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The Voice Center of Ear, Nose, & Throat Associates is dedicated to
providing comprehensive evaluation and treatment of voice and swallowing
disorders.
Anatomy
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The larynx ("voice box") is approximately at the mid point of your neck.
It includes the vocal folds and the cartilage that protects them in your
neck.
The vocal fold is made up of muscle, on top of which is a flexible layer
or covering called mucosa. When you breathe in or out over the vocal
folds, they vibrate up to 800 times per second. Those vibrations produce
the sound, or voice, that your mouth then forms into speech.
Swallowing
Disorders
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Dysphagia
Dysphagia is a swallowing disorder caused by the difficulty moving food
from the mouth, to the esophagus (food tube), to the stomach.
• Signs and symptoms
Signs and symptoms of
dysphagia (swallowing disorder) include but are not limited to:
• inability to control food/saliva in the mouth
• coughing during or after meals
• recurring pneumonia
• unexplained weight loss
• “gurgly” voice quality after mealtime
• Possible causes
Possible causes of
dysphagia may include neurologic disturbances (stroke, paralysis),
cancer of the mouth or throat, or age-related changes.
• Examination
Dysphagia can be
assessed through a simple office examination called F.E.E.S.
(Flexible Endoscopic Evaluation of Swallowing). In this exam, the
speech pathologist or physician will insert a small flexible scope
into your nose in order to look at your throat while you swallow. To
do this, you will be asked to eat and drink everyday foods. This
procedure allows your swallow to be videotaped and helps determine
the best treatment.
• Therapy
If recommended, therapy
for dysphagia will be provided by the
Speech Pathologist. This may include swallowing precautions,
techniques, and / or modification of diet.
Breathing
Disorders
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Paradoxical Vocal Fold Dysfunction (PVFD)
PVFD is a breathing disorder that often imitates asthma-like symptoms.
During inhalation, the vocal folds inappropriately narrow, causing
constriction of the airway. This closing causes mild to severe
respiratory distress. Such “attacks” can last anywhere from seconds to
minutes to an entire day. PVFD is often misdiagnosed and treated as
asthma due to similarities in presentation.
Symptoms and Causes
Symptoms
Shortness of breath
Tightness in throat
Coughing
Difficulty “getting air in”
Fullness in throat
Wheezing on inhalation |
Causes
Exercise/Physical Activity
Stressful situations
Upper Respiratory Infections
Emotional upset
Postnasal drip
Odors, fumes, smoke |
Examination
PVFD can be assessed through a simple office procedure called videoendoscopy. This allows the
speech pathologist or physician to view the
vocal folds during breathing and voice production. This procedure will
be video recorded in order to review.
Treatments
Common treatments for PVFD:
• Breathing exercises with speech pathologist
• Relaxation techniques
• Counseling
• Medications to treat associated problems
Voice
Disorders
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Voice disorders are caused by a variety
of conditions. Abuse or misuse of the voice with yelling, singing, or
speaking is common. Changes in the vocal folds due to smoking, aging, or
growths are possible. Medical conditions such as chronic acid reflux or
thyroid disorders need to be considered. Lack of movement and poor or
improper function of the vocal folds are other causes.
Signs and Symptoms of Voice Disorders
• Hoarseness
• Vocal fatigue
• Weak or breathy voice
• Loss of singing range
• Loss of voice
• Pitch breaks, or abnormally high or low voice
• Strained voice
• Tremor
• Pain while speaking/singing
Examination
After meeting with your physician, you may be scheduled to see a speech
pathologist for videostroboscopy. This simple office procedure shows
the vocal folds vibrating in slow motion in order to see details of
possible growths, vocal cord motion, and function. A scope attached to a
camera will be used to see the vocal folds, either through your nose or
mouth. This is usually a quick and well-tolerated procedure. Anesthetic
spray may be used to make it more comfortable. The strobe exam is
recorded on videotape for later review with your physician followed by
an explanation of the findings and discussion of options for treatment
and rehabilitation.
Voice Therapy
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If voice therapy is recommended, you will be scheduled to see a
Speech
Pathologist. Your exam findings and voice use patterns will be further
evaluated in order to provide an appropriate course of treatment. For
the professional/singing voice, the expertise of the voice instructor is
used to establish proper use and techniques.
Spasmodic Dysphonia
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Spasmodic dysphonia is a neurological voice disorder characterized by
frequent “breaks” or “shut-offs” while speaking. Speech may be
effortful, strained, or unpredictable. At this time, it is unknown what
causes this disorder. Although not a cure, Botox has proved to be
effective in treating the vocal symptoms.
Botulinum Toxin (Botox)
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Botox injections are performed by a physician as an office procedure.
Botox temporarily stops the vocal folds from spasming, which can relieve
symptoms for up to several months. If you would like more information
about the use of Botox for spasmodic dysphonia, please
contact us.
Speech
Pathologist
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The Voice Care Center currently has two
speech pathologists who are qualified and experienced in evaluating and
treating patients with voice or swallowing disorders.
After the initial exam, your physician may refer you to the speech
pathologist for further evaluation and treatment. Together, they will
collaborate to determine the best course of treatment.
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