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May 28, 2011

American Idol Laryngitis Scare for Lauren Alaina

On May 24, 2011, US Magazine reported that American Idol Finalist Lauren Alaina "blew a vocal cord during afternoon rehearsal" and apparently completely lost her voice (aphonia).

Apparently, a doctor on set and ordered Lauren not to sing or speak which brought a very real possibility that she would not be able to perform that evening. Fortunately, "emergency" care was provided along with resting the voice and apparently sang quite well that night.

Without benefit of having examined Lauren's voice or being told what the exact emergency care that was provided, I have an idea of what might have happened and what care might have been provided.

Usually in the event of a sudden loss of voice during extreme voice use, it does suggest a blood vessel that might have ruptured. Blood vessel formation in the vocal cords is not unusual in the setting of heavy vocal use as shown in the picture to the left (normal is shown above for comparison). However, vasculature presence in the vocal cords is not a great situation as it does lead to a bit of unpredictability of how the vocal cords will perform in any given moment. Why? Because the vessel(s) may fluctuate in size leading to unintended pitch variation and at worst, raspiness. If you consider the vocal cord analagous to a violin string, a blood vessel is like adding the ability of the violin string to fluctuate in size.

In any case, once blood vessels are significantly present, the singer often has to continuously adjust the voice to achieve consistency in vocal quality. Often this leads to changes in vocal technique and even increased exertion in order to produce a consistent "good" voice.

However, with increased exertion to achieve that "good" voice, further irritation of the vocal cord vasculature may occur to the point it may rupture leading to a sudden loss of voice which is often accompanied with some transient pain. Here is a picture of what her vocal cord might have looked like after vessel rupture.

At this point, a few things can be done to try and resolve this situation as quickly as possible. By resting the voice, you reduce the repetitive trauma to the vocal cords that may further exacerbate bleeding into the vocal cord.

High dose steroids can be administered to reduce the inflammatory reaction to the vocal cord lining as well as swelling that is bound to happen.

Improvement can happen within hours... HOWEVER, injury is still present and vocal rest is mandatory to complete the healing process. Otherwise there is potential for permanent vocal cord injury that may require surgical intervention.



If you listen carefully to Lauren Alaina's voice right before her performance in this video, you can hear a slight rasp to her voice especially when saying the word "fine" indicative of a persistent vocal cord injury. I believe that if she sang a song containing  passages requiring a very quiet upper-range pitch, her voice would have sounded quite bad. As it is... by singing loudly, she would be able to "power" past any vocal cord imperfections. Indeed, she "beat" her laryngitis, though she'll have to be careful in the days to weeks after her performance.

Read the US Magazine article here.
Fauquier blog
Fauquier ENT

Dr. Christopher Chang is a private practice otolaryngology, head & neck surgeon specializing in the treatment of problems related to the ear, nose, and throat. Located in Warrenton, VA about 45 minutes west of Washington DC, he also provides inhalant allergy testing/treatment, hearing tests, and dispenses hearing aids. Google+ Christopher Chang, MD Bio

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