A Clear Voice

Do you have a question? Send it here

In this episode of A Clear Voice, we speak with Dr Aaron Johnson about age-related changes to the larynx. Following a decade-long career as a professional classical singer and singing teacher, Dr Johnson trained to be a Speech and Language Pathologist. He now works at NYU Langone’s Voice Centre and researches the effects of vocal training, voice use and ageing on the muscles of the larynx.

We start by looking at the ageing process of the voice – how this differs for males and females related to hormonal changes and how other age-related changes to the body affect our voice. Dr Johnson then shares his experience as a singing teacher working with the ageing voice and how his own preconceptions were challenged as he saw first-hand the effect of vocal exercise on the ageing voice. This experience has made him passionate about sharing the message that getting older doesn't have to mean the inevitable decline of voice function and that there is something you can do about it. Likewise, he urges clinicians to not make assumptions about patients, as a lot can be done for the ageing voice to strengthen and improve function.

We discuss some of Dr Johnson’s recommended interventions and exercises based on his research into neuromuscular changes in the larynx as it ages. He shares his take on the most effective form of vocal exercise, focussing on endurance and intensity. He also emphasises the importance of ensuring that the voice remains active and in regular use as we age; “If you don't use it, you lose it.” 

Voice remains an important interdisciplinary, multidisciplinary field, and clear clinical and surgical interventions are also needed to improve muscle function and make this kind of exercise possible, and we touch on some of the established and emerging areas of treatment. 

In closing, Dr Johnson focuses on advocacy and the need to make people aware that voice doctors like him are out there and able to provide real support and improvement for those suffering from voice problems.

Further information:

Singing Through Change by Nancy Bos, Joanne Bozeman and Cate Frazier-Neely – looking at the singing voice in women going through menopause
https://singingthroughchange.com/ 

Lee Silverman Voice Treatment (LSVT) – an intensive voice therapy for individuals with Parkinson’s disease and other neurological conditions which affect voice.
https://www.slt.co.uk/speech-language-and-communication/one-to-one-therapy/lee-silverman-voice-treatment/ 

Phonation Resistance Training Exercises (PhoRTE) – a high-intensity voice therapy program designed specifically for pathologic age-related voice changes. https://phorte.org/ 

Encore Creativity for Older Adults – A Choral organisation for adults 55 years of age and older with ensembles around the United States. https://encorecreativity.org/ 

For more information about Dr. Aaron Johnson, please visit http://voicescientist.com/

Contact Information
Visit www.britishlaryngological.org and our podcast library.

Cutting Edge Laryngology 2026 registration is now open: Register here

Email: [email protected] for any questions or topic suggestions you may have for future episodes.

This show is brought to you by the BLA; you can follow us on  X, Linkedin and Instagram hosted by Natalie Watson @surgeonsinger, produced  and directed by Heather Pownall of Heather's Media Hub Ltd and award-winning producer. 

The opinions of our host and guests are their own; The BLA does not endorse any individual viewpoints, given products or companies. 
If you enjoyed this podcast, please rate, review and subscribe with the podcast provider of your choice.

Do you have a question? Send it here

In this very special episode, Natalie Watson is joined by Charlie Harper to tell us his personal experience of airway stenosis. Charlie shares his advice to other patients going through similar experiences, as well as his incredibly valuable thoughts on how we as healthcare professionals can do better for our patients.

After experiencing severe symptoms including nosebleeds, deafness and breathing difficulties, Charlie was diagnosed with granulomatosis with polyangiitis (GPA) in 2019. As the benefits of successive dilation surgeries reduced, he required an emergency tracheostomy – an experience which Charlie describes as devastating in its impact on day-to-day life, and perhaps not sufficiently acknowledged as such by healthcare professionals. Charlie was eventually referred to a hospital in London, where, very unusually, he underwent two laryngeal tracheal resections, following a second stenosis after the first procedure, caused by his tracheostomy. Whilst all of this was happening, healthcare services and all our daily lives were changed beyond recognition by the start of the Covid-19 pandemic. And Charlie’s personal life was also changed forever by the birth of his daughter – an experience which was massively impacted by his health issues, which meant he was unable to be present at the birth in the way he would have wished, or even to hold his newborn daughter.

