Singing and Performing Voice Services

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Specialized Care for Singers at All Levels

Singers, actors, and other vocal performers are at increased risk for developing a vocal cord (or vocal fold) injury or vocal disorder, including vocal nodules and muscle tension dysphonia. Common voice problems that can occur with aging, surgery, or certain medical conditions can also affect your singing voice (for example, vocal cord atrophy, paralysis, and tremor).

We understand that your voice is an essential part of your identity, your creative expression, and your livelihood. Our advanced training and experience ensure we have the knowledge and expertise to help you achieve the best possible recovery of your voice.

Need Urgent Voice Care Before a Performance?

We'll work with you to arrange a voice evaluation and expert voice care -- quickly, compassionately, and with discretion. Call 919-681-4984.

Tests

A thorough singing voice evaluation assesses your pitch/vocal range, loudness range, vocal stamina, breath support, resonance, and register transitions. Our singing voice specialists will identify any muscle tension that may be contributing to your voice problem and evaluate your vocal technique relative to your singing style. We also identify strategies to optimize your vocal hygiene and vocal pacing. If needed, we will advocate for your vocal health with directors, producers, tour managers, and other artistic personnel.

Videolaryngostroboscopy

This detailed visual exam helps us evaluate how your vocal cords vibrate while you make sounds. A tiny camera attached to a small tube called an endoscope is inserted through your nose and into your throat. This allows us to see your vocal cords and larynx (voice box). A flashing strobe light simulates slow motion video images of your vocal cords. The exam takes about a minute; your nose may be sprayed with topical anesthetic for your comfort. The exam allows your team to look for lesions, stiffness, paralysis, irregular movements, throat strain, or incomplete closure of the vocal cords. Videolaryngostroboscopy is essential to reach an accurate diagnosis and determine the best treatment for your voice.

Our Locations

Duke Health offers locations throughout the Triangle. Find one near you.

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Treatments

Voice Therapy for Singers

Singing voice therapy includes customized vocal exercises designed to optimize your vocal quality, stamina, and range while also helping to heal vocal injuries and protect you against re-injury. Our clinical singing voice specialists teach you how to maintain optimal vocal health as well as strategies to restore your best-possible level of vocal performance.

Vocal Hygiene

Your clinical singing voice specialist will offer guidance on factors that support the health and function of your voice, such as improving hydration, reducing misuse or overuse of your voice, avoiding throat clearing and coughing, and in coordination with your laryngologist, managing allergies, asthma, acid reflux, or other medical conditions that can affect your voice.

Vocal Pacing

Finding a balance between voice use and voice rest every day is important if you have a voice problem that worsens with heavy voice use. Vocal pacing means not talking or singing for small intervals during the day to allow your vocal cords time to recover from trauma. If your profession makes heavy demands on your voice, it's also important to take longer periods of voice rest outside of work. Without these recovery times, your vocal cords may be injured more quickly and heal more slowly. Vocal pacing is challenging but necessary, and your clinical singing voice specialist will work with you to develop good strategies for vocal pacing while helping you get back to your singing baseline.

Complete Voice Rest

While complete voice rest is not the first line of treatment for most voice problems, completely avoiding talking or singing is beneficial in certain situations, such as acute laryngitis, after vocal cord surgery, or in the case of vocal cord hemorrhage. There are times when complete voice rest is recommended to give the vocal cords a break so they can heal from injury. Your laryngologist may recommend a week or so of complete voice rest. During this time, you can communicate by writing, sending emails or texts, or using a text-to-speech app on your smartphone.

Microsurgery for Noncancerous Lesions

Surgery may be recommended to remove noncancerous vocal cord lesions. While you are under general anesthesia, tiny surgical instruments are inserted through your mouth into your throat. The surgeon makes a very small incision away from the vibrating edge of your vocal cord, and a tiny flap of tissue is lifted so the lesion can be removed. Also known as phonomicrosurgery, this technique reduces the risk of scarring and offers the best voice outcomes. A course of voice therapy after microsurgery is essential for optimal recovery.

Call for an Appointment

855-855-6484

Why Choose Duke

A Team of Experts
Your team includes laryngologists -- ear, nose, and throat (ENT) physicians who have advanced training in voice disorders. It also includes clinical singing voice specialists -- speech pathologists with additional training in vocal performance and singing instruction. Because our clinical singing voice specialists are also professional singers and voice teachers, we bring a performer's perspective to evaluating and improving your singing voice.

Personalized Approach to a Performer's Needs
Our clinical singing voice specialists will assess the role of vocal load in your vocal injury and provide therapy for the specific needs of your performing voice. We can also advocate for you regarding planned performances and help you with vocal pacing and scheduling decisions. If your condition calls for surgery, we'll collaborate with your surgeon on steps to protect your singing voice before, during, and after surgery.

Coordinated Care
If you have other medical conditions that may contribute to changes in your singing voice -- such as allergies, asthma, or acid reflux -- we will work with your other providers throughout Duke Health to ensure you receive the best care from an integrated team.

Ongoing Research to Advance Voice Care
Our research into the performing voice ensures you receive the most advanced care for your vocal disorder.

Consistently Ranked Among the Nation’s Best Hospitals

Duke University Hospital is proud of our team and the exceptional care they provide. They are why we are once again recognized as the best hospital in North Carolina, and nationally ranked in 11 adult and 10 pediatric specialties by U.S. News & World Report for 2024–2025.