A 'broken' voice may be caused by spasmodic dysphonia
May 10, 2024
Lesley French Childs, M.D., has sung all her life. Once, as a high school choir singer in Austin, she grew hoarse and went to an otolaryngologist. The doctor used a scope to look at her vocal cords, then described what he saw (mild inflammation, it turned out). Photos on his wall showed performers he’d taken care of.
“I thought, ‘That is what I want to do,’” Dr. Childs recalls, adding that she had wanted to be a doctor since early childhood. “It was the perfect marriage of my two passions.”
Dr. Childs attended Yale University and then Vanderbilt University School of Medicine, where her classmates voted her the person they would most want as their own physician. During her residency in head and neck surgery at Vanderbilt, she won more awards for excellence. Dr. Childs then completed a specialty fellowship at the New York Center for Voice and Swallowing Disorders, where she often took call for the opera.
In 2012, Dr. Childs returned to Texas, joining the faculty of UT Southwestern. She is Associate Professor of Laryngology, Neurolaryngology, and Professional Voice. Dr. Childs was recently appointed the Medical Director of the Clinical Center for Voice Care. Along with her colleague, Dr. Ted Mau, and four speech therapists, Dr. Childs cares for patients with vocal-fold disorders at the Clinical Center for Voice Care.
Dr. Childs hasn’t neglected her own singing. She has recorded songs for Walt Disney Records, playing characters such as Mulan and Sleeping Beauty. She sings with the professional choir Vox Humana and continues to take voice lessons regularly.
Thanks to technological advances, Dr. Childs can now show her patients video of their own vocal folds. “It’s pretty spectacular to see their expression. ‘Wow, so that’s my instrument!’
“That’s one of the most rewarding things: to educate singers about their instrument and about caring for it and protecting it.”
Dr. Child consults with individuals in other professions as well; in 2022, she was interviewed for a KTBS News feature about anchor Linnea Allen’s journey to overcome two voice disorders.
In 2019 and 2020, Dr. Childs was named a Texas Monthly Super Doctor Rising Star.
“Nodule” is a word that can strike fear into a singer. These benign vocal-fold growths can occur after overuse of the voice and, as a result, mar its pure, clear tone.
“It’s your only set of vocal folds – and unlike the flute or a guitar, you can’t trade it in or upgrade it 10 years down the road.”
Not to worry, says Lesley Childs, M.D., an Associate Professor of Laryngology, Neurolaryngology, and Professional Voice at UT Southwestern’s Clinical Center for Voice Care. “People think of nodules as a career-ending diagnosis, and it’s not,” she says. “The truth of the matter is, nodules are reversible with therapy.”
Nodules are just one of the problems that bring voice-dependent professionals to see the Center’s specialized laryngologists and therapists. Overuse of the voice can also, for example, cause polyps and cysts, while surgery and viruses can lead to vocal-fold paralysis. “I see vocal athletes,” says Dr. Childs. “Our speech therapists are physical therapists for the vocal folds.”
In addition to patient care, Dr. Childs contributes to her field, having written numerous book chapters and peer-reviewed articles on laryngology, and she has spoken at meetings of laryngologists and musicians alike.
To diagnose voice problems, Dr. Childs uses state-of-the-art videostroboscopy, which shows freeze frames of the vocal folds in action. Treatments she offers include specialized voice therapy, microsurgery, Botox injections for spasmodic dysphonia, and laser surgery, many of which can be done in the office. “People are completely awake – they don’t have to undergo a general anesthetic, and they don’t have to have a driver, so they have much less downtime,” Dr. Childs says of in-office procedures.
But, as with nodules, many voice problems resolve with therapy alone. “Our mantra as laryngologists is to operate on the vocal cords as a last resort,” she says. “Even if the growth doesn’t go away with speech therapy, it will at least get smaller. That allows a much less invasive surgical procedure, with less risk of permanent hoarseness from scarring.”
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