NOT THE SAME OLD SONG SURGEONS LOOKING AHEAD TO REVOLUTIONARY TECHNIQUES THAT MAY REPAIR VOCAL CORDS.

Byline: Evan Henerson Staff Writer

A soprano is halfway through a beast of a Verdi aria when she starts to detect a strain in her singing voice. She soldiers on, finishes the performance and babies herself for the next several days.

In many cases, with proper rest, the voice retains its strength and the singer is back in business. But when a polyp or cyst develops, no rest or rehabilitation will correct it. When surgery is the only course of action, a person's speaking voice is rarely at risk. A singing voice is another matter.

``It depends on how serious it is,'' says Dr. Gerald Berke, professor and Chief of Head and Neck Surgery at UCLA School of Medicine. ``Singing requires a lot of fine motor control, using muscles to help change the frequency of vibration. It's hard to get a patient with vocal cord paralysis back to a normal singing voice. You can't produce the fine motor control that a normal body does.''

The future may hold great promise for singers whose voices - and careers - are threatened. Suppose that while he was ``clearing your pipes'' of vocal polyps or lesions, your throat surgeon could also reinforce your vocal cords with more durable material than genetics provided you the first time around.

Such a scenario is probably the only hope someone with severely damaged vocal cords can cling to. One of Hollywood's most famous voices is back in the news again, supporting such research. Julie Andrews can't sing, but she can speak out.

Andrews, the owner of one of nature's most perfect musical instruments, will be touring the eastern United States and Canada this month with a holiday celebration titled ``A Royal Christmas.'' The event's featured voice will belong to young Welsh soprano Charlotte Church.

Andrews will be a mistress of ceremonies along with her fellow ``Sound of Music'' star Christopher Plummer. ``A Royal Christmas'' is a musical attraction, but don't count on tunes from Andrews. After an operation to remove noncancerous throat nodules damaged her vocal cords, Andrews lost her ability to sing and ended up suing her surgeons. The case was ultimately settled, but Andrews has repeatedly stated that her musical career is over.

Asked by CNN's Larry King recently whether she would ever sing again, Andrews replied, ``My guess is that I won't, but actually it's now not about me anymore.''

Reason for hope

Last summer, the actress held a press conference in behalf of the research being conducted by her Boston-based laryngologist, Dr. Stephen Zeitels, and doctors at the Massachusetts Institute of Technology, Massachusetts General Hospital and Harvard Medical School. Potential beneficiaries of research to restore or replace damaged vocal cords include cancer victims, premature babies whose vocal cords have been damaged by intubation tubes and people who have had extensive vocal cord scarring.

And, yes, even singers whose voices have suffered the effects of years of continual use. If damaged cords can be replaced by specially engineered synthetic material, scientists could theoretically produce a breed of ``super singers,'' according to Zeitels.

Or they could potentially restore a ``super singer'' like Julie Andrews to her former vocal glory.

``We're optimistic,'' says Zeitels, director of the division of laryngology at the Massachusetts Eye and Ear Infirmary and head of the vocal restoration project. ``The term I've used for singing is, 'It's how you're wired,' and Julie is wired very well. If we could restore the pliability of her vocal cord membranes, she would be singing on stage tomorrow without problem.''

Mezzo soprano Frederica von Stade, another of Zeitels' patients, described the lump in her throat as feeling like ``a blocked tear duct.'' What proved to be a cyst caused von Stade to feel a continual hoarseness and made singing ``so unpredictable.''

Zeitels removed the cyst in August. A grateful Von Stade has been doing benefits in the Bay Area, where she lives, and is looking forward to her January date in the L.A. Opera's production of ``The Coronation of Poppea.''

``Steve is highly gifted and highly skilled,'' says von Stade, ``and he's interested in extending this not only for the professional singer but for everyone who uses their voice professionally.''

