As winter approaches – replete with COVID, flu, colds and other ailments – so does the season of throat clearing. But this hem, ahem, hawk, cough, or tickle in the throat doesn’t have to linger on and off until spring. The stakes are particularly high for professional singers, as well as those in professions heavily reliant on voice, such as teachers, elected officials, clinicians, attorneys and many others.
Robert Thayer Sataloff, MD, DMA, professor and chair of Otolaryngology – Head & Neck Surgery at Drexel University’s College of Medicine, shared insight on how cold air impacts our vocal folds, debunks some misconceptions about voice and what we can do to sound our best during the cold and throughout the year.
An award-winning physician, educator, inventor, singer, conductor, and extensively published researcher, Sataloff is a world leader in otolaryngology and the voice.
Why are people more likely to “lose their voice” during the cold?
People are more likely to get sick and have voice problems during cold, winter months. Laryngeal tissues function best when our airstream is warm and humid. Humidity close to 70% is ideal. Cold winter air is dry, with humidity that can be as low as 15%. This interferes with efficient vocal fold vibration. It also predisposes people to laryngeal surface cell damage, inflammation, injury and infection.
If someone feels laryngitis coming on, what can someone do to prevent further damage to their voice?
If people feel early signs of “laryngitis” such as mild hoarseness, voice fatigue and irritation possibly leading to mild cough, a few precautions may help prevent progression to more substantial voice loss, especially if the symptoms are due to irritation rather than infection.
At the first signs of a potential problem, people should hydrate well – drinking enough water so that their urine is pale in color; rest their voices and avoid speaking over noise; avoid smoke and other irritants; and take other measures to maintain good health and a strong immune system. If the symptoms persist or worsen, examination by an otolaryngologist should be arranged and should include visualization of the vocal folds.
Beyond medicine, are there any recommendations for patients when they start to feel a “tickle in the throat” or hoarseness in their voice, like diet changes, rest, etc.? When is it appropriate to make an appointment with an ENT doctor?
The recommendations for a “tickle in the throat” are the same as those for mild laryngitis discussed above. In addition, in both situations, if patients have reflux, they should make a special effort to avoid eating foods that aggravate it and to keep the reflux well-controlled. Acid on the vocal folds impairs healing and immune response. They should see an otolaryngologist if the condition worsens or does not resolve within a few days.
How has your experience as a professional singer and singing teacher equipped you to relate to your patients who are professional singers or in other professions where voice is paramount? Are there any major misconceptions of this patient population?
Professional voice users are wonderful patients. Like other professional athletes, they require not only “normal” function, but more critically “superior, near-perfect” function. Because many singers and other voice professionals seek medical care (appropriately) for minor deviations from optimal function that might not be apparent to most otolaryngologists, some doctors are under the misconception that singers are neurotic or hypochondriacal. That is generally not the case. If an established singer has a voice complaint, failure to reach a diagnosis is usually due to lack of expertise on the part of the physician rather than to an imaginary complaint on the part of the singer.
Are there ingredients in cough drops, dry throat lozenges and related products that patients should look for, i.e., what works to protect someone’s voice?
Some lozenges and related products create a sensation of wetness to help relieve a dry mouth and throat by using an astringent that can irritate mucosa linings. Such substances include eucalyptus, strong mints, menthol and similar substances. More gentle ingredients, such as glycerin and honey, usually are not problematic for most people.
Are there any common misconceptions about what causes laryngitis or other impacts on voice during winter or other times of the year? For example, can cannabis use affect someone’s voice?
Any irritant that reaches the larynx can cause inflammation, or “laryngitis.” That includes smoke (tobacco or marijuana), some very strong spices, hydrocarbon and other fumes, inhaled chemicals and similar exposures. Voice abuse/misuse are extremely common causes of vocal fold trauma that can result in injury or even in impaired healing that leads to vocal fold masses. Voice abuse and misuse are common at parties (especially where alcohol has been consumed), noisy bars, Eagles games and in other similar environments.
Any tips for keeping our voices strong, even when it’s not cold outside?
Maintaining good physical condition, especially aerobic conditioning, helps maintain appropriate support of the voice and avoid injury. Learning and using proper speaking and singing technique not only helps avoid voice problems but also improves voice quality and endurance.
Reporters interested in speaking with Sataloff should contact Greg Richter, assistant director of News & Media Relations, at gdr33@drexel.edu or 215.895.2614.
