Chapter List

• Introduction
• Achilles Tendon
• Adrenal Glands
• Ankles
• Appendix
• Arteries
• Back
• Belly Button
• Birth Control
• Birthmarks
• Bladder
• Blood
• Body Hair
• Body Type
• Brain
• Breasts
• Cervix
• Childbirth
• Chin
• Circulatory System
• Clitoris
• Collarbone
• Digestive System
• Ears
• Elbows
• Emotions
• Endocrine System
• Energy
• Esophagus
• Eyes
• Fallopian Tubes
• Fat
• Feet
• Fertility
• Fingernails
• Gallbladder
• Gums
• Gynecological Exam
• Hair
• Hands
• Heart
• Hips
• Hormones
• Intestines
• Jaw
• Joints
• Kidneys
• Knees
• Larynx and Vocal Cords
• Lips
• Liver
• Lungs
• Lymphatic System
• Medical Tests
• Menopause
• Menstrual Cycle
• Moles
• Mouth
• Muscular System
• Neck
• Nervous System
• Nose
• Nutrition
• Ovaries
• Pain Relief
• Pancreas
• Pelvis
• Pregnancy
• Rectum
• Reproductive System
• Respiratory System
• Ribs
• Salivary Glands
• Scalp
• Sex
• Sexually Transmitted Diseases
• Shins
• Shoulders
• Sinuses
• Skeletal System
• Skin
• Skull
• Spine
• Spleen
• Stomach
• Stress
• Sweat Glands
• Tailbone
• Tear Ducts
• Teeth
• Throat
• Thyroid
• Toenails
• Tongue
• Tonsils
• Underarms
• Urinary System
• Urine
• Uterus
• Vagina
• Veins
• Vulva
• Wrists
• Shaping Up
• The Total Body Shaping Workoout
• Abdominals
• Biceps
• Buttocks
• Calves
• Chest
• Forearms
• Neck3
• Shoulders3
• Thighs
• Triceps
• Aerobic Conditioning

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Larynx and Vocal Cords

Larynx and Vocal Cords

Whether your voice emits the sultry growl of Lauren Bacall, the raucous whoop of Bette Midler or the babyish purr of Marilyn Monroe is mainly a matter of biology, thanks to two thin mucus membrane bands, or folds of skin, called the vocal cords.

The larynx, or voice box, attaches to both the windpipe (trachea) and the throat (pharynx). It acts as a main switching point for guiding air and food into the proper tubes. At the top of the larynx are the vocal cords. When we aren't using our voices, these reedlike sheets of tissue, no bigger than a thumbnail, are separated, forming a V-shaped opening called the glottis.

When we speak, air is forced through the cords, causing them to tighten, close and vibrate. The result: a one-of-a-kind voice that's as unique to each individual as fingerprints, says Jason Surow, M.D., otolaryngologist at Valley Hospital in Ridgewood, New Jersey, and Holy Name Hospital in Teaneck, New Jersey.

The vocal cords are like your own personal woodwind instrument, observes Dr. Surow. "The vibration of the cords is what makes the sound, but no more of a sound than the vibrating reed on a clarinet makes." When we change the shape of the throat, tongue and palate we also change the voice, creating different sounds.

In fact, these cords are so sensitive to change that your menstrual cycle could have an effect on the sound of your voice. "Some women notice a mild decrease in pitch or harshness in their voices premenstrually or in the early days of their periods," explains Michael Benninger, M.D., chairman of the Department of Otolaryngology at Henry Ford Hospital in Detroit and author of Vocal Arts Medicine. In Europe, by contract, professional vocalists cannot sing during this time; this condition is called premenstrualis larnygopathia. Also, some women experience a postmenopausal decrease in pitch caused by a hormonal change, he adds.

Tuning Your Instrument

You do have some say in how pleasant your voice is--although the general pitch is pretty much dictated by the cords, says Dr. Surow.

A lot depends on muscles like your diaphragm and how you use those muscles, Dr. Surow notes. "Can I make you into a bass? No. Can a speech therapist change the quality of your voice? Yes. You could be talking through your nose. Or maybe your nose is blocked off. Even the size of your tonsils could affect your voice."

The larynx, or voice box, is the area at the top of the trachea--the passage that carries air.

The vocal cords are stretched across the larynx, held in place by bands of cartilage.

But sometimes the instrument sounds temporarily out of tune, whether from a virus like the common cold or from overuse, like trying to shout above the din of a noisy party for a couple of hours.

The result is laryngitis, which means your cords have swollen up--leading to a lower, scratchier-than-normal voice, says Barry Baron, M.D., chairman of the Department of Otolaryngology at California Pacific Medical Center in San Francisco. "Even the slightest swelling can change the thickness of the vocal cords and your voice. The same way as when you tighten the string of a guitar in the tiniest way, it changes the sound."

Although it's impossible to dodge voice snatchers like the cold virus, there are lots of steps you can take to put the vigor back in your vibrato.

Finding Your Voice A drill sergeant giving orders to her troops in a weak voice or a telemarketer trying to hawk magazines in an overbearing bark: Chances are, neither will be taken seriously. There's something about the voice that tells others who you are--even more than the words you speak, says Katherine Verdolini, Ph.D., director of voice and speech at the Joint Center for Otolaryngology at Harvard Medical School. "Some people have a tiny, insecure, tight voice that sounds like they're apologizing all the time. Muscle tightening may come from fear or poor self-esteem. Freeing up your voice has a lot to do with freeing yourself." If you think your voice sounds weak and you don't like what you hear, Dr. Verdolini's advice is to "loosen up." Try to make a naturally soft voice sound louder without changing your muscle-use patterns, and it will probably just sound strained. The same applies to big-voiced women trying to tone themselves down: Trying to force a different voice, it just sounds . . . well, forced. "Don't squeeze your throat to get a more authoritative voice, which is usually thought of as low-pitched," says Dr. Verdolini. "The number one thing is freedom. Don't strain in any part of your body to get a free voice." For the best possible voice, your abdomen needs to be pressed in--but not in a forced or exaggerated way--when you speak. Your throat should be open and free, and your mouth should be whatever shape gives you the most volume.

