Dear Doctor Jahn,
I have some kind of sore or lesion on my false folds (I’m told it is not cancer) and am having surgery so that the doctors can get a “piece” of it to examine further – since it just doesn’t go away. I have some gigs coming up and want to know what kind of voice rest (total?) I need after this surgery before I can sing – when can I start rehearsing after this operation! One week? Then, when can I expect my voice be back to normal? I stress that we are talking about the false folds rather than the vocal folds themselves.
-Diane
Dear Diane,
If we’re talking about a small biopsy, there are three main post-op issues.
I am making the assumption that this a small benign lesion, the procedure is done carefully, without excessive tissue removal or bleeding, and your anesthesiologist is also skillful. The issues pertain to postoperative discomfort, swelling, and the irritation to the true vocal folds from intubation. Some discomfort is possible, and this may be felt in the throat as well as the ear on the same side. This in turn may cause some splinting, i.e. Elevation of the larynx when you sing, causing you to muscle the voice.
The amount of actual swelling at the biopsied site may vary. If significant, it can temporarily reduce vocal projection, since the “ring” In the voice (the singer’s formant) is generated in the ventricle, the hollow area between the true and false fold. Finally, you may have some true vocal fold swelling from being intubated.
To specifically answer your questions, I would put you on modified voice rest (no singing or loud speaking, talk minimally in a “confidential voice” only) for one week. The second week, start vocalizing, and after two full weeks, you can start performing.
Just one more thought – some laryngologists are able to do the biopsy in their office under local anaethetic, without the need to be put to sleep and intubated. Something to consider.
-Anthony F. Jahn, MD, FACS, FRCS(C)
This discussion is for general information and not to be construed as specific medical advice that you should obtain from your own physician.
Dr. Jahn is an internationally renowned otolaryngologist based in Manhattan with a sub-specialty interest in the professional voice. His practice includes classical and popular singers. He holds academic appointments at Mount Sinai School of Medicine and Westminster Choir College in Princeton. He is Medical Director at Jazz at Lincoln Center, and former Director of Medical Services at the Metropolitan Opera in New York. Dr. Jahn has published several books for vocalists, including “Vocal Heath for Singers” (Singdaptive) and “The Singer’s Guide to Complete Health” (Oxford University Press).
