My school project on Bill Kaulitz
Hi guys! I’ve been really excited over the past few weeks about this project I had to do for a class. The class is about the larynx and voice disorders people can get. You know, like how singers are always losing their voice and canceling shows and stuff. Well, we had to chose a celebrity to do this project on. We had to give background information, make a mock evaluation, and a mock treatment plan. This was to be presented to the class and also had to be in a mock evaluation report.
My first choice for a celeb was Bill Kaulitz, and he’s who I ended up doing the project on!
So, my first choice was Bill. But I wasn’t sure if he was normal enough. Other people were reporting on American celebs like Sophia Bush, Rachel Ray, Steven Tyler, Fran Drescher, Whitney Houston, Julie Andrews, Adele, sports team coaches, Michael J. Fox, etc etc. Bill is so different (and so much more awesome) than them. I hesitated to sign up with him as my project, and I went the safe route and selected Jordin Sparks.
There was no information on Jordin Sparks. I’d have to make everything up about her case and making up cases is hard (Yes, I've made up cases for assignments). Forget that! Plus, she's nowhere NEAR as awesome as Bill.
I wondered if I should step a little out of my comfort zone and do the project on lovely Bill. This was kind of a big deal to consider. There are 33 people in the class, and I’ve been in the academic program with them for 4 years. I know them and they know me, and we’re going to be professional colleagues one day. I wasn’t sure if I wanted to share someone as wonderfully different as Bill with them. Additionally, sharing him with them was really personal, since Bill is a huge part of my personal/lesure/recreational life. Aside from wearing the occasional TH or Bill shirt and TH wristband, my classmates have no idea about my fascination with Bill.
Additionally, this was a project consisting of a professionally-written (mock) report as if I really had evaluated Bill, and also a presentation that would be graded in line with the higher standards of graduate school. Kinda didn’t want to blow it.
But I got over myself with a little discussion and input from some of you guys and I went for it! I told the teacher I was changing my celeb to Bill. She was taken by surprise and I was gleeful. Later in the written feedback, the teacher wrote, “I like how you came up with someone different :-)” And yes, there was seriously a smiley face.
So, that was the buildup to eventually selecting Bill. After that, it was easy to research the topic, write the report, and make the presentation. I even knew what video clip to use in the presentation. That all came very easily. It was all done in love~ It wasn't even work, you know?
Then, it was presentation day! I was maybe 5th or 6th to present. We were all presenting that day (it was dreary and boring). I knew it would be dreary so I tried to have a little fun with my presentation, since we like watching people have fun more than watching people who are clearly bored and uninterested in their own topic. I guess my passion for Bill shone through a little bit? I kept referring to him as “my guy.” XD “I evaluated my guy….” “So, the symptoms my guy presented with were…” *huge grin* I wish I really could call him "my guy."
I even made a little video, which no one else did. They showed video clips that they found on youtube, but I *made* my own video. I did it for multiple reasons (save time waiting to reach a desired point in the vid, commentary within the vid instead of trying to talk over it, control over what the vid contained). The teacher later gave written feedback and said: “Nice work with your clip! Very unique - you went the extra mile.”
The presentation took around 8 minutes to present, which went a little over the limit of 5-7 minutes. I made the class laugh maybe four times, which was four times more than how much other presentations made people laugh. If I remember right, it was about the hairspray, the shrugging/clavicular breathing, interpreting the endoscopy, and the video saying “ow.” People seemed to enjoy it!
I heard a few murmurs after presenting the video clip where we saw pretty pretty Bill. Wonder what they said. The murmurs didn’t last long, and they didn't bother me in the least. When it was over, people seemed to clap enthusiastically. But maybe I was just high on the happiness that Bill usually brings me.
In the written feedback, the teacher said my content was very nice and detailed, the background information on Bill and his voice problem was good, and that overall, she “really enjoyed” my presentation! :D :D :D :D I got 50 out of 50 points. :D It went super well!
I made two videos about it, where I present it to share with you guys. It’s in two parts.
