JOINT BASE ANDREWS, Md. –
April has been designated as an important month to reflect on throat and voice disorders. Having vocal folds, commonly called vocal cords, that function normally is easy to take for granted until you have a problem with them and have difficulty communicating or sometimes even breathing. For Staff Sgt. Jonathon Troy, a clarinetist for the “President’s Own”, United States Marine Band, a condition known as vocal web prevented him from talking normally. Vocal web occurs when the vocal folds are bridged together by a web of connective tissue that prevents them from vibrating.
“I probably had vocal web for a long time but it wasn’t something I was aware of until another unrelated surgery caused it to expand,” said Troy. “I had severe vocal limitations and could only manage a weak, breathy voice at the top of my vocal range. It was extremely difficult to converse in public.”
Troy was seen by Lt. Col. (Dr.) Pryor Brenner, an Ear Nose and Throat surgeon at Malcolm Grow Medical Clinics and Surgery Center. Brenner used an endoscope to view Troy’s vocal folds and determine the size of the vocal web and see how it was hindering normal vibration. Brenner later performed surgery to separate the conjoined portion of Troy’s vocal folds with a keel or “spacer”. The keel remained in place for a month to ensure the web did not grow back while healing took place. A second surgery was needed to remove the spacer.
“I was absolutely elated following surgery. The difference in my voice was immediately noticeable after the keel was removed. I no longer have fear or stress over talking,” said Troy. “The experience has left permanent scar tissue though, which has caused some hoarseness and certain things like singing are virtually impossible.”
Following surgery, Troy avoided acidic foods to prevent any reflux, which could damage the vocal folds, especially while healing. He continues to follow-up with Brenner to discuss new procedures that have shown varying degrees of success in correcting scarring and hoarseness. He also works with a speech therapist to further improve his voice.
“The care I’ve received from military providers is remarkable. I’m most impressed by how willing the team has been to go the extra mile to ensure my voice continues to improve,” said Troy.
“When speaking with patients about preventive practices to avoid overuse or injury to vocal folds, I usually use an engine analogy,” said Brenner. “Warming up the voice before a performance or heavy speaking engagement is always a good idea. Just like engines need oil to stay lubricated, voice boxes need water to stay lubricated and decrease friction and inflammation. Overuse of your voice can cause fatigue and even soreness in the throat from the use of other muscles to aid in speaking.”
Hoarseness that progressively gets worse over six weeks, severe hoarseness and acute pain during vocal use, or decreased vocal endurance over several months are all reasons to seek medical attention from an ENT specialist.
“Staff Sgt. Troy had a very severe vocal fold web; the worst I have seen in ten years,” said Brenner. “Fortunately, his surgeries went well and he has come a long way. I am elated to hear his voice at every visit!”