Dr. med. Reinhard Kürsten
Ear, Nose and Throat Consultant

Unfortunately the vocal chords are "well hidden" and it takes the knowledge and experience of an ENT specialist to examine them. The appropriate ENT equipment allows the doctor and patient to look at the patient's vocal chords on video. The examination is much more harmless than it may appear to a layman.

Examination of the larynx
During a laryngoscopy I ask the patient to stick out their tongue and try to say 'e'. That doesn't sound much like an 'e' with an open mouth, but the larynx moves to the position in which the vocal chords can be observed using a mirror or an endoscope.

With the help of the flexible endoscopy, I am even able to examine patients whose gagging reflex is so severe that they have problems brushing their teeth and for whom every visit to the dentist fills them with dread. These patients "love" the more comfortable examination of the larynx via the nose, which is, of course, desensitized by the use of a spray in advance.

A video-stroboscopy uses a trick to make things visible which would remain hidden with a normal examination (e.g. very small swellings, changes on the underside of the vocal chords or malfunctions).

The videos are stored. The advantage is that details which are only visible for a fraction of a second can be analyzed at length. It allows me to look at still frames which I can show and explain to my patients and save in their medical record on my computer.

With this technology it is possible to assess any changes more accurately over the years. I always take the opportunity to document the "normal condition" of a patient, whether he is healthy at the end of a routine checkup or at the end of a treatment course.


Are my vocal chords 'normal'?
Many patients (but also several doctors) believe that every healthy vocal chord looks the same - unfortunately this is not true. There are differences which affect patients differently. One patient might experience no problems at all and sing in the most famous opera houses in the world for years, whereas another patient might suffer and require surgical correction.

Therefore the correct documentation of your personal "normal vocal chords" can often save patients from undergoing unnecessary operations, which are prescribed on the basis that every vocal chord should look like it does in a textbook.

Many of my patients know their normal vocal chords (they even have a photo of them) and can help doctors all over the world to make the correct diagnosis.

Singing is Sport
Vocal chords are muscles which are covered with mucous membranes. When you sing or speak, your vocal chords resemble a lid on the windpipe which moves from an open position (respiration) to a closed position in the middle (phonation). This movement produces vocal sounds.

As with every sport, it is important to achieve the right mix of power and technique in order to produce the maximum energy.

As a "Sports doctor for vocal chords" I treat ailments which are related to the voice. I try to identify voice-use related problems as quickly as possible. I help my patients to avoid or correct mistakes.

Vocal chord operation

Unfortunately it is a widespread misconception that every vocal chord is as smooth as in a teaching manual. Surgery might not be necessary and can often be avoided by so-called 'conservative measures' (medication, vocal training etc.).

Of course there are also cases when a vocal chord operation is the only and often the simplest way to solve a vocal problem. Singers who are "Top Vocal Chord Athletes" might overstrain their voices by having a performance schedule which allows no regeneration time, or at least they believe they are too busy to allow time to recover properly from illnesses. This sometimes leads to changes to the vocal chords which can only be corrected by an operation.

Do not be frightened of vocal chord surgery!
Many patients are terrified of vocal chord operations. However, if all patients who were about to have an operation knew how many of the great singers have already undergone such operations, they would be much more confident. Unfortunately, unlike in many other top sports, the operations in this field go unmentioned as they are mistakenly seen as a sign of weakness, as a consequence of bad technique or as a sign of an early end to a career.

You should therefore not panic if the only solution is an operation. The painless operation is conducted under general anesthesia and is followed by a week of total rest for the voice. After this week the voice can be used normally. Public speaking professionals may need a few days of voice training and opera singers generally take several weeks before they are back on stage.

Opernring 4/2/6
A-1010 Wien
Telephone: +43 1 5126011
Telefax: +43 1 51260114
E-Mail: office.kuersten@gmail.com
Office Opening Hours:

Mo 13:30 to 6pm
Tue9 am to 12 noon
We13:30 to 6pm
Th13:30 to 6pm
Fr11 am to 3pm

We do not offer walk in appointments.

You are welcome to leave a message on the answering machine.
Standing on Ringstraße facing the Opera you will find my office on the left hand side.

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