Voice and Swallowing Treatment Services - Coastal Ear Nose & Throat

1. VoiceandSwallowing The Coastal Voice and Swallowing Center is led by Dr. Pratik B. Patel, focusing on the diagnosis and treatment of laryngologic (voice box and throat) conditions. We offer a wide variety of in-office and operative procedures, and partnerwithspeechpathologistsin the greaterNewJerseyShoreareatoget youthe careyouneed. FlexibleLaryngoscopy Asmall flexible cameraisusedtovisualizethenose,throat,andvocalcordsafter numbing thenoseandthroat. VideoStroboscopy Thevocalcordsareexaminedwithahighpowercameraand strobelighttoexamine for abnormalities thatmaybecausingvoiceproblems. FiberopticEndoscopicEvaluationofSwallow(FEES) A test thatevaluatesyourswallowingfunctionusing a cameraasyourswallowvarious consistenciesoffood.

2. VocalCordLesions Diagnosis begins with a complete history of the voice problem and an evaluation of speaking method. The otolaryngologist will perform a careful examination of the vocal cords, typically using rigid laryngoscopy with a stroboscopic light source. In this procedure, a telescope- tubeispassedthroughthepatient’smouththatallowsthe examinertoviewthevoicebox(imagesareoftenrecorded onvideo).Thestroboscopiclightsourceallowsthe examinertoassessvocalfoldvibration.Sometimesa secondexamwillfollow atrialofvoicerest toallow the otolaryngologist an opportunity to assess changes in the vocalcordlesion.

3. VocalCordParesis/Paralysis Hoarsenessandotherproblemscan occur relatedto problemsbetweenthenervesandmuscleswithinthe voice box or larynx. The most common condition is a paralysisorweaknessofoneorbothvocalcords. Involvement of both vocal cords is rare and is usually manifestedbynoisybreathingordifficultygetting enough air while breathing or talking. However, one vocalcordcanbecomeparalyzedorseverely weakened(paresis)after aviralinfectionofthe throat,aftersurgeryintheneckorcheek,orfor unknownreasons.

4. Presbyphonia(Agingvoice) Causes Aspartofthenormalagingprocess,themusclesthat sustainandsupportourvocalfolds(cords),aswellasthe structure ofthe larynx(voice box),mayalterandchange. Thesechanges,thatcanaffectthewayweuseourvoice andthewayitsounds,usuallyoccurafterage60. Treatment An ENT doctor will first examine the larynx to evaluate the structureandfunctionalityofyourvocalfolds. Depending on your specific problems, treatment options caninclude:

5. SpasmodicDysphonia Spasmodic dysphonia, also known as laryngeal dystonia, is a rare neurological disorder characterized byinvoluntary musclespasmsofthe larynx(voicebox). Spasmodicdysphonia causesthevoicetobreak,orto have a tight, strained or strangled quality. Patients withspasmodicdysphonia mayhavedifficulty communicatingclearly.Thedisorderappearsmost ofteninpeoplebetween30and50yearsofage,and more frequently in women. While the exact cause of spasmodicdysphonia isnotalwaysknown,itis sometimes due to psychological stress, however, most cases result from a problem in the brain and nervous system. Spasmodic dysphonia is often a chronic condition.

6. ProfessionalVoice Anoccupationalor professionalvoiceuserisanyonewhosevoiceis essential to their job. We are all accustomed to thinking of singers, actors,actresses, and broadcastpersonalitiesasprofessionalvoiceusers. Indeed, special or unique qualities of the voice are often the essential featureoftheircareers.Butwhataboutotheroccupationalvoiceusers? Teachers, clergy, salespeople, courtroom attorneys, telemarketers, and receptionistsarealsopeopleforwhomspokencommunicationisan essentialpartofwhattheydo,and therearecountlessotherprofessions that rely heavily on the voice. In spite of this era of email and Internet communications,we can’t reallyimagineaneffectiveclassroom,pulpit, or courtroom without voice. Can you imagine the difficulties of a physicianconveyingsensitiveorcomplexinformation to apatientor colleague,ora businessexecutiveconductingameetingwithout voice? Onceyoupauseto considera worldwithoutvoicecommunications,you realizethatvoiceiscrucialtomanyprofessions.

7. VocalCordCancer Tobaccouseisthemostpreventablecauseofthesedeaths.Inthe United States, up to 200,000 people die each year from smoking- relatedillnesses.Thegoodnewsisthatthisfigurehasdecreaseddue totheincreasingnumberofAmericanswhohavequitsmoking.The badnewsisthatsomeofthesesmokersswitchedtosmokelessorspit tobacco, assuming it is a safe alternative. This is untrue. By doing this, they are only changing the site of the cancer risk from their lungs to their mouth. While lung cancer cases are down, cancers in the head and neck appear to be increasing. Cancer of the head and neck is curable if caught early. Fortunately, most head and neck cancersproduceearlysymptoms.Youshouldknowthe potential warningsignssoyoucanalertyourdoctorassoonaspossible. Remember—successful treatment of head and neck cancer depends on early detection. Knowing and recognizing the signs of head and neckcancercansaveyourlife.

8. ThroatCancer Throatcanceris a veryseriousconditionrequiringimmediate medical attention. When cancer attacks the vocal cords, the voice changes in quality, assuming the characteristics of chronic hoarseness,roughness,orraspiness.Thesesymptomsoccurat an early stage in the development of the cancer. It is important to remember that prompt attention to changes in the voice facilitate early diagnosis thus early and successful treatment of vocalcordcancercanbeobtained.

