SINUS,  NASAL AND THROAT PROBLEMS

Are you a singer, actor, or someone who depends on using their voice such as a teacher? And do you suffer from sinus, nasal or throat problems that affect your voice? Well, join the club! I have suffered these conditions for many years, and it seems that most of us who need, or want to have, a good voice are prone to these problems.

Sinus, nasal and throat problems can have many causes and the symptoms can vary from day-to-day and from person to person, so these notes are not intended as medical advice - you should consult a medical doctor for that. In this article I am only sharing some of the information that is readily available to the public and explaining what I have found helps me.

What I can state as fact is that sinus, nasal or throat problems make it more difficult for anyone to sing (or speak) well, and can affect the way your voice sounds, especially to yourself!

First, let’s get some of the physiology and terminology understood:

Respiratory Tract is the collective term used for those parts of the body concerned with breathing (respiration) and include – from top down – the sinuses, nose and nasal cavity, mouth, throat, larynx, trachea (windpipe), bronchi and lungs. It is common knowledge that the respiratory tract is susceptible to infections, eg- the common cold. The upper parts are also susceptible to allergies.

The vocal tract is the collective term used for those parts of the body concerned with vocalising and include the sinuses, nose and nasal cavity, the mouth, throat, larynx, trachea (windpipe), bronchi and lungs. If you have a respiratory tract infection, ipso facto your vocal tract is infected. [Note: it is a mute point (pun intended) whether the sinuses, nose and nasal cavity are all strictly part of the vocal tract. I say they are, and most singing teachers would agree].

Rhinitis is an inflammation of the mucus membrane of the nose. It is often caused by allergies, increased sensitivity to irritants such as smoke, temperature changes or the overuse of decongestant nasal sprays. Poorly controlled rhinitis can, however, lead to sinusitis.

Sinusitis is an inflammation of the para-nasal sinuses. It may be a short-term, acute inflammation caused by bacterial infection following an infection such as the common cold. However, sinusitis can sometimes be a long-term, chronic condition related to allergies, crooked nasal anatomy, smoking, nasal polyps and overuse of decongestant nasal sprays.

The sinuses are hollow cavities within the skull, situated in the forehead, cheeks and between and behind the eyes. They are connected to the nose through small tunnels that are little wider than a pinhead. Blockage of these tunnels often causes pain in the face. Also, a blocked sinus creates an environment that favours the growth of bacteria, in a similar way that algae grows in stagnant water.

Mucus is a natural product of glands in the respiratory system, most obviously from the nose. In an adult, about one litre is produced each day to clean the nasal membranes, humidify air, trap and clear inhaled foreign matter, and fight infection. Healthy nasal mucus is thin and clear and is normally swallowed unconsciously, lubricating the esophagus on the way to the stomach.

Abnormal Mucus secretion. As our ‘first line of defence’ against infections and allergens, mucus must ‘move them on and out’. But this system easily ‘clogs up’ as the volume of mucus increases and/or the mucus thickens in response to the infection or irritant. Stagnant, thickened mucus becomes an ideal breeding ground for infection. Herein lies the reason why respiratory tract infections are so commonly occurring!

Post-nasal Drip is the term used to describe the accumulation of mucus in the throat causing us to become aware of mucus leaving the nasal cavity and dripping down the throat. In the presence of infection or allergy the mucus is carrying infection/irritation to the throat. During sleep, swallowing occurs less frequently than when awake so mucus accumulates in the throat and some of it will enter the larynx and trachea instead of passing down to the stomach. We wake up with ‘a bad throat’ and, if infection is present, it can then spread into the trachea and lungs.

In my own case, I’ve had a damaged nose since I was a child and I have suffered from allergies most of my adult life. What have I had done about it? Well, I’ve twice undergone nasal surgery – about 20 years apart, with initial benefits that faded after a few years. I’ve been tested for allergy and undergone de-sensitising treatment with significant benefits - I’m much less sensitive and live a much better life.

My sinus problems usually start from having a cold or similar infection of the respiratory tract or from an allergy attack. After recovering from the cold or allergy in a few days, I would be left with symptoms such as headache, sore throat (mostly in the mornings from post-nasal drip while asleep), restricted breathing, excessive nose blowing, tiredness, and watery eyes. Those damned sinuses!

The voice is affected in two ways: firstly by mucus finding its way into the larynx and coming in contact with the vocal folds. This directly interferes with phonation and you often need to ‘clear your throat’.  Secondly, the clogged sinuses alter the way we hear our voice and can change the actual sound but to a lesser extent than you think! For some singers the change in the ‘internal sound’ of their voice is bizarre and very unsettling!

The treatment which I have personally found effective is a ‘saline nasal & sinus wash’. There are several brands, available over-the-counter from chemists, such as ‘Flo’ or ‘NeilMed’ brands. I have found this to be effective and cheap. Ask at your chemist for the isotonic type. Try this website for more information: http://www.neilmed.com/aus/products.php

If you are troubled by recurring symptoms, please consult your GP and ask to be referred to an Ear-nose-throat (‘ENT’) specialist.

References: a huge amount of information can be found on the Internet if you search for ‘sinus’, ‘post nasal drip’, ‘rhinitis’, etc. Some sources I made use of in compiling these notes are:

The Australasian Society of Clinical Immunology and Allergy http://www.allergy.org.au/component/option,com_frontpage/Itemid,1/

The Australian Society of Otolaryngology  http://www.asohns.org.au/outreach

American Academy of Otolaryngology  http://www.entnet.org/HealthInformation/

Sinus Wars  http://www.sinuswars.com/index.htm