris, as well as those who actively participate in patient care.
Dr. Perouse (ENT surgeon), Dr. Albert Jacobs (ENT surgeon), Dr. Coulombeau (phoniatrist), Dr. Natalie Malitchenko (phoniatrist), Dr. Jean Charmoille (psychiatrist, psychologist and psychoanalyst), Maryse Beaupied (osteopath/etiopath) are trusted specialists who work together for patient recovery.
This team is led by our President Adeline Toniutti, a renowned vocal coach, passionate about the physiology of the phonatory system and various vocal techniques, from interpretation to stage direction.
DOCUMENTARY
Operation Opera: a documentary immersed in the ENT operating theatre
Documentary film shot at Clinique des Portes du Sud in Venissieux in 2017, "Operation Opera" deals with more difficult and complex pathologies (open cysts, sulcus with mucosal bridges) than vocal cord nodules and offers a total immersion into the operating theatre of Dr. Perouse and CALYP members.
The CALYP International Voice Symposium
CALYP organised two international symposiums on voice, singing, medicine and psychoanalysis — in 2022 and 2023 — bringing together doctors, artists and specialists around the question of voice and pathologies.
The vocal coach: an increasingly diverse role
Following the example of the French President Emmanuel Macron, who was coached by a well-known opera singer, senior executives are increasingly turning to vocal coaches to improve their oral presentations, whether in public or in small groups.
Mastering your voice means developing your leadership. Needless to say how much the voice relies on breath and how much it communicates about the speaker... Owning your voice means ensuring that you truly convey your message to your audience, whether expert or not.
Adeline Toniutti offers role-playing exercises that involve acting out a situation that caused difficulty for the patient, in their personal or professional context, in order to understand the issue and correct it. These vocal elements can be combined with psychological work and playful exercises using sung sounds.
Thus, regardless of age, initial pathology, or profession, the goal is to regain full use of one's voice with maximum performance and comfort.