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Voice And Swallowing Disorders
The Maryland Ear, Nose and Throat Center has one of the most extensive programs for voice disorders in the Mid-Atlantic region. Our patients include people who depend on their voices for their careers, such as teachers, actors and professional singers. In fact, we offer dedicated services for voice professionals.
Using highly specialized equipment, including video laryngeal stroboscopy and video fluoroscopy, our physicians can diagnose complicated voice and swallowing disorders. Video laryngeal stroboscopy illuminates the vocal folds as they vibrate so that we can examine any changes in the vocal cord tissue that may account for hoarseness, persistent laryngitis or a change in vocal range and control.
A common cause of voice problems is vocal cord paralyzed, sometimes a result of injury, viral illness, or post-intubation trauma. Patients with one paralyzed vocal cord often respond to injections of bulk, such as Teflon (or Cymetra) into the vocal cord, or thyroplasty, in which a silicone implant is inserted between the layers of the vocal cord. In some cases, in which both vocal cords are paralyzed, a tracheostomy may be necessary. Tracheotomy patients lose the ability to speak without a prosthetic device. An enhanced speaking valve, the “Shikani speaking valve”, allows these patients’ speech to be restored, with minimal effort. Patients often prefer this valve to other valves on the market because it is small enough to hide inside the tracheostomy, and it’s superior voice quality.
The Shikani Tracheotomy Speaking Valve is named for Dr. Shikani’s pioneering work in the field of voice disorders.
Other common causes of voice changes include voice overuse and abuse syndromes, recurrent laryngitis, reflux disease (GERD), spasmodic dysphonia, cancer, previous surgeries on the larynx or thyroid, benign growths (polyps, granulomas, glottic webs, cysts, nodules and papilloma) and the aging process. Some of these conditions may require surgery, such as minimally invasive laser surgery to remove a vocal cord nodule, polyp or tumor. Others may require a combination of surgery and voice rehabilitation, which is also offered through the Maryland Ear, Nose and Throat Center. A voice and swallowing therapist works with our team to provide computerized speech (CSL) evaluation and therapy.
Voice rehabilitation includes a range of therapies. For total laryngectomies, patients may require mechanical prostheses which allow them to learn to talk. Patients with less extensive voice disabilities may benefit from speech therapy and exercises to strengthen facial muscles and improve coordination.