Singer Nicki Minaj with Strained Vocal Cords

Media has reported that pop star Nicki Minaj had to cancel upcoming concerts in England due to injured vocal cords.

She apparently saw a doctor who diagnosed "strained vocal cords" after an x-ray and recommended voice rest for a few days.

The singer apparently ignored this advice and sang in New York City on Aug 18 causing her voice to substantially worsen resulting in her decision to cancel her concerts this weekend.

Details of her vocal cord condition are sparse. However, based on the limited information provided, there's a few things I can guess at.

First off, an x-ray can NOT diagnose any type of vocal cord condition. The singer must have undergone a trans-nasal endoscopic procedure which is the ONLY way to visualize the vocal cord and diagnose any vocal problems.

Given the singer was instructed to rest her voice for "a few days," she most likely suffered from a mild acute laryngitis causing inflamed vocal cords. By ignoring advice to rest her voice, she potentially turned a mild laryngitis into a more severe laryngitis. She probably did not suffer from any physical problems on her vocal cords like nodules or polyps which would take weeks if not months to recover (not days) as happened to singers Adele and John Mayer.

Really, at this point, strict voice rest, hydration, acid reflux control, and steroids (ie, prednisone) would enable her to recover her normal voice ASAP.

Here's a picture of a severe laryngitis (left) compared a normal appearing vocal cords (right). Note that the vocal cords are swollen and red compared to normal pearly white and thin appearance.

 

Source:
Nicki Minaj cancels U.K. concerts due to strained vocal cords. NBC News 8/18/12

People DO Suffer Hearing Loss After a Loud Concert

Almost everybody at some point in their lives have attended a loud concert or loud nightclub.

Almost everybody will also recall a temporary reduction in their hearing with or without ringing afterwards for a short period of time.

This phenomenon is called temporary threshold shift (TTS) whereby the affected person has a temporary hearing loss that may last hours to days due to temporary damage of the outer hair cells of the cochlea.

If loud nose exposure happens enough times, permanent hearing loss can occur.

For some, permanent hearing loss may occur after attending numerous loud concerts whereas in other more "susceptible" individuals, it can happen after a single loud concert.

It doesn't even have to be a loud music concert. ANY loud noise exposure can do including shooting guns, listening to a portable music player like the iPod, fireworks, playing in an orchestra/band, etc.

However, loud concerts are of particular interest given how many individuals are exposed all at once and provided a unique research opportunity which was presented on May 21, 2012 at the American Otologic Society Meeting in Los Angeles.

The researchers (led by Dr. Jennifer Derebery of the House Ear Institute) essentially took hearing test before and after the concert of 29 teenagers.

72% suffered objective hearing loss after the concert though only 53% reported subjective hearing loss. 25% reported new onset tinnitus after the concert.

Of note, hearing ear plugs were offered to the study subjects, but only 3 accepted them.

Adult researchers who sat with the teenagers under investigation measured sound levels throughout the concert. During the 26 songs played during the three hour concert, sound levels ranged from 82 to 110 decibels with an average of 98.5 decibels. The mean level was greater than 100 decibels for 10 of the 26 songs.

As a reference, ear pain occurs at 125dB. Jet engine noise is at 140dB. Sustained loud noise exposure of 90-95dB can result in permanent hearing loss.

OSHA (Office of Safety and Health Administration) mandates workers to never be exposed to sound levels of 100dB for more than 2 hours per day (no more than 4 hours per day at 95dB).

Clearly something more needs to be done to protect teenagers' hearing, especially given how few accepted hearing ear plugs. A fundamental cultural shift would most likely have to occur with encouragement from not only the musicians but also parents and teachers...

OR, the music volume at concerts should be turned down... No boos please.


Reference:
Teenagers Hear Worse After Attending Concert. LiveScience 5/21/12

Another Rock Singer With Injured Voice

On Sept 16, 2011, the Stone Temple Pilots had to cancel their tour because their lead singer Scott Weiland was placed on voice rest due to damaged vocal cords at risk for permanent damage. Specifically, the doctors at University of Cincinnati Voice Health Center determined that he had scarring on his left vocal cord and a tremendously inflamed right vocal cord.

The left vocal cord scarring is likely from past vocal trauma that did not heal properly and is now permanently damaged whereas the right vocal cord is at risk of also becoming permanently damaged if not aggressively managed. The picture shown here is an example with inflammation involving both vocal cords. Compare this with the picture below which shows one normal vocal cord and one inflamed vocal cord.

Without further information, beyond voice rest to allow the vocal cord inflammation to resolve without further injury, treatment may also include steroids as well as reflux medication.

It seems to be a continuing trend for singers of all genres to be pushed to the point where their vocal cords get injured resulting in show cancellations and at worst, become a one-hit wonder.

Other singers THIS YEAR alone who have cancelled tours due to voice injury include Kings of Leon, Duran Duran, Adele, The Vaccines, etc

And it's not just rockers, but also opera singers.

If you are a singer and you don't have a voice coach and supportive management, you need to remedy this immediately or you risk having a career that's a one-hit wonder.