Speech Swallowing Disorders

Voice Disorders

Hoarseness is probably the most common type of voice disorder. Patients experience a lack of vocal clarity or difficulty singing. Hoarseness occurs with infections such as laryngitis, but may also be due to voice strain and abuse, particularly in individuals who use their voice professionally such as singers, actors, and teachers. Patients may develop vocal cord nodules or polyps. Anyone with hoarseness that persists more than a few weeks should have their vocal cords evaluated by a physician.

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A helpful tool for identifying and diagnosing disorders of the vocal fold is a video stroboscopy (a specialized diagnostic procedure in which a stroboscopic light is used in conjunction with a laryngoscope to electronically slow down the motion of the vocal folds in order to identify subtle changes in vibratory patterns that are diagnostically significant). With the use of a camera and video recording system, the results can be viewed many times by the examiner and patient.

Swallowing Disorders

Difficulty swallowing can be caused by a number of problems ranging from a throat infection to neurologic disorders, including stroke. Whenever one experiences a sensation of a lump in the throat or difficulty eating, a swallowing evaluation should be performed. This may include a direct endoscopic examination of the structures involved in swallowing, most commonly referred to as aFEESST (Flexible Endoscopic Evaluation of Swallowing with Sensory Testing).

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FEESST combines an innovative test of airway protection of the throat with an endoscopic swallowing test. The first part of the test assesses sensation in the larynx in order to elicit an airway protective reflex. Pulses of air are directed at points on the larynx, and the reaction to this stimulus is observed through an endoscopic camera.

The second part of FEESST entails observing how and where the food travels down the patient’s throat during swallowing through an endoscopic camera with a real-time, magnified view. The test reveals areas where sensory reactions are impaired, thus enabling physicians to better treat patients with swallowing disorders.

FEESST testing can also be helpful in diagnosing and treating patients with GERD (Gastro-Esophageal Reflux Disease), a chronic disorder whereby acid from the stomach backs up into the esophagus causing heartburn type symptoms. If gone untreated for an extensive period of time, GERD can contribute to an ulcer and/or difficulty swallowing.

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