Doc: My Voice is Malfunctioning!

Doctor's Corner with Anthony Jahn
“I cannot reach the high notes like I used to…”

Dear Dr. Jahn,

I need some help!  I dare not engage in performances because I have no control over my voice. I start out singing beautifully but over the course of the song, when going up in range, it becomes an embarrassing struggle.  I cannot reach the high notes like I used to and my vocal chords seem to be suffering from something horrible. Sometimes when I practice, the sound comes out in plural, like I am singing with another person (but of course it is just me). Also, sometimes it is like a gurgling sound. I have no control over it. I did see a throat doctor who checked for nodules. He discovered inflammation on the vocal chords. He said it was from gastroenteritis and put me on meds to help, but it did not solve the problem.

– LM

Dear LM,

There are a couple of clues in what you have told me. The first is that your high notes are impaired. Is this all (or most) of your head voice, or just the top couple of notes?

If all of your head voice is impaired (usually above E or E flat on the first line of the staff), I would think about a weakness in the superior laryngeal nerve to one vocal fold.  This condition is caused by a virus, and usually gradually resolves.

If it’s just the top head voice notes, it’s more likely to be a swelling, not a nerve problem.

The other clue is the “plural” sound you mentioned. This symptom, called diplophonia, is usually called by a local swelling like a nodule, or some difference in mass or flexibility between the two vocal folds.

If the anti reflux doesn’t work, I suggest you get a second opinion from another laryngologist.

– Anthony F. Jahn, MD, FACS, FRCS(C)

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This discussion is for general information and not to be construed as specific medical advice that you should obtain from your own physician.

  • Murray Farrell MC

    Paragraph 2 of the answer doesn’t make sense.

  • This has been fixed now – thanks for pointing this out!