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

1. Know More About Voice and Swallowing 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 partner with speech pathologists in the greater New Jersey Shore area to get you the care you need. Flexible Laryngoscopy A small flexible camera is used to visualize the nose, throat, and vocal cords after numbing the nose and throat. Video Stroboscopy The vocal cords are examined with a high power camera and strobe light to examine for abnormalities that may be causing voice problems. Fiberoptic Endoscopic Evaluation of Swallow (FEES) A test that evaluates your swallowing function using a camera as your swallow various consistencies of food.

2. Vocal Cord Lesions 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- tube is passed through the patient’s mouth that allows the examiner to view the voice box (images are often recorded on video). The stroboscopic light source allows the examiner to assess vocal fold vibration. Sometimes a second exam will follow a trial of voice rest to allow the otolaryngologist an opportunity to assess changes in the vocal cord lesion.

3. Vocal Cord Paresis/Paralysis Hoarseness and other problems can occur related to problems between the nerves and muscles within the voice box or larynx. The most common condition is a paralysis or weakness of one or both vocal cords. Involvement of both vocal cords is rare and is usually manifested by noisy breathing or difficulty getting enough air while breathing or talking. 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 unknown reasons.

4. Know About Presbyphonia (Aging voice) Causes As part of the normal aging process, the muscles that sustain and support our vocal folds (cords), as well as the structure of the larynx (voice box), may alter and change. These changes, that can affect the way we use our voice and the way it sounds, usually occur after age 60. Treatment An ENT doctor will first examine the larynx to evaluate the structure and functionality of your vocal folds. Depending on your specific problems, treatment options can include:

5. Know About Spasmodic Dysphonia Spasmodic dysphonia, also known as laryngeal dystonia, is a rare neurological disorder characterized by involuntary muscle spasms of the larynx (voice box). Spasmodic dysphonia causes the voice to break, or to have a tight, strained or strangled quality. Patients with spasmodic dysphonia may have difficulty communicating clearly. The disorder appears most 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 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. Professional Voice 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 feature of their careers. But what about other occupational voice users? Teachers, clergy, salespeople, courtroom attorneys, telemarketers, and receptionists are also people for whom spoken communication is an essential part of what they do, and there are countless other professions 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, or a business executive conducting a meeting without voice? Once you pause to consider a world without voice communications, you realize that voice is crucial to many professions.

7. Know About Vocal Cord Cancer 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 news is that some of these smokers switched to smokeless or spit 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 cancers produce early symptoms. You should know the potential warning signs so you can alert your doctor as soon as possible. Remember—successful treatment of head and neck cancer depends on early detection. Knowing and recognizing the signs of head and neck cancer can save your life.

8. Throat Cancer Throat cancer is a very serious condition requiring immediate medical attention. When cancer attacks the vocal cords, the voice changes in quality, assuming the characteristics of chronic 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 vocal cord cancer can be obtained.

9. Vocal Misuse and Abuse Improper or poor speaking technique is caused from speaking at an abnormally or uncomfortable pitch, either too high or too low, and leads to hoarseness and a variety of other voice problems. Examples of this condition are when young adult females, in a work environment, consciously or subconsciously choose to speak at a lower than appropriate pitch and with a heavy voice. Percussive speaking, a voice too loud or focusing on the first syllable of each word, is another improper speaking technique that may result in injury or trauma to the vocal cords and muscles causing “vocal fatigue”.

10. Know More About Laryngitis Voice problems result when the lungs, voice box (larynx), or mouth are damaged. If you have a voice problem, you may experience discomfort or pain in your neck as you speak, 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, or jobs that require you to talk or project your voice for long periods, can be rough on your vocal cords. As you age, vocal cords will be naturally strain. Talking loudly, screaming, and yelling will also increase your probability of developing voice complications. If you are a smoker, had throat cancer, or have ever had surgery in your throat and neck, you may develop voice problems.

11. Swallowing Difficulty (Dysphagia) When dysphagia is persistent and the cause is not apparent, the otolaryngologist—head and neck surgeon will discuss the history of your problem and examine your mouth and throat. This may be done with the aid of mirrors. Sometimes a small tube (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 procedures provide visualization of the back of the tongue, throat, and larynx (voice box). These procedures are called FEES (Fiber optic Endoscopic Evaluation of Swallowing) or FEESST (Flexible Endoscopic Evaluation of Swallowing with Sensory Testing). If necessary, an examination of the esophagus, named TransNasal Esophagoscopy (TNE), may be carried out by the otolaryngologist. If you experience difficulty swallowing, it is important to seek treatment to avoid malnutrition and dehydration.

12. Pain with Swallowing (Odynophagia) The larynx has multiple functions, including voice production, cough, and airway protection. The larynx also acts as a conduit for breathing. Pathologic conditions that affect normal laryngeal function can result in poor cough production, aspiration with subsequent pneumonia, change in phonation, and dysphagia. Chondronecrosis of the larynx is a rare complication encountered in otolaryngology.

13. Laryngopharyngeal / Gastroesophageal Reflux Disease 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 from the stomach rises upward, towards the esophagus, and enters the back of the throat. Patients with LPR report experiencing a bitter taste and the feeling that something is caught in the back of their throat. In some cases, LPR can cause breathing difficulties.

14. Know About Zenker's Diverticulum Zenker’s Diverticulum is a disorder characterized by the formation of pouches on the esophagus, most typically in older people. The pouches vary in size, but can cause swallowing problems, irritation, regurgitation and bad breath due to food trapped 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 invasive endoscopic procedures make treatment of Zenker’s Diverticulum much easier. Performed on an outpatient basis, no incision is necessary and patients may resume eating food the very next day.

15. Know About Cough A cough is a reaction to an airway irritation. It is generally the symptom of an illness or allergy. Some coughs are considered productive, which means they help to remove mucus from the lungs usually due to respiratory infections such as pneumonia and bronchitis. Others are considered nonproductive, and these are dry coughs that typically occur in response to exposure to an irritant such as smoke or because of a cold. Coughs may also be brought on by persistent problems including asthma, chronic obstructive pulmonary disease (COPD) or gastroesophageal reflux disease. The type of treatment for a cough will vary depending on its cause. Most coughs respond well to the use of a humidifier and increased fluid intake.

16. Parkinson's Disease Related Voice Disorder It has been estimated that more than 70% of patients with Parkinson’s disease experience voice and speech disorders. Some report that dysphonia, impairment in the ability to speak normally, is one of the disease’s most disruptive symptoms. People with Parkinson’s induced dysphonia are described as having a harsh, weak or breathy quality to their voices. There are, however, medical and behavioral treatments that may lead to voice improvements. Both vocal chord injections and voice therapy have shown some of the most positive results with the least amount of patient discomfort.

17. Contact Us Coastal Ear, Nose and Throat Address: 100 Commons Way #210 Holmdel, NJ 07733 (732) 280-7855 (732)-280-7815 Coastal Ear, Nose and Throat Address: 1301 Route 72 Unit 340 Manahawkin, NJ 08050 (609) 978-0590 (732) 280-7815 Coastal Ear, Nose and Throat Address: 3700 Route 33 Neptune, NJ 07753 (732) 280-7855 (main) (732) 280-7815 For More Details Visit Us: https://coastalearnoseandthroat.com/services/voice-and-swallowing/