Also, the evaluation report is below! It's three pages on a microsoft word document. I wrote it as if I actually did have Bill as my patient. That report is a lot like what an actual, professional report would be! See? That’s how I write and that’s what I’m going to be writing as part of my job one day.
So without further ado, here is my presentation! The second video has that picture of the vocal folds but I promise that's the grossest pic for anyone who is squeamish. I am, believe you me. In an earlier class, the teacher showed us some youtube videos of surgery procedures for the voice and I couldn't watch those. This is just a still image of some inflamed and cysty vocal cords.
Here is the video clip of Bill that I made and showed in class as part of the presentation.
So, did you learn anything about cysts?
And here is the report I wrote up! It's a little more detailed than a real-life report would be because this was for an assignment. I had to be very thorough.
In the report, I even mentioned Tom and how Tom reported that Bill had no difficulty swallowing. Teeheeheee! *wicked grin* I wrote this report about a situation where I'd be getting Bill as a patient right after his 2 weeks of vocal rest, because realistically, that's when I'd ever be involved. I would never have been involved in the initial evaluation, the diagnosis, the surgery, or any of that. Just afterwards.
Voice Evaluation Report
Name: Bill Kaulitz
Type of Case: Vocal fold cyst
Age: 22 years
DOB: 9/1/1989
Address: Not a resident of the United States
Phone: +49-89-636-48018 (International Number)
Date of voice evaluation: 7/19/2012
REFERRAL: The patient was referred by Dr. Katie Smith, M.D., otolaryngologist, City, State.
HISTORY OF THE PROBLEM: The patient is a professional singer who was touring with his musical group when he was referred. The patient had performed 43 shows before his voice pathology significantly interfered with his performances. He also participated in numerous interviews and appearances during the tour, which required him to talk excessively. The patient lost his voice onstage and the tour was cancelled, which resulted in him seeking immediate medical attention.
At that time (7/5/2012) the patient reported, hoarseness, reduced pitch range, soreness, intermittent aphonia after prolonged use, increased effort and tension, fatigue, and difficulty singing. He said his voice was “out of voluntary control” and “difficult to find.”
Dr. Katie Smith, M.D. and otolaryngolist, performed rigid laryngoscopy and videostroboscope. The evaluation revealed an epidermoid cyst on the right vocal fold embedded in the lamina propria, bilateral vocal fold thickening, and swelling and irritation on the side opposite the lesion. The musocal wave was observed in the left vocal fold, and not observed on the right side, which contained the cyst. The complete absence of a mucosal wave across the surface of the cyst aided with the differential diagnosis of the cyst from a nodule or polyp. Additionally, the lesion was shiny, translucent, and had a dilated and pronounced blood vessel over its surface.
The cyst was severe and would have resulted in permanent vocal fold scarring if not removed, so surgery was the immediate option. The cyst was excised in a surgical procedure on 7/5/2012 and performed by Dr. Smith. The patient was ordered to undergo 2 weeks of vocal rest, and was prescribed corticosteroids to reduce swelling.
After two weeks of vocal rest, the patient was evaluated by Dr. Smith again, and a videostrobic examination was administered to assess healing and readiness for voice therapy. Dr. Smith declared the patient ready to phonate again as of 7/18/2012. The patient is motivated to begin voice therapy and regain his voice. He desires to return to singing as soon as possible.
MEDICAL HISTORY: In 2006, the patient took anabolic steroids for 6 months to stimulate appetite and bone growth. Side effects resulted in fluid imbalance and water retention, which was resolved in 2007. Currently, he reports to smoking since his adolescence and consumes alcohol occasionally.
SOCIAL HISTORY: The patient reports talking excessively and speaking loudly. He is a social young man. He has been singing since age 12, and has been in the music business with his twin brother and other band members since he was 15 years old. His musical and business career is very important to him. His brother attends every medical appointment and voice therapy session with him.
ORAL-PERIPHERAL EXAMINATION: The structure and function of the patient’s oral mechanism was within normal limits for the support of speech and voice production. The range of motion, strength, and accuracy of articulatory movements was evaluated to be adequate. The patient swallowed water without difficulty, and his brother reported that the patient has no difficulty with feeding and swallowing. The patient was observed to have good posture and typical healthy breathing.
