In 1976, Tyler developed nodules on her vocal cords and underwent surgery to remove them. Afterward, doctors instructed her not to speak for about six weeks so her vocal cords could heal. She found the silence extremely difficult and, at one point, screamed in frustration before she was supposed to use her voice.
When she recovered, her voice was noticeably rougher, huskier, and more gravelly than it had been before the operation. She initially feared that she'd ruined her singing career.
Instead, it became her trademark.