Vocal Rehabilitation
VOICE CLINIC
Vocal rehabilitation and accompaniment protocol at CALYP with Adeline Toniutti, in Paris and Geneva.
Vocal Rehabilitation with Adeline Toniutti, Director of CALYP, in Paris and Geneva
Discussing phonatory problems has never been easy for voice professionals:
- singers
- theatre actors
- film actors
- hosts and presenters
- radio and television broadcasters
But also for those who are voice professionals without realizing it:
- teachers
- lecturers
- politicians and legal professionals
- people in contact with the public
- people who are always on the phone
- salespeople and commercial representatives
Indeed, while in the sports world getting injured has mostly become commonplace and publicly disclosed, this is not the case for singers, whether classical or popular...
Voice loss or vocal conditions are difficult to admit, and communicating on this subject proves to be a perilous exercise: is it for fear of losing one’s career, because the voice is invisible and intangible, or for fear of never recovering it?
It is not for us to answer here; however, CALYP offers its services in Paris and Geneva in vocal rehabilitation and accompaniment protocol for people suffering from vocal cord conditions or wishing to preserve them.
Vocal Cord Surgery: Singers Break the Silence
In recent years, courageous singers have used the media to publicly discuss their voice problems and the constraints involved in treating the pathology.
Céline Dion was photographed on her way to her ENT specialist in Paris, Maurane in an article in Le Point mentioned not having recovered her voice after surgery, Johnny Hallyday after a major operation confided on television that he feared he had lost his voice, and singer Adele cancelled prestigious concerts for fear of damaging her voice.
Opera singer Natalie Dessay even had her last operation filmed — a film that, so to speak, shook the world of opera and allowed a liberating breakthrough for classical singers.
The famous tenor Jonas Kaufmann also explained his cancellations by voice problems.
Although one can say that humans have been singing since almost the beginning of their existence, the treatment of voice conditions and surgical treatment are still relatively recent. The latest advances allow treatment of most pathologies, even if in some cases the result is optimized without being able to fully correct the problem.
Most surgeons agree on absolute vocal rest after laryngeal microsurgery, but pioneers such as Dr. Perouse and Dr. Coulombeau (Vénissieux clinic, France) in the case of an open cyst suggest that certain experienced patients (professional singers) perform daily vibrations after the operation: the results are very significant in terms of the flexibility of the operated cords. This means that this specialty is evolving and making remarkable and promising advances thanks to the courage of several talented surgeons.
Treatment Through Vocal Rehabilitation in Paris and Geneva
Treatment through vocal rehabilitation is used when it comes to correcting the vocal gesture in order to learn to use one’s voice properly. One must understand how the voice is being misused and how to adapt one’s behavior in order to preserve it.
This rehabilitation can take place in the pre-operative and/or post-operative phase but also in the treatment of a condition without surgical intervention.
Laryngeal Microsurgery
In the case of a lesion, the surgeon will consider operating when the lesion is bothersome and does not recede or cannot recede through medical or rehabilitative treatment.
Some pathologies are easier to operate on than others, and the result is more “certain.” Indeed, it is not always possible to promise a superb voice or a return to normal in certain conditions: sulcus, vocal cord striae, for example.
Voice conditions should be classified according to their primary cause:
- malformation of the vocal apparatus: laryngeal micro-web, intracordal cyst, sulcus or open cyst, striae…
- misuse of the vocal apparatus, or injury to it, possibly caused by the misuse itself: kissing nodules, phlyctena, polyp, granuloma, mucous retention cyst…
Finally, some conditions beyond the phonatory apparatus can affect the voice, for example thyroid problems.
In his book Le guide de la Voix, Dr. Yves Ormezzano reports that he classifies voice professionals into two categories:
Voice professionals:
- singers
- theatre actors
- film actors
- hosts and presenters
- radio and television broadcasters
Those who do not know they are voice professionals:
- teachers
- lecturers
- politicians and legal professionals
- people in contact with the public
- people who are always on the phone
- salespeople and commercial representatives
We observe that the use of the voice concerns virtually all people.
Vocal Rehabilitation of Singers in Paris and Geneva
The onset of dysphonia in singers disrupts their vocal expression capabilities, whether it involves organic dysphonia due to acquired and more rarely congenital lesions, or functional dysphonia.
Alterations of the speaking voice can and often do affect the singing voice, and vocal strain particularly exposes singers to vibratory stress lesions, especially in the form of nodules.
The laryngeal whiplash from a vocal fold hematoma is quite specific to singers, who are also exposed to acute incidents that can suddenly and temporarily inhibit their laryngeal motor function. In such cases, most are forced to suspend their activity to begin rehabilitative treatment or to undergo surgery.
Depending on the case, rehabilitation prioritizes or combines improved body posture, muscular relaxation, glottal care, optimization of pneumo-laryngeal coordination and, more difficult, laryngo-resonantial coordination.
Vocal Rehabilitation: the Voice Teacher and Specialists
In the case of a singer, this type of care from the rehabilitator requires a personal knowledge of singing, an ability to cooperate with professionals who have a very personal conception of their way of singing, or with voice teachers when it comes to beginners.
The voice teacher and vocal rehabilitator will achieve the best results if they are accustomed to collaborating effectively, transparently, and swiftly with medical specialists: ENT surgeon, phoniatrician, speech therapist, psychiatrist, psychologist, osteopath.
The Accompaniment Protocol of the Centre d’Art Lyrique de Paris
Voice teacher Adeline Toniutti oversees at the Centre d’Art Lyrique de Paris the creation of an accompaniment protocol for people affected by vocal cord pathology.
It seemed essential to us that the voice teacher be able to establish direct contact with specialists (ENT surgeons, phoniatricians, speech therapists, psychiatrists, clinical psychologists, osteopaths, etc.) in order to help people treat their problems.
This response was born from an observation in the clinic of the human voice.
Adeline Toniutti: “It became apparent to me that if aspiring singers possessed a vocal instrument — the larynx — whose sensitivity developed as vocal work progressed, this same sensitivity could become a great fragility leading to the cessation of singing through discouragement or, more seriously, through the development of pathological conditions, in amateurs as in professionals. A diagnosis was called for: deficiency in vocal technique, inappropriate on a case-by-case basis, and a lack of scenic, organic, and psychological accompaniment.
Thus, accompaniment is offered to heal, to avoid the often-frequent relapses, and above all to improve technique and the art of singing, so that a return to performance is possible and of better quality.”
How to meet Adeline Toniutti and get a vocal assessment?