Dr. Jennifer Long: “Sometimes procedures to improve breathing or swallowing interfere with a patient’s voice. We often need to strike a delicate balance.” “It’s amazing that when we are talking, our vocal cords are robust enough to bang together about 100 times a second, without stress or strain.” 22 U MAGAZINE vocal titans play their voices like fantastic musical instruments, but the truth is that every healthy human voice is a complex and nuanced instrument. The f lexible, versatile and emotional sounds produced by our bodies have been the envy of composers and musicians for generations. Ironically, our vocal cords, also called vocal folds, have humble origins. Early in our development as human beings, they were simply a barrier to protect the airway against food passing into the lungs. Eventually they evolved to produce the array of sounds that form the basis of our voice. Located in the larynx, the cords consist of loose tissue that vibrates in a wave-like manner at 80-to-300 cycles a second when air from the lungs is pushed through them. “It’s amazing that when we are talking, our vocal cords are robust enough to bang together about 100 times a second, without stress or strain,” says Dr. Berke. The cords are operated by specialized muscles that have exceptionally fine control. As we talk louder, the folds are closed longer and are pressed together more firmly. To manipulate the pitch of our voice, we automatically tighten the cords to make our voice higher or loosen them to make our voice lower. “It works in the same fashion as letting the air out of a blown-up balloon,” Dr. Berke says. If you pull the neck of the balloon, it changes the sound coming out. What makes each of our voices unique is the size of the cords we are born with — superstar- tenor Pavarotti, for instance, had massive vocal cords that could push large amounts of air through at high pressure — combined with the way we modulate sound through our throat, mouth, tongue and lips. “We learn how to control our voices as infants,” Dr. Berke says. “A baby making seemingly meaningless baby talk is probably the child first experiencing how its voice works.” But to this day, the actual mechanism that causes vocal cords to vibrate is not very-well understood. “Because the cords are down low in the throat, and they vibrate so fast, it has been hard to study and measure the process until recently,” says Dr. Berke. Only in the last 20-to-25 years have researchers had instruments that can examine