Two laryngologists collaborate to provide reliable recommendations related to vocal health.
Although vocal health is covered in practically every voice pedagogy course, and space is dedicated to the topic in nearly every vocal pedagogy textbook, singers often find themselves scrambling when they experience a sudden voice problem. Out of desperation, people in this situation often look to where information can be gathered quickly, like Internet searches and social media pleas. This hastily gathered advice, however, may not be as trustworthy as they hope.
What singers need is vetted information provided by professionals with both medical expertise as well as a knowledge of singers’ unique vocal demands. A recent publication offers just that. Keep Your Singing Voice Healthy: The Doctor’s Guide to Vocal Vitality and Longevity (Oxford University Press, 2024) is co-authored by two laryngologists, Anthony F. Jahn, MD, and Youngnan Jenny Cho, MD. Jahn is a professor of Clinical Otolaryngology at the Icahn School of Medicine at Mount Sinai, New York, and has had a professional association with the Metropolitan Opera for more than 40 years. In addition, he serves as an adjunct professor of Vocal Pedagogy at Westminster Choir College in New Jersey. Cho is an assistant professor of Clinical Otolaryngology at Columbia University College of Physicians and Surgeons, New York. She also oversees medical care at three Lincoln Center performance venues, including the Metropolitan Opera, where she is Director of Medical Services.
The authors make a necessary disclaimer right away in the preface, acknowledging that the book does not offer personal medical advice. They recommend that singers consult their physicians, when necessary, for individualized medical attention. What the book does provide is an “understanding of the voice from the medical point of view,” which is designed to empower readers to “take full ownership of their instrument and deal with the various factors, both extrinsic and intrinsic, that may affect singing over a lifetime.”
Jahn and Cho present an array of information, from simple descriptions of anatomy and physiology to identifying common disorders of the larynx to exploring the impact of muscle tension on the voice. They delve into frequently prescribed interventions, both medicinal (“Classes of Medications and their Effects on the Voice,” “Cortisone and the Voice”) and practices (“Voice Rest,” “The Glissando Test: A Simple Vocal Checkup”). They even recommend “common-sense solutions” to voice complaints like throat infections, sinusitis, and acid reflux, among others.
Throughout the book, they insert “Case Reports” that address issues experienced by specific patients in their practice—most of them singers. In these reports, they explain how the patients presented, describe what was diagnosed, and reveal how the problems were addressed. These accounts highlight that there is a person behind each voice problem, emphasizing the need for individualized care.
A particularly noteworthy chapter of Keep Your Singing Voice Healthy is titled “Visiting the Voice Doctor,” which raises many cautionary points not often discussed in other sources. The authors write, “The medical management of voice disorders is as much art as science. While the diagnosis you receive is hopefully accurate, it may be colored by your doctor’s personal experience, and even a subconscious tendency to favor one diagnosis over others.” They advise, “If your doctor offers only one treatment option, especially one that involves injection or surgery, consider another option.” They encourage readers to inform themselves and ask questions of their doctors, evaluating physicians based on their knowledge, experience, and attitudes—not just based on a celebrity endorsement.
Jahn and Cho also assert (and reiterate) that the diagnosis of voice disorders is primarily an auditory process, believing that both patients and doctors can become overly focused on visual examinations of the larynx. On one hand, doctors often report that “everything looks normal” even when singers inherently know there is a vocal problem. On the other hand, visual abnormalities can be misleading if not viewed (and, presumably, heard) in the context of function. As the authors state, “…not every visible difference needs treatment.”
Just as singing teachers should be mindful of their scope of practice—not offering medical advice to students and clients if they are not qualified to do so—Jahn and Cho recognize their own limitations, as well: “We write this not as voice teachers (we are not!) but as laryngologists.” The book, therefore, comes from their combined years of study and experience in the medical field, reflecting what they have learned from discussions with voice teachers and speech therapists and from treating their patients, “…from the youngest beginners to the top professionals in the field.”
In the age of the Internet, there is no shortage of information and opinions on best practices for optimal vocal health. The challenge for singers who seek to be well-informed is deciphering what is worthless from what is worthwhile. With Keep Your Singing Voice Healthy, Drs. Jahn and Cho provide an invaluable resource that dispels disinformation and promotes healthy habits for sustainable singing.
