Procedure alters southeast Michigan teenager's voice

Doctors say palate malformation was to blame

ROCHESTER HILLS, Mich. – Cassandra Gauthier, 16, of Oakland Township, was born to be a performer. Over the years, Gauthier has been cast in countless productions, including as Rapunzel in "Into the Woods" and Joy, one of Cinderella's evil step-sisters.

Gauthier dreams of a career in the arts, even performing on Broadway. But there was one problem.

"I knew that my voice was different," said Gauthier.

Since she was a child, Gauthier's speaking voice has always been very nasal.

"Kids in school, they would come up to me and like plug their nose and make fun of me, which was annoying," said Gauthier. "I knew in the future, going up against all these amazing people, it was going to hold me back."

Her vocal coach suggested she see a speech pathologist to find out if certain exercises could improve her voice. That's when Dr. Antonio Ysunza, coordinator of speech services at Beaumont Hospital, made a stunning discovery.

"When I saw her, I detected that there was a malformation in the palate, from ever since she was born," said Ysunza.

Imaging revealed a significant gap in Gauthier's palate, or the roof of her mouth. That hole was allowing air to escape when she spoke, altering her voice.

"You cannot do exercises for this. You have to correct it with surgery," said Ysunza.

Gauthier was surprised to learn there was a medical reason for how her voice sounded and a potential way to fix it.

"I just thought my voice was nasally, but knowing that I could change it was exciting," said Gauthier.

Before surgery, doctors had to carefully study exactly how Gauthier's palate and throat moved during speech, then design a custom "flap" to cover the hole.

"It closes the hole, but allows the rest of the structures to move during the speech, so the speech will become natural," said Ysunza. "It's a very very complicated procedure, but usually the success rate is over 90 percent."

Dr. Kongkrit Chaiyasate performed the procedure with Ysunza at Beaumont. It was a delicate balance, correcting Gauthier's speech without changing her singing voice.

"Especially when you're operating on someone who wants to follow a career in acting and singing," said Ysunza.

There's actually a nasal scale. A normal female voice has a nasal measure of about 34. Before surgery, Gauthier's was a 64. After the surgery, she is a 32.

Palate malformations are actually quite common, occurring somewhere between 1 in 100 and 1 in 1,000 births, but not of all them cause a speech or voice problem. The primary symptom is a very nasal voice. Experts said if you suspect you or your child could have a problem, you should see a speech pathologist for an evaluation.

Gauthier is putting her new voice to work. She landed the role of Morticia in the Adams High School production of "The Addams Family."

"This is like my dream role, so it was really exciting," said Gauthier.

"She auditioned for this play a couple weeks after the procedure, which is amazing," said Ysunza.

"It gave me more confidence for sure, for speaking on stage and going out for auditions," said Gauthier. "Especially for Morticia, because she has a really low and sultry voice, that before if I were to do that, it wouldn't sound right. And so now I feel like I can actually embody Morticia and be her."

The surgery did change her singing voice, but only for the better.

"I can actually sing higher, and for a longer amount of time. I don't get as tired as easily," said Gauthier.

Gauthier's doctors now count themselves among her fans. Both of them came to watch her perform in the show.

"She's extremely talented, and I just hope that she can follow her dream and become a Broadway star someday," said Ysunza. "And I'll be there, front row."

To learn more about Beaumont's Speech & Language Pathology Department, click here.