Voice, Speech & Swallowing Services - Coastal Ear Nose & Throat

1. KnowMoreAboutVoiceandSwallowing The Coastal Voice and Swallowing Center is led by Dr. Pratik B. Patel, focusingonthediagnosisandtreatmentoflaryngologic(voiceboxandthroat) conditions.Weofferawidevarietyofin-officeandoperativeprocedures,and partner with speech pathologists in the greater New Jersey Shore area to get youthecareyouneed. FlexibleLaryngoscopy Asmallflexiblecameraisusedtovisualizethenose,throat,andvocalcordsafter numbingthenoseandthroat. VideoStroboscopy Thevocalcordsareexaminedwithahighpowercameraandstrobelighttoexamine forabnormalitiesthatmaybecausingvoiceproblems. FiberopticEndoscopicEvaluationofSwallow(FEES) Atestthatevaluatesyourswallowingfunctionusingacameraasyourswallowvarious consistenciesoffood.

2. VocalCordLesions Diagnosis begins with a complete history of the voice problem and an evaluation of speaking method. The otolaryngologistwillperformacarefulexaminationofthe vocal cords, typically using rigid laryngoscopy with a stroboscopic light source. In this procedure, a telescope- tubeispassedthroughthepatient’smouththatallowsthe examinertoviewthevoicebox(imagesareoftenrecorded on video). The stroboscopic light source allows the examinertoassessvocalfoldvibration.Sometimesa second exam will follow a trial of voice rest to allow the otolaryngologist an opportunity to assess changes in the vocalcordlesion.

3. VocalCordParesis/Paralysis Hoarsenessandotherproblemscanoccurrelatedto problemsbetweenthenervesandmuscleswithinthe voiceboxorlarynx.Themostcommonconditionisa paralysisorweaknessofoneorbothvocalcords. Involvementofbothvocalcordsisrareandisusually manifestedbynoisybreathingordifficultygetting enoughairwhilebreathingortalking.However,one vocal cord can become paralyzed or severely weakened (paresis) after a viral infection of the throat, after surgery in the neck or cheek, or for unknownreasons.

4. KnowAboutPresbyphonia(Aging voice) Causes As part of the normal aging process, the muscles that sustainandsupportourvocalfolds(cords),aswellasthe structureofthelarynx(voicebox),mayalterandchange. These changes, that can affect the way we use our voice andthewayitsounds,usuallyoccurafterage60. Treatment AnENTdoctorwillfirstexaminethelarynxtoevaluate thestructureandfunctionalityofyourvocalfolds. Dependingonyourspecificproblems,treatmentoptions caninclude:

5. KnowAboutSpasmodicDysphonia Spasmodic dysphonia, also known as laryngeal dystonia, is a rare neurological disorder characterized byinvoluntarymusclespasmsofthelarynx(voicebox). Spasmodic dysphonia causes the voice to break, or to have a tight, strained or strangled quality. Patients with spasmodic dysphonia may have difficulty communicatingclearly.Thedisorderappearsmost often in people between 30 and 50 years of age, and more frequently in women. While the exact cause of spasmodic dysphonia is not always known, it is sometimesduetopsychologicalstress,however,most cases result from a problem in the brain and nervous system. Spasmodic dysphonia is often a chronic condition.

6. ProfessionalVoice An occupational or professional voice user is anyone whose voice is essential to their job. We are all accustomed to thinking of singers, actors, actresses, and broadcast personalities as professional voice users. Indeed, special or unique qualities of the voice are often the essential featureoftheircareers.Butwhataboutotheroccupationalvoiceusers? Teachers, clergy, salespeople, courtroom attorneys, telemarketers, and receptionistsarealsopeopleforwhomspokencommunicationisan essentialpartofwhattheydo,andtherearecountlessotherprofessions that rely heavily on the voice. In spite of this era of email and Internet communications, we can’t really imagine an effective classroom, pulpit, or courtroom without voice. Can you imagine the difficulties of a physician conveying sensitive or complex information to a patient or colleague,orabusinessexecutiveconductingameetingwithoutvoice? Onceyoupausetoconsideraworldwithoutvoicecommunications,you realizethatvoiceiscrucialtomanyprofessions.