In his advice to other patients in similar circumstances, Charlie explains the importance of a positive outlook and surrendering oneself to the process. He emphasises the key role of psychological support in adapting to life changing diagnoses and treatments, and believes that professional help in this area should be available to all patients. He also has some excellent suggestions for improving care and support pathways for tracheostomy patients and shares his views on how essential it is for different specialties to work together. Lastly, Charlie gives us clinicians a striking reminder that what is routine to us is often life changing for patients, and we must try to remember this in our interactions.

Charlie leaves us with the lighter side of his story, sharing some funny anecdotes and a heartfelt thanks to his wife for her support and love. This episode is truly essential listening for both patients and clinicians. We hope you enjoy it.

Contact Information
Visit www.britishlaryngological.org and our podcast library.

Cutting Edge Laryngology 2026 registration is now open: Register here

Email: [email protected] for any questions or topic suggestions you may have for future episodes.

This show is brought to you by the BLA; you can follow us on  X, Linkedin and Instagram hosted by Natalie Watson @surgeonsinger, produced  and directed by Heather Pownall of Heather's Media Hub Ltd and award-winning producer. 

The opinions of our host and guests are their own; The BLA does not endorse any individual viewpoints, given products or companies. 
If you enjoyed this podcast, please rate, review and subscribe with the podcast provider of your choice.

Do you have a question? Send it here

Welcome to the latest episode of BLA Connect, A Clear Voice, where we join host, Natalie Watson and Mr James O’Hara, Clinical Senior Lecturer at Newcastle University and Honorary Consultant Otolaryngologist at Newcastle-upon-Tyne Hospitals, to talk about a topic that is incredibly common in the laryngology clinic – persistent throat symptoms.

James and Natalie discuss the many and varied causes of an irritated larynx and persistent throat symptoms, and the historic low-level of evidence for standard treatments such as proton pump inhibitors. The results of the TOPPITS (Trial of Proton Pump Inhibitors) run by James O’Hara with Prof Janet Wilson showed that these were no more effective than placebo treatment. So where does that leave us? Treatment is moving towards the use of alginates, such as Gaviscon, and James is involved in a new pre-clinical trial, (TALGITS – Trial of Alginates and Throat Symptoms) to look at the effectiveness of these in treating persistent throat symptoms and hopefully improve the management of these symptoms in primary care.

Ultimately, we all want to provide the best care for patients and providing a diagnosis or label for their symptoms can seem a good way of doing this. However, the lack of clear treatment pathway for persistent throat symptoms can lead to unnecessary worry with patients often referred to Head and Neck Cancer clinics. When we do see patients in clinic, James and Natalie emphasise the importance of letting the patient talk, being honest about the lack of evidence-based treatment in this area, considering comorbidities such as fibromyalgia and chronic pain symptoms, and discussing behavioural modifications and strategies for how patients can take ownership of and manage their own symptoms.

The take home message from this episode must be to always question and improve what we do for the patient’s benefit.  

Contact Information
Visit www.britishlaryngological.org and our podcast library.

Cutting Edge Laryngology 2026 registration is now open: Register here

Email: [email protected] for any questions or topic suggestions you may have for future episodes.

This show is brought to you by the BLA; you can follow us on  X, Linkedin and Instagram hosted by Natalie Watson @surgeonsinger, produced  and directed by Heather Pownall of Heather's Media Hub Ltd and award-winning producer. 

The opinions of our host and guests are their own; The BLA does not endorse any individual viewpoints, given products or companies. 
If you enjoyed this podcast, please rate, review and subscribe with the podcast provider of your choice.

Do you have a question? Send it here

Welcome back to a new series of BLA Connections – A Clear Voice. In today’s episode we talk to Professor Guri Sandhu about the management of airway stenosis.

“That's what got me interested, because you could improve someone's quality of life immensely in a relatively short timeframe.”

Professor Guri Sandhu works in the national Airway Centre for Airway Reconstruction based at Imperial College Healthcare NHS Trust in London. Prof Sandhu is also our BLA president and having trained in airway stenosis at Great Ormond Street Hospital, and  with Prof David Howard, he is the ideal person to take us through this rare complaint. 

He explains that patient history is the first key step in diagnosis and management for a cohort of patients including those who have been ventilated in intensive care units, those with idiopathic stenosis and those with systemic conditions. We go through the various diagnostic steps, however for Prof Sandhu, the most valuable assessment of the nature of the stenosis takes place on the operating table. 