VOICE EVALUATION:
The patient attempted phonation the first time during the session. Speech was attempted successfully, and the patient sang a short excerpt from a song. Perceptual qualities were noted, and near the end of the session, a VisiPitch was used to instrumentally measure the patient’s voice.
General Quality: The patient’s first attempt at voicing was a success. His voice was weak, hoarse, and breathy at the beginning of the session, but increased in strength and clarity as the session continued. By the end of the session, the patient’s voice had reduced hoarseness, breathiness, and weakness.
Respiration: The patient demonstrated posture to support phonation tasks. The patient demonstrates abdominal breathing for speech, and clavicular breathing for singing. The patient’s s/z ratio was 1, and within normal limits.
Phonation: During quiet speech, the patient’s voice contained glottal fry at the ends of sentences and during certain words. The timing of the patient’s glottal fry was appropriate for the prosodic inflection of his speech.
The patient’s singing style utilizes occasional glottal fry and late onsets in voiceless consonant-vowel sequences. He alternates between a soft, breathy singing voice, and a strong, forceful singing voice.
The patient’s maximum phonation time was 20 seconds, which was within normal limits.
Resonation: Perceptually observed to be within normal limits
Pitch: The patient’s reported pitch range is 4 octaves. However, at the time of evaluation he was only comfortable attempting a 2 octave range. During the evaluation, he experienced no pitch breaks. Instrumental assessment revealed the patient’s fundamental frequency to be 130 Hz, which is within normal limits for trained voice users. The patient’s frequency perturbation (jitter) was revealed to be 0.80, which is slightly outside normal limits.
Intensity: Perceptually, the patient’s vocal intensity was appropriate when speaking. During evaluation, his loudness levels were appropriate for the vocal task. However, the patient reported singing with considerably more force when performing. Instrumentally, the patient’s dB levels during a reading passage were 60 dB and within normal limits. The patient’s amplitude perturbation (shimmer) was revealed to be 0.40, which is within normal limits.
Rate of Speech: When speaking his native language, the patient’s speech rate is 220 words per minute, which is higher than the norm (160-170 wpm). When speaking his secondary language (English) his speech rate is 170 wpm.
Hearing: The patient reported having hearing loss, but the nature of which was not known. He reports being in loud environments very often. The patient passed a hearing screening at the frequencies 1000 Hz, 2000 Hz, and 4000 Hz at 25 dB. However, due to his concerns he was referred to John Bayer, CCC-AuD in City, State, for further evaluation.
Laryngeal Strength and Tone: Visible tension was observed in the supralaryngeal and sublaryngeal neck muscles during the singing task. The patient recruited neck and shoulder muscles to aid in inhaling large amounts of air, and shrugged with every inhalation. When asked to support singing using his abdominal muscles, the patient experienced difficulty.
Vocal Abuse and Misuse: At the time of the evaluation, the patient exhibited clavicular breathing and laryngeal tension. The patient reported a large number of abusive vocal behaviors before his surgery, such as smoking, alcohol consumption, excessive talking, increased volume when talking and singing, tension, emotional stress, glottal fry, excessive, prolonged loudness, continued use of the voice despite strain and fatigue.
IMPRESSIONS:
The patient’s voice has functionally recovered from surgical removal of the cyst, and he is able to phonate to achieve speech. During the evaluation, the patient revealed that his vocation and habits of vocal abuse and misuse put his voice at risk for further voice disorders.
PROGNOSIS:
If suggested recommendations are followed, the patient’s prognosis is fair. Positive prognostic factors are his is based on his high motivation to return to his job and the patient’s determination to not allow vocal problems to happen again. Negative prognostic factors are the nature of the patient’s job as a singer, and the environments he is in that encourage vocal misuse and abuse behaviors.
RECOMMENDATIONS:
It is recommended that the patient receive voice therapy twice a week for 4 weeks.
