Getting Scoped

My vocal cords and I have, what I like to call, a long distance penpalship: we communicate on a regular basis, but never really get to see each other. I have relied on my vocal cords’ support in the past and continue to do so; they were there for me at every audition, they performed with me each night at sea, and now help me give vocal lessons to others. They help me express myself with a grunt if the football is on, or with a whoop as the ‘Love Island’ theme tune plays (yes – I am ashamed). They help me to communicate to others how I am feeling, and they are part of the team that helps me tell my husband that I love him (you wanted cheese with that, right?) 

It was a rainy Monday 10th June (that’s England for you) when my vocal cords and I had our ‘meet cute’ via a laryngoscopy or ‘scope.’ 

What even is a scope?

A scope is an examination of the larynx (or voice box) using an instrument which is, usually, either placed into the mouth (videostroboscopy) or a passed through the nose (flexible laryngoscopy), and should, preferably, be performed by a laryngologist or an Ear, Nose and Throat doctor who specialises in voice. 

Why did I choose to have a scope? 

A cocktail of curiosity, wonder and neurosis led to my decision to schedule a scope. Call me a nerd, (NERD!) but I have a love for learning, and the more I delved into vocal anatomy the more fascinated I became. I started to think how peculiar it is for us all to go through life without ever seeing the very things that are working to keep us alive; no quick ‘hey guys – how are you doing?’ or ‘thanks for all you do’, or ‘keep it up, champs!’ (woah, that got a bit deep!) 

Equally, the more I read up on vocal health the more apprehensive I became about the condition of my own vocal cords, especially after a bout of acid reflux symptoms. Finally, as a vocal coach, I felt I had to practise what I preach. 

The white bands are the vocal cords themselves, and this is a still of them mid-oscillation.

A little bit about the vocal folds… 

The vocal folds look like two little bands sitting in a horizontal V shape located just above the windpipe.

FUN FACT: The vocal cords are tiny, really, measuring, approximately, no bigger than a 5-pence piece. 

There are a few different layers to the vocal folds. Let’s look at them like a trifle: 

1. Cream: The top layer which, in terms of the vocal folds, is called the Epithelium layer, and is often likened to the lining of the cheek. 
2. Custard: For the vocal folds, this makes up the superficial, intermediate and deep layer known as the ‘lamina propria.’ Instead of being made up of eggs and cream, though, these layers consist of collagen and elastin. It is at approximately 8-years of age when these 3-layers start to develop and become more distinct. This special custard stuff or lamina propria is what allows the vocal cords to vibrate as they do, and it cannot be replaced if damaged. 
3. Jammy Sponge: This is the deepest layer of both vocal fold and trifle, and this is made up of muscle. It is this muscle, called the thyroarytenoid muscle, that is in dominant use when we sing in chest voice. 

CONFESSION: I’ve never eaten trifle in my life. 

Here, the vocal cords are set apart in their V-like shape and this is their position when we inhale. Those two shoulder-like arms to each side are the arytenoid cartilages which help in opening and closing the vocal cords, and that little ringed pipe you can see is my windpipe.

Want to increase your chances of vocal damage? Here’s how in 3 easy steps:

1. Misuse Your Voice: Go ahead – scream at your brother, talk loudly in a restaurant and yell over music at a concert. All are sure ways to upset your vocal cords. 
2. Overuse It: If you think you can damage your voice by talking all day, teaching in the evening and socialising afterwards with some singing practise and auditioning in between, then you are absolutely right. 
3. Lifestyle: An unhealthy diet, smoking and drinking alcohol are a few lifestyle choices that are advocates of vocal ‘unwellbeing.’

What happens after the scope? 

Some will skip away proud as punch that their vocal cords are in great condition. However, others may have discovered that there is an abnormality and this can be terribly upsetting. 

The road to recovery will depend on the problem; for some, lifestyle changes may be in order which could mean anything from changing up the diet to making alterations to the social life. In some cases, a few rehabilitation sessions with a speech and language therapist or a vocal massage will do the trick. For others, surgery may well be required. In addition to this, the injured singer will benefit from having a supportive network around them, made up of their family, friends, employees, a vocal coach to help with maintaining healthy technique, an ENT specialist and a speech and language therapist, all who can help them manage their situation both physically and emotionally. 

Heck, all singers would benefit from having that network in place – vocal injury or not. 

If you have experienced changes in vocal quality, increased fatigue, loss of range or hoarseness any of which have persisted for 48-hours, then the best thing to do is to get a scope booked in. Damage detected in its early stages is much easier to reverse than damage which has lingered and worsened. Or, if you are a curious cat, you could choose to get a scope even though you have no real vocal concerns. This gives you what laryngologist and voice specialist Dr Reena Gupta calls a ‘baseline strobe’, giving you the ability to understand your vocal condition at a time when all feels well, so you have something to compare it to should you run into trouble in the future. 

The voice is a sensation based instrument; we don’t have the ability to hold, pluck, dissect or probe it when we sing (thank goodness – ouch!), so we have to rely on what it feels and sounds like. The only way to really check in with our vocal cords and get the facts is to visit an ENT for a scope. 

Plus, it’s pretty darn cool to see inside our bodies, and get a small insight to what goes on inside our cave of wonders. Icky – but cool!