Case Study #1

Pre-operative

Voiceover Actress Who Loses Her Voice

A 24-year-old voice actor loses her voice when she performs.

She saw a voice doctor and was put on vocal rest on and off for three months due to vocal hemorrhage/bruising. This cost her income and career opportunities. She came for a second opinion after being told that she would need more rest and that her voice would not recover fully because of the bruising.

Notes

  • Voice loss after performance needs to be evaluated within 1-2 days
  • A laryngologist, not an ENT or  “voice doctor”, should be consulted for professional voice care
  • Frequent, prolonged voice rest rarely is required
  • 1-3 weeks of voice rest is the average for injury or surgery
  • Repeated bruising requires advanced treatment, not simply voice rest

Approach

This actor uses her voice for her career. She cannot go on voice rest every time she bruises. Voice rest takes her out of work and she had been on voice rest for months, with a loss of income and work. She has become less agile with her voice due to prolonged rest. She needed a more permanent solution, one that also allowed her to use her voice without fear of injury and bruising.

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Details

Bruising of the vocal cords (also called vocal hemorrhage) occurs when a blood vessel in the vocal cords ruptures, leaking blood into the vocal cord. This happens with forceful vocal cord contact (belting, shouting, sneezing), often when there is already inflammation of the cords. It is important to rest the voice (complete silence) when this happens, to prevent injury. More about this here.

But for professional voice users, even one week of voice rest can have a huge impact on their career.

This actor was in a cycle of bruising, resting, working, and then bruising again. She was doing one show and then having to cancel everything for 2 weeks because of a bruise. This repeated for months before she came to CVH. Dr. Gupta recognized that this patient had a complex injury and that this cycle of bruising would not end with voice rest alone. She took the patient to surgery and identified the underlying injury. The patient was able to return to voiceover work and has not had a bruise since surgery. She has not had to go on vocal rest and just landed a voiceover role in major network series.

Challenges and Considerations

Fear of Surgery
While surgery can be seen as a risky choice, for this patient, we weighed the risk of surgery causing a negative impact on her voice against the risk of her continuing on her current path. As was, she was missing weeks of work at a time, her voice was unreliable when she worked, and she was in constant fear of a bruise, which impacted her emotional performance. She was in pain from compensating. This was not a sustainable path and, for her, surgery was the right decision. 
Second Opinion
For a professional voice user, every month lost has a major impact on the momentum of a career. If there is not a strategy beyond weeks of voice rest, a second opinion from a laryngologist is important. 
Rehabilitation
This patient went through months of injury and rest before coming to CVH and finding a long-term solution. That delay prolonged her recovery after surgery. She had to overcome pain from compensating for her injury, her fear of injury, and the loss of endurance from voice rest. When a voice problem is identified early and treated, a voice athlete can return to work and artistry faster.

Pre-operative view

Operative view

Post-operative view