Recommended therapy targets:
• Establishing healthy and efficient voice use
o Reducing tension and strain
o Using abdominal breath support
o Reducing loudness
o Implementing vocal rests
• Counseling and education and the vocal mechanism and healthy/unhealthy use of the voice
• Elimination of vocal abuse and misuse behaviors
Recommended therapy techniques:
• Abdominal breathing training
• Change loudness levels
• Chant talk
• Counseling
• Easy onset
• Education about the voice
• Eliminate abuse and misuse
• Reduction of emotional stress
• Hierarchy analysis
• Hydration
• Laryngeal massage
• Negative practice
• Professional singing training
• Periods of vocal rest
• Yawn-sigh
Evaluation Completed by:
_______________________
Melluransa Marshmallowpants
Graduate Clinician
Resources
American Academy of Otolaryngology. (n.d.) Fact sheet: nodules, polyps, and cysts. American Academy of
Otolaryngology, and Head and Neck Surgery. Accessed 7/21/2012 from http://www.entnet.org/HealthInformation/nodPolypCysts.cfm
Colton, R.H., Casper, J.K., Leonard, R. (2011). Understanding voice problems: A physiological perspective
for diagnosis and treatment: Fourth edition. Philadelphia, Pennsylvania: Wolters Kluwer.
Chang, C. (2011). The voice with normal speech, but loss of upper range quality. Falquier Professional
Voice Care of Northern Virginia. Accessed 7/22/2012 from
http://www.fauquierent.net/voiceupper.htm#cyst
DDP/The Local. (2008). Tokio Hotel singer to have surgery. The Local: Germany’s News in English.
Accessed 7/22/2012 from http://www.thelocal.de/society/20080325-10879.html
Schweinfurth, J., Ossoff, R.H., Rosen, C.A., Talavera, R.M., Slack, C.L., & Meyers, A.D. (2010). Vocal
fold cysts: Treatment and management. WebMD. Accessed 7/21/2012 from
http://emedicine.medscape.com/article/866019-overview
RTL. (2009). Special: 100% Tokio Hotel Documentary. RTL Plus Television, Air date: 6/10/2009.
Accessed 7/22/2012 from http://www.youtube.com/watch?v=RJAD-JGsUjM
My first choice for a celeb was Bill Kaulitz, and he’s who I ended up doing the project on!
So, my first choice was Bill. But I wasn’t sure if he was normal enough. Other people were reporting on American celebs like Sophia Bush, Rachel Ray, Steven Tyler, Fran Drescher, Whitney Houston, Julie Andrews, Adele, sports team coaches, Michael J. Fox, etc etc. Bill is so different (and so much more awesome) than them. I hesitated to sign up with him as my project, and I went the safe route and selected Jordin Sparks.
There was no information on Jordin Sparks. I’d have to make everything up about her case and making up cases is hard (Yes, I've made up cases for assignments). Forget that! Plus, she's nowhere NEAR as awesome as Bill.
I wondered if I should step a little out of my comfort zone and do the project on lovely Bill. This was kind of a big deal to consider. There are 33 people in the class, and I’ve been in the academic program with them for 4 years. I know them and they know me, and we’re going to be professional colleagues one day. I wasn’t sure if I wanted to share someone as wonderfully different as Bill with them. Additionally, sharing him with them was really personal, since Bill is a huge part of my personal/lesure/recreational life. Aside from wearing the occasional TH or Bill shirt and TH wristband, my classmates have no idea about my fascination with Bill.
Additionally, this was a project consisting of a professionally-written (mock) report as if I really had evaluated Bill, and also a presentation that would be graded in line with the higher standards of graduate school. Kinda didn’t want to blow it.
But I got over myself with a little discussion and input from some of you guys and I went for it! I told the teacher I was changing my celeb to Bill. She was taken by surprise and I was gleeful. Later in the written feedback, the teacher wrote, “I like how you came up with someone different :-)” And yes, there was seriously a smiley face.
