Month: February 2017

Singers and scars

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Sometimes the singer must undergo surgery, although not strictly related to chordal dysfunction.

The more related with the vocal function is the vocal tract. This region can be influenced in its physiological dynamics and it’s important to assess its mobility post intervention.

The most common scar we can found is the frontal access for thyroidectomy. It appears as an horizontal line, visible just above the sternum, large up to 10 – 15 cm.

Sometimes the access to the thyroid provides scars U shaped that reach the lateral parts of the larynx. In this case the surgery is more invasive.
A frequent consequence of a scar is the retraction. Between the superficial and deep tissutal planes we can observe a loss of mobility, expecially in the sliding parameters, sometimes associated with swelling and fibrosis of the scar’s tissues that do not allow a correct biomechanic.

For the singer the mobility that can be limited is the upwards and downwards movement of the laryngeal tract. Sometimes we can also observe a lateral deplacement to the scar tissue. Often the head is tilted to the side of the retraction or the movements of rotation of the head can be limited in their range of motion. Even the opening and closing of the mouth can lead to a mandibule deviation.

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Lateral fibrous scar after surgery

Scars in the neck area can bring to uncorrect positions and a non phisiologic compensation in the phonation. Even scars situated in further anatomic regions can perturb the singing. Scars of the abdominal wall (classical appendectomy, or caesarean sections) can change the dynamic of the abdomen during inspiration and can influence, through deep fascial tensions the phase of appoggio and sostegno.

Where a scar is retracted the effect can lead to postural compensation even without sympthomps. It is essential, during the evaluation of the subject, to keep in mind this possibility.

If a student should have to undergo surgery it is useful to verify, in the post intervention period, if the scar tissue has postural influence in order to prevent the onset of symptoms which will lead in the long term. In this case manual therapy can be a good solution to the problem.

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