Barbara F Worth and an introduction to videolaryngostroboscopies

Here's a picture of me with Barbara F Worth, who is the Senior Voice Specialist at Beth Israel Deaconess Medical Center, a Harvard teaching hospital in Boston, MA.

 
Barbara F Worth at IVACON
 

Barbara spoke at IVACON, a conference I attended recently in the USA, run by IVA (the Institute of Vocal Advancement). And like all of the speakers at IVACON, she really knew her stuff. She talked to us about maintaining vocal health - the things that might be harmful for our voices and the things that aren't. In a breakout session, she also conducted three live videolaryngostroboscopies. I know, long word. All that means etymologically is video + larynx + strobe light. The video is so you can see what's going on, the larynx because that's what we're looking at, and the strobe because otherwise you can't really get a good idea of how the vocal folds are functioning. Why? Well "A 440", for example, is the A above middle C, and it's called A440 because something has to be vibrating at 440 vibrations per second to make that frequency. This is way too fast for the naked eye to see - it's all a blur. But use a strobe light to take out our ability to perceive some of that movement, and all of a sudden it looks like the folds are vibrating in slow motion! Awesome. 

This is actually a really important point. If you're ever getting your voice checked out by an ENT (otolaryngologist or Ear, Nose & Throat doctor), and you're worried about your voice, it's important to know that unless they're using the strobe light, they may not be able to fully detect what's going on, on a functional level. Sure a normal laryngoscopy might be fine if you're detecting most injuries or physical abnormalities. But for functional abnormalities, you may only see these once you can actually see the action of the vocal folds vibrating against each other. Something like a simple "posterior chink" -where the back cartilaginous portion of the folds are not adducting properly - might be almost impossible to detect unless you can clearly see the vocal folds in action with a stroboscopy. And although something like this isn't as serious as a full-blown injury, it will still cause a breathy voice and may lead to issues down the road.

The solution? Familiarise yourself with your vocal health and your vocal options. Ideally we'd all have stroboscopies done when our voices are healthy, to produce a base-line or comparative reading, so that when something goes wrong, our voice doctor will know what may have changed. If you're a vocalist and can access this kind of information, then go for it! Unfortunately though, many of us can't (these kinds of health services are more difficult to access in some countries than others), so in the mean time, stay informed about your voice, look after it, and keep monitoring it. Especially important to look out for are the common causes of that thing singers hate so much: phlegm. If you're feeling phlegmy, you might be suffering from allergies (causing post-nasal drip), or LPR (laryngopharyngeal reflux), which both cause acidic/phlegmy substances to end up in the throat. I'll go into more details in about these in another post, but in the mean time, stay vigilant, and look after that voice!