Von Stade recalls a follow-up visit with the doctor three weeks after the procedure. Zeitels looked at his patient's vocal cords, pronounced them cyst-free and then gave her an instruction.

``He said, 'Now sing to me. Now sing another song,' '' recalls von Stade. ``People are beating down his door. Everybody wants a piece of his time, and I'm sitting there in his office singing him songs. That's who he is.''

Tired muscles

``Wiring'' is, in fact, the reason human beings have the ability to make any noise. Sound is produced through the vibration of vocal fold flaps - 100 to 200 times per second - within the larynx. When a person sings, he changes the frequency of the waves, causing the pitch of the sound to go up or down. Singing involves flexing muscles and those muscles will eventually give out, just as an athlete eventually loses strength, speed or endurance.

Zeitels estimates the majority of people lose their voice because their vocal cord membranes lose pliability.

``We anticipate within five years, there will be biological materials to restore vocal fold pliability,'' he says. ``That will be a great boon to the human voice whether it is a schoolteacher who can't talk; people who have sustained injuries from having been intubated, such as premature infants; throat cancer patients; or even people who have sustained injuries singing.''

Through years of training, professional singers have learned what their ``instrument'' can do, how to take care of it and when something isn't right. When they end up in a laryngologist's office, it's usually because they've lost a portion of their vocal range. They want to know what happened and how to fix it.

``Most rock performers who have any degree of longevity are the ones who take very good care of themselves,'' says UCLA's Berke, who estimates that 20 percent of his clients are singers. ``Opera singers have a tremendous amount of training, an innate knowledge of when they're using a lot of tension in their larynx or when their breath control isn't right. They know when to rest or when they're not singing up to par.''

Terry Mason, a former musical theater performer, had actually moved out of singing when she began to experience problems with her speaking voice. Speaking to her over the phone, clients and acquaintances assumed she was sick or had been crying.

``I just assumed that my muscles had gotten out of shape,'' says Mason, an Encino resident who leads a software development project for SBC and spends much of her professional life on the phone. ``I went back to my vocal coach, who is still teaching at 85. I said, 'OK, I'm going to commit to getting my voice back into shape.' ''

The situation didn't improve, and she was eventually diagnosed by Berke with spasmodic dysphonia, the vocal equivalent of writers' cramp. Botox injections on both sides of her laryngeal muscles provided temporary relief, but didn't solve the problem.

Finding her voice

Mason had surgery in July 2001. During the five-hour procedure, Berke slit Mason's throat, disconnected the muscle causing the spasm, reattached a ``passive'' nerve from the same area and sewed everything up. Doctors informed Mason that it would take six months to a year for the new nerve to ``learn its role.'' When she woke up in the recovery room, Mason said she could tell her voice was fixed.

Her speaking voice, that is. A former soprano with a three-octave range and a high belt, Mason says her entire range is considerably lower.

``I don't have very much control or power,'' says Mason, who emphasizes that a professional singing career was no longer a priority. ``The trade- off is being able to speak comfortably. It's nice to be able to talk to people and have them understand you.''

Von Stade realizes she took a risk both in having the procedure and in going public, but she figures she owes it to the next generation of singers to help Zeitels' research effort.

``It's so easy to get an injury, burst a blood vessel or whatever,'' she says. ``After 30 years on stage and in airplanes, it's almost impossible to have virgin vocal cords. The more informed people are, the better it is.

``Steve is trying to get research and projects going. He's given me this gift. If my career falters, it will be because I've told the truth.''

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4 photos

Photo:

(1 -- color -- cover) Once again, from the top

Julie Andrews' singing career may be over, but new research could help others with vocal damage

(2) Gerald Berke, a head and neck surgeon, examines Karey Williams of Los Angeles, who is concerned about nodules on her larynx. Some doctors believe a breakthrough in treating vocal cords is only a few years away.

Charlotte Schmid-Maybach/Staff Photographer

(3) Terry Mason

David Sprague/Staff Photographer

(4) Frederica von Stade