We look at the different surgical techniques employed for systemic conditions, scarring and stenosis treatment, with Prof Sandhu explaining that his aim is to do something that gives you the maximum gain for minimal injury. Postoperative treatment is also differentiated by patient history and diagnosis, from day case procedures to longer hospital stays. Finally, Prof Sandhu shares his key take-home messages. To find out more about this topic please take a look at his many published works: https://www.researchgate.net/profile/Guri-Sandhu.

Our full series can be found in the podcast provider of your choice or you can find every episode on our BLA Connect App. We would love to hear from you about the topics you would like us to explore, any questions you have, and the experts you would like to hear from. Get in touch at [email protected]. If you enjoy these podcasts please do remember to subscribe and leave a review with your podcast provider. Thank you for listening.

Contact Information
Visit www.britishlaryngological.org and our podcast library.

Cutting Edge Laryngology 2026 registration is now open: Register here

Email: [email protected] for any questions or topic suggestions you may have for future episodes.

This show is brought to you by the BLA; you can follow us on  X, Linkedin and Instagram hosted by Natalie Watson @surgeonsinger, produced  and directed by Heather Pownall of Heather's Media Hub Ltd and award-winning producer. 

The opinions of our host and guests are their own; The BLA does not endorse any individual viewpoints, given products or companies. 
If you enjoyed this podcast, please rate, review and subscribe with the podcast provider of your choice.

Do you have a question? Send it here

As we embark on Series 4, host Natalie Watson invites Heather Pownall, the producer of 'A Clear Voice', onto the show to discuss the original vision for the podcast and what to expect from the new series.
 
Natalie looks back on her guiding aims for the podcast, to educate, build a community and to give a voice to all those associated with laryngology – surgeons, allied health professionals, patients and clinicians from across the globe.

Heather and Natalie share their memories of launching the podcast at the beginning of the Covid-19 pandemic and their pride and enjoyment in seeing it grow and evolve.

We hope you enjoy listening to Series 4, as we continue to spread the word and spread the love of laryngology.

Contact Information
Visit www.britishlaryngological.org or download BLA Connect from your app store for further information and details on becoming a BLA member.

Email: [email protected] for any questions or topic suggestions you may have for future episodes.

This show is brought to you by the BLA, you can follow us on  Twitter, Facebook, Linkedin and Instagram hosted by Natalie Watson @surgeonsinger produced and directed by Heather Pownall of Heather's Media Hub Ltd. 

Contact Information
Visit www.britishlaryngological.org and our podcast library.

Cutting Edge Laryngology 2026 registration is now open: Register here

Email: [email protected] for any questions or topic suggestions you may have for future episodes.

This show is brought to you by the BLA; you can follow us on  X, Linkedin and Instagram hosted by Natalie Watson @surgeonsinger, produced  and directed by Heather Pownall of Heather's Media Hub Ltd and award-winning producer. 

The opinions of our host and guests are their own; The BLA does not endorse any individual viewpoints, given products or companies. 
If you enjoyed this podcast, please rate, review and subscribe with the podcast provider of your choice.

Do you have a question? Send it here

Justin Roe is the Speech and Language Therapist representative for the BLA. He works at the National Centre for Airway Reconstruction treating people with laryngotracheal stenosis and a wide range of swallowing problems. 

Gemma Clunie is a specialist dysphagia speech and language therapist also working at the National Centre for Airway Reconstruction at Charing Cross Hospital, part of Imperial College Healthcare NHS Trust. 

Justin and Gemma share their expert knowledge on the management of dysphagia, explaining the importance of treating each person holistically as an individual. The partnership between clinicians, patients and multidisciplinary colleagues is key to achieving and measuring successful outcomes.  

Useful links:

https://journals.sagepub.com/doi/abs/10.1177/0003489420966339 

https://link.springer.com/content/pdf/10.1007/s00455-017-9799-x.pdf

https://socialworkpodcast.blogspot.com/2009/10/prochaska-and-diclementes-stages-of.html

https://www.stephenrollnick.com/motivational-interviewing-in-health-care-helping-patients-change-behavior/

https://www.entandaudiologynews.com/features/ent-features/post/the-role-of-the-multidisciplinary-team-in-laryngology-and-airway-the-charing-cross-experience

Contact Information
Visit www.britishlaryngological.org and our podcast library.