7. KnowAboutVocalCordCancer Tobacco use is the most preventable cause of these deaths. In the United States, up to 200,000 people die each year from smoking- related illnesses. The good news is that this figure has decreased due to the increasing number of Americans who have quit smoking. The bad newsisthatsomeofthesesmokersswitchedtosmokelessorspit tobacco,assumingitisasafealternative.Thisisuntrue.Bydoing 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 theheadandneckappeartobeincreasing.Canceroftheheadand neck is curable if caught early. Fortunately, most head and neck cancers produce early symptoms. You should know the potential warningsignssoyou canalertyourdoctorassoonaspossible. Remember—successful treatment of head and neck cancer depends on early detection. Knowing and recognizing the signs of head and neckcancercansaveyourlife.

8. ThroatCancer Throatcancerisaveryseriousconditionrequiringimmediate medical attention. When cancer attacks the vocal cords, the voicechangesinquality,assumingthecharacteristicsofchronic hoarseness, roughness, or raspiness. These symptoms occur at 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 Improperorpoorspeakingtechniqueiscausedfrom speakingatanabnormallyoruncomfortablepitch,either toohighortoolow,andleadstohoarsenessandavarietyof othervoiceproblems. Examplesofthisconditionarewhenyoungadultfemales, inaworkenvironment,consciouslyorsubconsciously choosetospeakatalowerthanappropriatepitchandwitha heavyvoice. Percussive speaking, a voice too loud or focusing on the first syllable of each word, is another improper speaking techniquethatmayresultininjuryortraumatothevocal cordsandmusclescausing“vocalfatigue”.

10. KnowMoreAboutLaryngitis Voice problems result when the lungs, voice box (larynx), or mouth are damaged. If you have a voice problem, you may experiencediscomfortorpaininyourneckasyouspeak, trouble reaching proper pitch, quality, or loudness of your voice. Anybody can acquire a voice problem, but there are specific occupations that make it more likely. For instance, teachers,preachers,singers,orjobsthatrequire you totalk or project your voice for long periods, can be rough on your vocal cords. As you age, vocal cords will be naturally strain. Talkingloudly,screaming,andyellingwillalsoincrease your probability of developing voice complications. If you areasmoker,hadthroatcancer,orhaveeverhadsurgery inyourthroatandneck, you may developvoiceproblems.

11. SwallowingDifficulty(Dysphagia) When dysphagia is persistent and the cause is not apparent, the otolaryngologist—headandnecksurgeonwilldiscussthehistory of your problem and examine your mouth and throat. This may be donewiththeaidofmirrors.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, andlarynx(voicebox).TheseproceduresarecalledFEES(Fiber opticEndoscopicEvaluationofSwallowing)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) Thelarynxhasmultiplefunctions,includingvoice production, cough, and airway protection. The larynxalsoactsasaconduitforbreathing. Pathologic conditions that affect normal laryngeal function can result in poor cough production, aspirationwithsubsequentpneumonia,changein phonation,anddysphagia.Chondronecrosisof thelarynxisararecomplicationencounteredin 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. KnowAboutZenker'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, regurgitationandbadbreathduetofoodtrapped 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 invasiveendoscopicproceduresmaketreatmentof 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 helptoremovemucusfromthelungsusuallydueto respiratoryinfectionssuchaspneumoniaand bronchitis.Othersareconsiderednonproductive,and these are dry coughs that typically occur in response to exposuretoanirritantsuchassmokeorbecauseofa cold. Coughs may also be brought on by persistent problemsincludingasthma,chronicobstructive 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,impairmentintheabilityto speaknormally,isoneofthedisease’smostdisruptive symptoms. PeoplewithParkinson’sinduceddysphoniaaredescribedas havingaharsh,weakorbreathyqualitytotheirvoices.There are, however, medical and behavioral treatments that may lead to voice improvements. Both vocal chord injections and voicetherapyhaveshownsomeofthemostpositiveresults withtheleastamountofpatientdiscomfort.

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/