So, that was the buildup to eventually selecting Bill. After that, it was easy to research the topic, write the report, and make the presentation. I even knew what video clip to use in the presentation. That all came very easily. It was all done in love~ It wasn't even work, you know?
Then, it was presentation day! I was maybe 5th or 6th to present. We were all presenting that day (it was dreary and boring). I knew it would be dreary so I tried to have a little fun with my presentation, since we like watching people have fun more than watching people who are clearly bored and uninterested in their own topic. I guess my passion for Bill shone through a little bit? I kept referring to him as “my guy.” XD “I evaluated my guy….” “So, the symptoms my guy presented with were…” *huge grin* I wish I really could call him "my guy."
I even made a little video, which no one else did. They showed video clips that they found on youtube, but I *made* my own video. I did it for multiple reasons (save time waiting to reach a desired point in the vid, commentary within the vid instead of trying to talk over it, control over what the vid contained). The teacher later gave written feedback and said: “Nice work with your clip! Very unique - you went the extra mile.”
The presentation took around 8 minutes to present, which went a little over the limit of 5-7 minutes. I made the class laugh maybe four times, which was four times more than how much other presentations made people laugh. If I remember right, it was about the hairspray, the shrugging/clavicular breathing, interpreting the endoscopy, and the video saying “ow.” People seemed to enjoy it!
I heard a few murmurs after presenting the video clip where we saw pretty pretty Bill. Wonder what they said. The murmurs didn’t last long, and they didn't bother me in the least. When it was over, people seemed to clap enthusiastically. But maybe I was just high on the happiness that Bill usually brings me.
In the written feedback, the teacher said my content was very nice and detailed, the background information on Bill and his voice problem was good, and that overall, she “really enjoyed” my presentation! :D :D :D :D I got 50 out of 50 points. :D It went super well!
I made two videos about it, where I present it to share with you guys. It’s in two parts.
Also, the evaluation report is below! It's three pages on a microsoft word document. I wrote it as if I actually did have Bill as my patient. That report is a lot like what an actual, professional report would be! See? That’s how I write and that’s what I’m going to be writing as part of my job one day.
So without further ado, here is my presentation! The second video has that picture of the vocal folds but I promise that's the grossest pic for anyone who is squeamish. I am, believe you me. In an earlier class, the teacher showed us some youtube videos of surgery procedures for the voice and I couldn't watch those. This is just a still image of some inflamed and cysty vocal cords.
Click to viewHere is the video clip of Bill that I made and showed in class as part of the presentation.
So, did you learn anything about cysts?
And here is the report I wrote up! It's a little more detailed than a real-life report would be because this was for an assignment. I had to be very thorough.
In the report, I even mentioned Tom and how Tom reported that Bill had no difficulty swallowing. Teeheeheee! *wicked grin* I wrote this report about a situation where I'd be getting Bill as a patient right after his 2 weeks of vocal rest, because realistically, that's when I'd ever be involved. I would never have been involved in the initial evaluation, the diagnosis, the surgery, or any of that. Just afterwards.
Voice Evaluation Report
Name: Bill Kaulitz
Type of Case: Vocal fold cyst
Age: 22 years
DOB: 9/1/1989
Address: Not a resident of the United States
Phone: +49-89-636-48018 (International Number)
Date of voice evaluation: 7/19/2012
REFERRAL: The patient was referred by Dr. Katie Smith, M.D., otolaryngologist, City, State.
HISTORY OF THE PROBLEM: The patient is a professional singer who was touring with his musical group when he was referred. The patient had performed 43 shows before his voice pathology significantly interfered with his performances. He also participated in numerous interviews and appearances during the tour, which required him to talk excessively. The patient lost his voice onstage and the tour was cancelled, which resulted in him seeking immediate medical attention.
At that time (7/5/2012) the patient reported, hoarseness, reduced pitch range, soreness, intermittent aphonia after prolonged use, increased effort and tension, fatigue, and difficulty singing. He said his voice was “out of voluntary control” and “difficult to find.”
