Music, Medicine, & Ministry

In this episode of BackTable ENT, Dr. Mark Williams joins Dr. Gopi Shah and Dr. Ashley Agan to discuss various diagnoses for voice problems, treatment options, and special considerations for treating singers.

Dr. Williams always begins a workup by taking a full history which includes questions about patterns in voice changes and pain. These questions help specify the type of voice change beyond the umbrella term of “hoarseness.” He describes the differences between examinations with a rigid laryngoscope, a flexible fiberoptic laryngoscope, and videostroboscopy (allows for observation of vocal fold vibration). He also performs laryngeal palpation to check for muscle tension dysphonia.

When discussing treatment, Dr. Williams speaks about the importance of getting allergies under control, to allow patients the best quality of voice possible. He prefers nasal steroid sprays over antihistamines. Dr. Williams also describes indications for microlaryngeal surgery, such as polyps and cysts. Dr. Williams notes that voice problems may have an underlying cause that is hidden by compensatory behaviors, which end up causing more issues than the original pathology. In these instances, voice therapy can help break harmful habits. Finally, by merging his experience as an otolaryngologist and a gospel singer, he shares insights on counseling singers about steroid shots, vocal hygiene, and voice rest.