9. VocalMisuseandAbuse Improperorpoorspeakingtechnique iscausedfrom speakingatanabnormallyoruncomfortablepitch,either toohighortoolow,andleads to hoarsenessandavarietyof othervoiceproblems. Examplesofthisconditionarewhenyoungadultfemales, in a workenvironment,consciouslyorsubconsciously chooseto speakat alowerthanappropriatepitchandwitha heavyvoice. Percussivespeaking, a voicetooloudorfocusingonthe first syllable of each word, is another improper speaking technique that may result in injury or trauma to the vocal cordsandmusclescausing“vocalfatigue”.

10. Laryngitis Voiceproblemsresultwhenthelungs,voicebox(larynx),or moutharedamaged.Ifyouhave a voiceproblem,youmay experiencediscomfortorpaininyourneckasyouspeak, trouble reaching proper pitch, quality, or loudness of your voice. Anybodycanacquireavoiceproblem,but therearespecific occupations that make it more likely. For instance, teachers,preachers,singers,orjobsthatrequireyou to talk orprojectyourvoiceforlongperiods,canberoughonyour vocalcords.Asyouage,vocalcordswillbenaturallystrain. Talking loudly, screaming, and yelling will also increase your probability of developing voice complications. If you areasmoker, hadthroatcancer,orhaveeverhadsurgery inyourthroatandneck,youmaydevelopvoiceproblems.

11. SwallowingDifficulty(Dysphagia) When dysphagia is persistent and the cause is not apparent, the otolaryngologist—headandnecksurgeon willdiscussthehistory of your problem and examine your mouth and throat. This may be donewiththeaid ofmirrors.Sometimesasmalltube(flexible laryngoscope) is placed through the nose and the patient is then given food to eat while the scope is in place in the throat. These proceduresprovidevisualizationofthe backofthetongue,throat, and larynx(voicebox).TheseproceduresarecalledFEES(Fiber opticEndoscopicEvaluation ofSwallowing) orFEESST(Flexible Endoscopic Evaluation of Swallowing with Sensory Testing). If necessary, an examination of the esophagus, named TransNasal Esophagoscopy(TNE),maybecarriedoutbytheotolaryngologist. If you experience difficulty swallowing, it is important to seek treatmenttoavoidmalnutritionanddehydration.

12. PainwithSwallowing (Odynophagia) The larynxhasmultiplefunctions,includingvoice production, cough, and airway protection. The larynxalsoactsasaconduitforbreathing. Pathologic conditions that affect normal laryngeal function can result in poor cough production, aspiration withsubsequentpneumonia,changein phonation,anddysphagia.Chondronecrosisof the larynxisararecomplication encounteredin otolaryngology.

13. Laryngopharyngeal / GastroesophagealRefluxDisease Laryngopharyngeal reflux, also known as LPR, is a condition that can occur in patients who have been diagnosed with gastroesophageal reflux disease, also known as GERD. Acid fromthestomachrisesupward,towardstheesophagus,and enters the back of the throat. Patients with LPR report experiencingabittertasteandthefeelingthatsomethingis caught in the back of their throat. In some cases, LPR can causebreathingdifficulties.

14. Zenker'sDiverticulum Zenker’s Diverticulum is a disorder characterized by the formation of pouches on the esophagus, most typicallyinolderpeople.Thepouchesvaryinsize, but can cause swallowing problems, irritation, regurgitation andbadbreathduetofoodtrapped within the pouches. Traditional surgical treatment for Zenker’s Diverticulum requires an incision in the neck to access the esophagus, resulting in a hospital stay and an inability to eat solid foods until the healing is complete. Now, however, minimally invasiveendoscopicproceduresmaketreatment of Zenker’s Diverticulum much easier. Performed on an outpatient basis, no incision is necessary and patientsmayresumeeatingfoodthe verynextday.

15. KnowAboutCough A cough is a reaction to an airway irritation. It is generally the symptom of an illness or allergy. Some coughsareconsideredproductive,whichmeansthey help toremovemucusfromthe lungsusuallydueto respiratoryinfectionssuchaspneumoniaand bronchitis.Othersareconsiderednonproductive,and these are dry coughs that typically occur in response to exposuretoan irritantsuchassmoke orbecause ofa cold. Coughs may also be brought on by persistent problemsincludingasthma,chronic obstructive pulmonarydisease(COPD) orgastroesophagealreflux disease. The type of treatment for a cough will vary depending on itscause. Most coughsrespondwelltothe useofahumidifierandincreasedfluidintake.

16. Parkinson'sDiseaseRelated VoiceDisorder It has been estimated that more than 70% of patients with Parkinson’s disease experience voice and speech disorders. Somereportthatdysphonia,impairmentin theabilityto speaknormally,is one ofthedisease’smostdisruptive symptoms. PeoplewithParkinson’sinduceddysphoniaaredescribedas havingaharsh,weakorbreathyqualitytotheirvoices.There are, however, medical and behavioral treatments that may lead to voice improvements. Both vocal chord injections and voicetherapyhaveshown some ofthemostpositiveresults withthe leastamount ofpatientdiscomfort.

17. ContactUs CoastalEar,Noseand Throat Address:100Commons Way #210 Holmdel,NJ07733 (732)280-7855 (732)-280-7815 CoastalEar,Noseand Throat Address: 1301Route72 Unit340 Manahawkin,NJ08050 (609)978-0590 (732)280-7815 CoastalEar,Noseand Throat Address:3700Route33 Neptune,NJ07753 (732)280-7855(main) (732)280-7815 ForMoreDetailsVisitUs: https://coastalearnoseandthroat.com/services/voice-and-swallowing/