Cutting Edge Laryngology 2026 registration is now open: Register here

Email: [email protected] for any questions or topic suggestions you may have for future episodes.

This show is brought to you by the BLA; you can follow us on  X, Linkedin and Instagram hosted by Natalie Watson @surgeonsinger, produced  and directed by Heather Pownall of Heather's Media Hub Ltd and award-winning producer. 

The opinions of our host and guests are their own; The BLA does not endorse any individual viewpoints, given products or companies. 
If you enjoyed this podcast, please rate, review and subscribe with the podcast provider of your choice.

Do you have a question? Send it here

Welcome to this weeks instalment of BLA Connections: A Clear Voice

In this episode, Natalie Watson is joined by fellow BLA Council member, Justin Roe who is the SLT representative for the BLA,  to discuss the programme for the upcoming  BLA Virtual Annual Conference taking place on 24th September. He was also one of the conference organisers and give a  fantastic overview of the programme and the diverse and multidisciplinary content available.

The conference content will also be available on-demand for all registered delegates. You can sign up here.

We hope you enjoy today’s discussion. Please do get in touch with any questions you might have. And if you have an idea for a topic let us know at [email protected].

Contact Information
Visit www.britishlaryngological.org and our podcast library.

Cutting Edge Laryngology 2026 registration is now open: Register here

Email: [email protected] for any questions or topic suggestions you may have for future episodes.

This show is brought to you by the BLA; you can follow us on  X, Linkedin and Instagram hosted by Natalie Watson @surgeonsinger, produced  and directed by Heather Pownall of Heather's Media Hub Ltd and award-winning producer. 

The opinions of our host and guests are their own; The BLA does not endorse any individual viewpoints, given products or companies. 
If you enjoyed this podcast, please rate, review and subscribe with the podcast provider of your choice.

Do you have a question? Send it here

Welcome back to BLA Connections: a clear voice with your host Natalie Watson, bringing you discussions and insights from experts from across the globe on all things laryngology.

In today’s episode, we’ll be discussing a lesser-known area of laryngology – the management of cricopharyngeal hypertrophy and small pharyngeal pouches with our guest, Kate Heathcote. Kate is a consultant laryngologist from Poole Hospital Foundation Trust on the south coast of England. As fellow to Professor Jean-Paul Marie in France, she learned techniques of laryngeal renovation, which she has continued to develop, research and introduce into the UK. During a further laryngology fellowship at the RNTNE she focused on airway procedures with Guri Sandhu, our president and phonosurgery with John Reuben. She now runs a comprehensive NHS laryngology service offering a voice clinic and a laryngology treatment clinic in which she treats many laryngological symptoms, one of which dysphagia, we focus on today. 

Kate became interested in dysphagia because of the scale and complexity of the problem and the lack of a clear treatment plan. She takes us step-by-step through in-office and surgical treatment of cricopharyngeal hypertrophy and small pharyngeal pouches, namely balloon dilation, endoscopic laser procedures and myotomy. Kate emphasises the importance of treating the individual, considering the risk/benefit factors and the vital role of the multidisciplinary team in managing these conditions.

We hope you enjoy today’s discussion. Please do get in touch with any questions you might have. And if you have an idea for a topic let us know at [email protected].

Contact Information
Visit www.britishlaryngological.org and our podcast library.

Cutting Edge Laryngology 2026 registration is now open: Register here

Email: [email protected] for any questions or topic suggestions you may have for future episodes.

This show is brought to you by the BLA; you can follow us on  X, Linkedin and Instagram hosted by Natalie Watson @surgeonsinger, produced  and directed by Heather Pownall of Heather's Media Hub Ltd and award-winning producer. 

The opinions of our host and guests are their own; The BLA does not endorse any individual viewpoints, given products or companies. 
If you enjoyed this podcast, please rate, review and subscribe with the podcast provider of your choice.

Do you have a question? Send it here

In our second Wellbeing episode, we welcome Dr Tim Anstiss, health and wellbeing coach and behaviour change specialist. Tim works with NHS trusts, local authorities, health charities, sports organisations and a wide range of companies. He has been involved in several international behaviour change initiatives. 