Dr. Katie Smith, M.D. and otolaryngolist, performed rigid laryngoscopy and videostroboscope. The evaluation revealed an epidermoid cyst on the right vocal fold embedded in the lamina propria, bilateral vocal fold thickening, and swelling and irritation on the side opposite the lesion. The musocal wave was observed in the left vocal fold, and not observed on the right side, which contained the cyst. The complete absence of a mucosal wave across the surface of the cyst aided with the differential diagnosis of the cyst from a nodule or polyp. Additionally, the lesion was shiny, translucent, and had a dilated and pronounced blood vessel over its surface.
The cyst was severe and would have resulted in permanent vocal fold scarring if not removed, so surgery was the immediate option. The cyst was excised in a surgical procedure on 7/5/2012 and performed by Dr. Smith. The patient was ordered to undergo 2 weeks of vocal rest, and was prescribed corticosteroids to reduce swelling.
After two weeks of vocal rest, the patient was evaluated by Dr. Smith again, and a videostrobic examination was administered to assess healing and readiness for voice therapy. Dr. Smith declared the patient ready to phonate again as of 7/18/2012. The patient is motivated to begin voice therapy and regain his voice. He desires to return to singing as soon as possible.
MEDICAL HISTORY: In 2006, the patient took anabolic steroids for 6 months to stimulate appetite and bone growth. Side effects resulted in fluid imbalance and water retention, which was resolved in 2007. Currently, he reports to smoking since his adolescence and consumes alcohol occasionally.
SOCIAL HISTORY: The patient reports talking excessively and speaking loudly. He is a social young man. He has been singing since age 12, and has been in the music business with his twin brother and other band members since he was 15 years old. His musical and business career is very important to him. His brother attends every medical appointment and voice therapy session with him.
ORAL-PERIPHERAL EXAMINATION: The structure and function of the patient’s oral mechanism was within normal limits for the support of speech and voice production. The range of motion, strength, and accuracy of articulatory movements was evaluated to be adequate. The patient swallowed water without difficulty, and his brother reported that the patient has no difficulty with feeding and swallowing. The patient was observed to have good posture and typical healthy breathing.
VOICE EVALUATION:
The patient attempted phonation the first time during the session. Speech was attempted successfully, and the patient sang a short excerpt from a song. Perceptual qualities were noted, and near the end of the session, a VisiPitch was used to instrumentally measure the patient’s voice.
General Quality: The patient’s first attempt at voicing was a success. His voice was weak, hoarse, and breathy at the beginning of the session, but increased in strength and clarity as the session continued. By the end of the session, the patient’s voice had reduced hoarseness, breathiness, and weakness.
Respiration: The patient demonstrated posture to support phonation tasks. The patient demonstrates abdominal breathing for speech, and clavicular breathing for singing. The patient’s s/z ratio was 1, and within normal limits.
Phonation: During quiet speech, the patient’s voice contained glottal fry at the ends of sentences and during certain words. The timing of the patient’s glottal fry was appropriate for the prosodic inflection of his speech.
The patient’s singing style utilizes occasional glottal fry and late onsets in voiceless consonant-vowel sequences. He alternates between a soft, breathy singing voice, and a strong, forceful singing voice.
The patient’s maximum phonation time was 20 seconds, which was within normal limits.
Resonation: Perceptually observed to be within normal limits
Pitch: The patient’s reported pitch range is 4 octaves. However, at the time of evaluation he was only comfortable attempting a 2 octave range. During the evaluation, he experienced no pitch breaks. Instrumental assessment revealed the patient’s fundamental frequency to be 130 Hz, which is within normal limits for trained voice users. The patient’s frequency perturbation (jitter) was revealed to be 0.80, which is slightly outside normal limits.
Intensity: Perceptually, the patient’s vocal intensity was appropriate when speaking. During evaluation, his loudness levels were appropriate for the vocal task. However, the patient reported singing with considerably more force when performing. Instrumentally, the patient’s dB levels during a reading passage were 60 dB and within normal limits. The patient’s amplitude perturbation (shimmer) was revealed to be 0.40, which is within normal limits.
