Good news for people having small thyroid cartilage!

Röntgenaufnahme - menschliche Kopf mit markiertem Kehlkopf
Recently, I ran into a man who has very small thyroid cartilage.
He had been made fun of for having a strange singing voice since he was a student. Every doctor said ”nothing was wrong.” He went to many otological hospitals for the phenomenon so far. Consequently, he was referred for a psyche evaluation at a local medical department,for suffering from depression because of his voice.
After countless dead ends he reached out to me and made an appointment, with high expectations!

He showed up and said, ”Please help!” as soon as he arrived to see me … and admitted we were his last hope. When I heard his voice and saw his throat, I immediately recognized the issue. His strange voice is caused by a failure of sound because his thyroid cartilage is uncommonly small. No doubt about it, he had a thin, boxy and weak voice.

First, I briefly taught him the mechanics of the voice and throat, and we started investigating.
When I palpated his throat, I was convinced “this is surely a tiny larynx!” As far as I could see there were no physical problems with his talking,singing,breathing,swallowing or eating – his voice was just bad, I mean… not appealing to the ears.
I do not mean that he has a disease or deformity, it is merely an individual variability, and you can even say “it’s just in his character.” Confirming what every doctor had told him before.
I deeply reflected, and decided to focus on how to compliment him, and small explain that defects could be covered or hidden by maneuverability.
It’s possible to fix the hypertonic phonation, the effort-phonation and LDP(Larynx Deep Position).
If thyroid cartilage is already small, it’s just like a small instrument.
For example: the ukulele and acoustic guitar, they both look similar in structure, but the sound is pretty different between a ukulele and acoustic guitar because a guitar is bigger. By the way, I never say ukulele is bad instrument, just small.
Just like a ukulele cannot recreate the same sounds as a guitar.  It is the same concept with the throat.
Do you think it is completely true the change in the strength and volume of a voice depends on the size of thyroid cartilage?
Many doctors debate this.
I do not think it’s big deal, because this is truly not a disease, but I would like to focus on why the sound is slightly different.
There is the thyroplasty type II which is a surgery that’s designed to address weakened vocal chords.
Surgeons aim to cut the median thyroid cartilage and implant a titanium bridge to prevent from glottic closure, and treat the spastic dysphonia.
But now I’m talking about size of the thyroid cartilage, not ”spastic dysphonia”.
In the thyroplasty type II, the width of the thyroid cartilage increases about a 1/2 to 2 inches because of the two titanium bridges.
I’ve investigated the differences of voice quality (tone) between before and after surgery.
Of course, the surgery originally aims to fix the voice catch.
I just heard their voice and I’ve never imposed on patients for the investigation.
I record the voice before and after surgical procedures, and I can judge from comparison.
Although doctors usually check for hoarseness or a cracked voice, I mainly check the quality of the voice.
That is the difference between a medical perspective and an aesthetic perspective.
Many patients showed an improved quality of voice after such surgical operations,because the thyroid cartilage has been expanded and also increased in size.
In conclusion, the size of thyroid cartilage obviously affects the sound of voice. If the thyroid cartilage is large,the voice is more richer sounding than the sound of having small thyroid cartilage would make.
However, if the thyroid cartilage is big, it’s harder to control because it’s also increased in size and weight and might lose sound.
Therefore, I cannot say that big is always good.
I do not recommend the people who have a small thyroid cartilage to take my treatment.
Because the size of thyroid is proportional to the size of  hyoid bone.
The size of pharyngeal cavity is an important factor in whether a voice’s tone can be fixed.
That is why it is difficult to fix the people who have small thyroid cartilage. Until now.
Although at first, it is hard to see a dramatic improvement … I believe I can make a voice better by focusing on training the oral cavity, ultimately improving the kinematic performance.
The point is temporomandibular joint(TMJ).
TMJ is a joint, which the mandibular condyle rolls(hinge movement) by sliding forward.
If you slide the mandibular condyle correctly, you can have a better voice.
I discovered this fun fact, after I thoroughly investigated Joseph Carreras, who is one of The Three Tenors and Diana Damrau who is a popular soprano singer.
I’ll share more details about how to approach TMJ later.
But this is good news, people who have a small thyroid cartilage do not need to give up on improving their voice!


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