George Michael's illness has put his voice at risk

George Michael says Austria was the best place to get so ill - as the medical care he received was top rate. Photo / AP

It will be some months before it is clear whether George Michael's voice has survived his month-long brush with death.

His pneumonia infection, which causes the lungs to fill with secretions, resulting in a sensation of drowning, was so severe that he required a tracheotomy to save his life.

That involved surgically inserting a tube at the base of his throat directly into his trachea, or windpipe, through which oxygen was pumped to ventilate his lungs.

Although the incision was made below the voicebox, the operation can result in scarring of the trachea with permanent effects on the voice.

The 48-year-old singer fell ill in Austria on his Symphonica world tour after playing 45 shows in 35 cities, and was forced to cancel the 14 remaining dates.

Doctors warned him that the chances of making a quick return to the stage were "remote".

Gerrit Wohlt, an Austrian ear, nose and throat surgeon, said at the time the treatment he needed could put his voice in danger. "In the worst-case scenario, being on a ventilator could harm his vocal cords. He could end up with a hoarse voice, so a new year comeback is unlikely.

"He will need months of rest."

Changes in the voice are common during the first few weeks after a tracheotomy.

The incision heals up quickly, in one to two weeks, but it takes longer for the inflammation to subside and the voice to return to normal. Some patients suffer permanent changes to their voice.

Wearing dark glasses and wrapped in a scarf and coat, Michael managed to speak to reporters on Saturday for only a couple of minutes before needing to stop. With visible emotion he thanked fans and staff at the hospital in Austria.

"I feel amazing. I mean I'm very weak but I feel amazing. I got a form of pneumonia and they spent three weeks keeping me alive," he said.

Michael said yesterday: "I'm incredibly fortunate to be here. And incredibly fortunate to have picked up this bug where I did because the hospital in Austria where they rushed me to was absolutely the best place in the world I could have been to deal with pneumonia. I have to believe that somebody thinks I've still got some work to do here."

He said the thought of his family kept him going, together with "all the people I still have to play to".

"I've been so lucky. I still have plenty to live for - I've had an amazing, amazing life. If I wasn't spiritual enough before the last four or five weeks, then I certainly am now.

"I'm really sorry that I couldn't contact [my fans] in any way before now but I really wasn't in a state to. But I promise them absolutely without question the plan is to play to every single person who had a ticket."

- Independent