A New Treatment Restoring Voices to Those Who Have Lost Them
By Karl Mercer
Reporting from London
"I've never been able to sing, I've never been able to shout - I've just been limited in so many ways."
These are the words of David Metherell, a 45-year-old critical care nurse who has struggled with speaking since he was a small boy. At just nine months old, he caught a rare strain of the human papillomavirus (HPV), which led to damage to his vocal cords and 21 operations before he turned six. These experiences have left him with scarred vocal cords, a croaky voice, and difficulty speaking for any length of time.
"The amount of times that I've sat round the table and really had to think - I have something to add to this conversation but the importance of it isn't enough to warrant me putting that much effort in to talk to someone at the far end of the table. Everyone else can just project their voice but I've never been able to do that."
David's struggle with his voice became even more pronounced during the COVID-19 pandemic when he was wearing full face masks and protective equipment, making it difficult for him to project his voice. He was referred to the Ear, Nose and Throat (ENT) Clinic at Guy's Hospital, where he became one of the first patients to receive a new trial treatment involving platelet-rich plasma (PRP).
The treatment involves taking plasma from David's blood and injecting it into his vocal cords or folds. While PRP has been used for tendon or ligament injuries before, this is the first time it has been used in this way. So far, David's consultant, Shiying Hey, and her team have treated 10 patients, all of whom have reported an improvement in their voices.
"It's incredibly exciting to be able to offer this treatment," says Hey. "It is also cheaper than the current treatments as we use the patient's own blood and it can be longer lasting as the PRP encourages the vocal cords to regenerate and accelerates the healing process."
David has had three injections and says it has transformed his life, making him more confident to speak up in busy social or work situations. "Being able to do that now is really liberating - really liberating - and I'll be eternally grateful for this because it's really changed my life."
The treatment has also made a significant difference in his bedtime routine with his five-year-old son. "My son knows that Daddy's got a poorly voice and Daddy's voice isn't great. But being able to read him one of his favourite stories without fatiguing, without having to clear my throat and recompose myself - just finishing a story and then singing him a little story to get him to sleep - yeah - it's what a dad should be able to do and I've never been able to do."
In addition to the injections, David also receives special exercises and training for his voice from senior speech therapist Sue Warner. "Your voice is so important for everything - a lot of people say it's the window to the soul," she says. "To be able to express yourself to reveal to people who you are and what you think, how you feel about something - calling out in case of danger or reading a story to your child. We use our voice for absolutely everything. Even just ordering a cup of coffee in a cafe. Not having a good voice often reduces people's confidence and it stops them from doing the things they want to do. It has a massive psychological impact and handicap in terms of day-to-day activities."
The ENT laryngology clinic at Guy's and St Thomas' is currently only accepting referrals for the treatment from GPs and health professionals. This new treatment offers hope to those who have lost their voices, and it will be interesting to see how it develops and becomes more widely available.