Rate of Speech: When speaking his native language, the patient’s speech rate is 220 words per minute, which is higher than the norm (160-170 wpm). When speaking his secondary language (English) his speech rate is 170 wpm.
Hearing: The patient reported having hearing loss, but the nature of which was not known. He reports being in loud environments very often. The patient passed a hearing screening at the frequencies 1000 Hz, 2000 Hz, and 4000 Hz at 25 dB. However, due to his concerns he was referred to John Bayer, CCC-AuD in City, State, for further evaluation.
Laryngeal Strength and Tone: Visible tension was observed in the supralaryngeal and sublaryngeal neck muscles during the singing task. The patient recruited neck and shoulder muscles to aid in inhaling large amounts of air, and shrugged with every inhalation. When asked to support singing using his abdominal muscles, the patient experienced difficulty.
Vocal Abuse and Misuse: At the time of the evaluation, the patient exhibited clavicular breathing and laryngeal tension. The patient reported a large number of abusive vocal behaviors before his surgery, such as smoking, alcohol consumption, excessive talking, increased volume when talking and singing, tension, emotional stress, glottal fry, excessive, prolonged loudness, continued use of the voice despite strain and fatigue.
IMPRESSIONS:
The patient’s voice has functionally recovered from surgical removal of the cyst, and he is able to phonate to achieve speech. During the evaluation, the patient revealed that his vocation and habits of vocal abuse and misuse put his voice at risk for further voice disorders.
PROGNOSIS:
If suggested recommendations are followed, the patient’s prognosis is fair. Positive prognostic factors are his is based on his high motivation to return to his job and the patient’s determination to not allow vocal problems to happen again. Negative prognostic factors are the nature of the patient’s job as a singer, and the environments he is in that encourage vocal misuse and abuse behaviors.
RECOMMENDATIONS:
It is recommended that the patient receive voice therapy twice a week for 4 weeks.
Recommended therapy targets:
• Establishing healthy and efficient voice use
o Reducing tension and strain
o Using abdominal breath support
o Reducing loudness
o Implementing vocal rests
• Counseling and education and the vocal mechanism and healthy/unhealthy use of the voice
• Elimination of vocal abuse and misuse behaviors
Recommended therapy techniques:
• Abdominal breathing training
• Change loudness levels
• Chant talk
• Counseling
• Easy onset
• Education about the voice
• Eliminate abuse and misuse
• Reduction of emotional stress
• Hierarchy analysis
• Hydration
• Laryngeal massage
• Negative practice
• Professional singing training
• Periods of vocal rest
• Yawn-sigh
Evaluation Completed by:
_______________________
Melluransa Marshmallowpants
Graduate Clinician
Resources
American Academy of Otolaryngology. (n.d.) Fact sheet: nodules, polyps, and cysts. American Academy of
Otolaryngology, and Head and Neck Surgery. Accessed 7/21/2012 from http://www.entnet.org/HealthInformation/nodPolypCysts.cfm
Colton, R.H., Casper, J.K., Leonard, R. (2011). Understanding voice problems: A physiological perspective
for diagnosis and treatment: Fourth edition. Philadelphia, Pennsylvania: Wolters Kluwer.
Chang, C. (2011). The voice with normal speech, but loss of upper range quality. Falquier Professional
Voice Care of Northern Virginia. Accessed 7/22/2012 from
http://www.fauquierent.net/voiceupper.htm#cyst
DDP/The Local. (2008). Tokio Hotel singer to have surgery. The Local: Germany’s News in English.
Accessed 7/22/2012 from http://www.thelocal.de/society/20080325-10879.html
Schweinfurth, J., Ossoff, R.H., Rosen, C.A., Talavera, R.M., Slack, C.L., & Meyers, A.D. (2010). Vocal
fold cysts: Treatment and management. WebMD. Accessed 7/21/2012 from
http://emedicine.medscape.com/article/866019-overview
RTL. (2009). Special: 100% Tokio Hotel Documentary. RTL Plus Television, Air date: 6/10/2009.
Accessed 7/22/2012 from http://www.youtube.com/watch?v=RJAD-JGsUjM