Having studied medicine at Southampton University, Dr Anstiss became interested in health education and behaviour change and was able to carve out a somewhat niche career for himself within the NHS, focussing on behaviour change, cognitive behavioural therapy (CBT) and occupational medicine. He trained in motivational interviewing which became the cornerstone of his coaching career, and a large part of his work has been in training clinicians and other professionals in using this approach, along with health and wellbeing coaching. He is particularly interested in promoting wellbeing, happiness, and ‘flourishing’ in those suffering from poor quality of life and burnout, using approaches such as the ‘five pillars of wellbeing’. He also practices compassion focussed therapy and compassionate mind training. 

Natalie and Tim discuss how clinicians are often already practising coaching in their professions as leaders and mentors. By actively learning about established coaching theories and approaches, clinicians can improve their interactions with patients and colleagues. We also look at how coaching can improve approaches to organisational change by promoting a guiding coalition and shared vision. 

Finally, Dr Anstiss gives his advice on what we can do to improve our wellbeing as we move through the Covid-19 pandemic, including looking at the five pillars of wellbeing, measuring wellbeing using psychopathology tools and endorsing the self-compassion approach. Dr Anstiss is passionate about making these practices accessible to as many people as possible and encourages us all to be passionate about the health and wellbeing of healthcare professionals. As such we have provided some links to the content discussed in this podcast which we hope our listeners will find helpful and inspiring.

Further Information

 The Pioneer Health Centre - South London Gallery

 Appreciative Inquiry Commons

Kotter’s 8 Steps To Accelerating Change

The Compassionate Mind Foundation

Thanking Your Mind: Taking The Power Out of Difficult Thoughts

Self-Compassion, Dr. Kristin Neff

The Happiness Trap: Evolution of the Human Mind

ENT UK Mentor training hosted by WENTS

Contact Information
Visit www.britishlaryngological.org and our podcast library.

Cutting Edge Laryngology 2026 registration is now open: Register here

Email: [email protected] for any questions or topic suggestions you may have for future episodes.

This show is brought to you by the BLA; you can follow us on  X, Linkedin and Instagram hosted by Natalie Watson @surgeonsinger, produced  and directed by Heather Pownall of Heather's Media Hub Ltd and award-winning producer. 

The opinions of our host and guests are their own; The BLA does not endorse any individual viewpoints, given products or companies. 
If you enjoyed this podcast, please rate, review and subscribe with the podcast provider of your choice.

Do you have a question? Send it here

“Radical self-care it is the foundation that the rest of your life and your career is based on.”

In the first of our Wellbeing episodes, Natalie speaks with master practitioner, coach and mentor, Dr Fiona Day MBChB, FFPH, Dip Occ Med about her experience of coaching over 200 doctors and healthcare professionals. Fiona shares the most common career challenges her clients face and how to overcome these, along with promoting and nurturing overall wellbeing. Fiona also gives her insights into the changing nature of leadership and how doctors can develop their leadership skills.

Fiona Day is a qualified doctor and Consultant in Public Health Medicine with over 25 years of experience in corporate and NHS Public Health environments. For the last 5 years she has focussed her passion for guiding and improving the complex careers of doctors, medical and public health professionals into her independent coaching practice, Fiona Day Consultancy. Fiona describes her interest in human behaviour change and emotional wellbeing  as the 'golden thread' through her career and she now specialises in using evidence-based ‘third wave’ approaches to behaviour change to develop compassionate, value-led professionals and enable them to take sustained, committed action to progress their goals. Read more from Fiona here, Blog - Fiona Day Consulting and visit here to sign up to Dr Day's bimonthly newsletter and receive a free career planning workbook.  

Contact Information
Visit www.britishlaryngological.org and our podcast library.

Cutting Edge Laryngology 2026 registration is now open: Register here

Email: [email protected] for any questions or topic suggestions you may have for future episodes.

This show is brought to you by the BLA; you can follow us on  X, Linkedin and Instagram hosted by Natalie Watson @surgeonsinger, produced  and directed by Heather Pownall of Heather's Media Hub Ltd and award-winning producer. 

The opinions of our host and guests are their own; The BLA does not endorse any individual viewpoints, given products or companies. 
If you enjoyed this podcast, please rate, review and subscribe with the podcast provider of your choice.