Mum's the word. Say as little as possible when your vocal cords are on strike, recommends George Simpson, M.D., professor and chairman of the Department of Otolaryngology at State University of New York at Buffalo. "In a short time your voice will return to normal, but you need to rest your voice for two or three days," he says. "Let your family know you can't talk."

Don't cheat. It's not a good idea to whisper instead of talking, says Dr. Simpson. "That bangs the vocal cords together more violently than talking."

Let the water flow. You need to knock back at least six to eight glasses of water a day to hydrate your dried-out cords, says Dr. Baron. The liquids don't touch the vocal cords, but they allow saliva to flow well, which in turn lubricates your vocal system. Better yet, squeeze some lemon juice into a glass of tea or water; it helps the glands produce thinner mucus and stirs up more saliva.

Don't smoke. Smoking is severely damaging, says Dr. Baron. "You are inhaling hot smoke directly onto the vocal cords, and it goes right on them." Over time this habit can lead to polyps--soft, fluid-filled lesions that appear on one or both cords--or even put you at high risk for cancer of the larynx.

In fact, if you're a heavy smoker, your voice is probably already taking on a husky timbre, says Dr. Surow. "Smokers get thickened, heavy vocal cords. Smoke is an irritant that causes the lining of the cords to get thicker. That heaviness causes them to vibrate at a lower frequency."

Curb throat clearing. When you clear your throat, you're grinding the vocal cords together, says Dr. Benninger. "People do it because there's an irritation, and it just causes more irritation." He advises taking a sip of water instead.

Can those tomatoes. Hoarseness could be a result of stomach acid (called reflux) backing up from the esophagus and into the larynx, says Dr. Surow. Cut down on reflux causers such as tomatoes, chocolate, peppermint and caffeine and eliminate bedtime snacks.

Hydrate the air. About to hit the hay? Before you turn out the lights, turn on a humidifier, says Dr. Baron. The moisture is inhaled down onto the vocal cords.

Also, during the day, use your own personal humidifier: your nose. "The nose warms and moisturizes the air. It's a more natural way to breathe than through the mouth," notes Dr. Baron. At first you may need to train yourself to breathe through your nose instead of breathing through your mouth, but it will soon become habit.

Take a shower. One way to hydrate your sore cords is by breathing in and out while standing in a hot shower, according to Dr. Surow. In this case, breathe in through your mouth instead of your nose so the shower steam comes in direct contact with your vocal cords.

Have a piece of candy. True, a piece of hard candy or a lozenge won't cure your laryngitis, but it will stimulate your saliva glands, which help the hydration process.

Don't Hoarse Around Long If your hoarseness has lasted for more than a few weeks, you might have nodules or polyps on your vocal cords. But there is also the risk of cancer of the larynx. So you should see a doctor or throat specialist to have the condition checked out. Nodules and polyps have many similarities. Typically harmless, they are usually the result of voice abuse, such as excessive shouting or singing without proper training. Nodules are like calluses on the vocal cords, says Barry Baron, M.D., chairman of the Department of Otolaryngology at California Pacific Medical Center in San Francisco. "You use the vocal cords so improperly that the place where the vocal cords meet gets thicker, and nodules form." The problem is found among those who use their voices professionally, such as actresses, singers, teachers and public speakers, according to Frederick Godley, M.D., otolaryngologist with the Harvard Community Health Plan of New England in Providence, Rhode Island. Sometimes they'll go away on their own if you stop shouting or other bad voice habits. Nodules can usually be helped with voice therapy, in which a certified speech therapist will study your way of speaking and determine if you're abusing your voice, notes Dr. Baron. They can also be surgically removed. Surgery is usually unnecessary, however, since nodules are rarely associated with cancer, and many people don't mind having a huskier, Lauren Bacall­type voice. Polyps--soft, fluid-filled lesions that appear on one or both cords--don't go away on their own, says Jason Surow, M.D., otolarynologist at Valley Hospital in Ridgewood, New Jersey, and Holy Name Hospital in Teaneck, New Jersey. They can be more worrisome than nodules, because they more commonly develop into a malignancy, notes Dr. Godley. Prolonged hoarseness could also be caused by a more serious condition such as cancer of the larynx, which is far more serious than nodules or polyps. It strikes 9,000 to 10,000 Americans a year, according to George Simpson, M.D., professor and chairman of the Department of Otolaryngology at State University of New York at Buffalo. The disease results in removal of the vocal cords in 20 to 30 percent of cases. "I'd say that 95 percent of the time, cancer of the larynx is related to smoking. Although it is prevalent in men, women are rapidly catching up, since their smoking habits match or exceed those of men." Fortunately, if caught early, it's among the most treatable forms of cancer. If the tumor hasn't invaded the surface of the vocal cord, doctors can remove it with either laser or traditional surgery. Some small tumors can be treated with radiation therapy, according to Dr. Simpson.

Be kind to your voice. If you yell or sing loudly, you could end up injuring vocal cords from the constant abuse, says Dr. Surow.

Concentrate on good breath support, he suggests. This means breathing from the diaphragm--expanding the curved area of muscle that lies just beneath your chest but above your abdomen when you draw in breath.

"Don't breathe just from the abdomen," says Dr. Benninger. "That can cause strain, and the belly gets tired." In most cases speech therapy can correct habitual misuse of the voice.

 

See also Respiratory System