Conditions & Treatments

Voice and swallowing care at CEENTA

Our state-of-the-art Voice and Swallowing Center provides patients with a single place to go for the evaluation, treatment and prevention of voice and swallowing disorders. By offering total voice care — including preventive, diagnostic and a full range of treatment for pediatric and adult patients —CEENTA provides a level of care unmatched in the region. The Center’s unique, multidisciplinary team of otolaryngologists, laryngologists and speech-language pathologists attracts patients from around our region, including many professional singers, actors, teachers and other voice professionals. To ensure your patient receives the most comprehensive care possible, we also work closely with other specialists, including gastroenterologists, pulmonologists and neurologists. The Center’s Head and Neck Dysphagia Clinic allows our physicians to evaluate and treat patients with head and neck cancer before, during and following their treatments. This unique, multidisciplinary approach attracts patients from around our region.

The Department was founded in 1991 at Presbyterian Hospital as a collaborative effort by the hospital, several ear, nose, and throat specialists and Dr. Terri Gerlach. Growth of the program and direct collaboration with many of the ear, nose, and throat doctors at CEENTA lead to the establishment and further development of this specialized program here at CEENTA in 2006.

How do I make an appointment? Contact our scheduler at 704-295-3345 to make an appointment. We do need a physician referral and any medical records faxed to 704-295-3424.

Botulinum Toxin Injections for Spasmodic Dysphonia

Botulinum toxin A (BOTOX®) injections have been performed for the treatment of Spasmodic Dysphonia (SD) for over 20 years. The safety and efficacy of this procedure has been extensively documented in the medical literature. These injections help control the vocal spasms associated with SD by temporarily weakening the vocal fold muscles enough to allow smoother voicing. Once the injection wears off, the voice begins to spasm again and another injection is required (typically, every 3 months).

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Benign Lesions and Inflammatory Conditions

Benign laryngeal lesions are defined as abnormal growths of the vocal folds or the larynx (voice box) that are NOT cancerous. These lesions are classified as nodules, polyps, cysts, granulomas & contact ulcers, leukoplakia & keratosis, and papilloma.

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Dysphagia Clinic

Dysphagia is the term used by healthcare professionals to describe difficulties in swallowing function. Patients with head and neck cancer must undergo treatments such as chemotherapy, radiation therapy and surgical removal of the cancerous tumor. These treatments can have a significant impact on the muscles essential for swallowing.

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Resources to Help You Quit Smoking

Smoking and exposure to smoke irritates and dries the tissues of the throat, particularly the vocal cords. This leads to improper vocal cord vibration and function. Smoking also may promote laryngopharyngeal reflux, or acid reflux, which can also affect the vocal cords. Additionally, smoking degrades lung function, which affects the voice by decreasing airflow through the vocal cords. Of course, no discussion about smoking would be complete without mentioning that smoking is the leading cause of both vocal cord and lung cancers.

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Spasmodic Dysphonia

Spasmodic dysphonia (SD) is a neurological voice disturbance that causes spasming of the vocal folds. It is also considered a focal dystonia of the larynx. At this point, we are not absolutely certain as to what causes SD. However, it is believed to be caused by a lesion in the brain involving the basal ganglia, which is responsible for coordinating movement. There are three types of SD: adductor, abductor, and mixed.

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Swallowing Disorders

Swallowing disorders, also called dysphagia, can occur at the oral, pharyngeal, or esophageal stages of swallowing. Common swallowing disorders include weakness of the lips, tongue, or jaw, weakness of the throat, aspiration, reflux, educed motility of the esophagus, esophageal stricture, Zenker’s Diverticulum, cricopharyngeal muscle spasm, and fibrosis following radiation treatment for head and neck cancer.

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Swallowing Evaluation

During a swallowing evaluation, a swallowing specialist will observe the patient eating and drinking foods of different consistencies, thus identifying potential problems, determining the need for further evaluation and/or dietary modifications, and establishing a therapeutic plan.

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Swallowing Therapy

Oral-motor exercises, posture changes and/or adjusting allowable food consistencies to prevent aspiration are all possible treatment techniques. VitalStim Therapy, a new technique, uses gentle electrical currents to stimulate muscle activity and improve the strength and efficiency of muscles responsible for swallowing.

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Voice Disorders

A voice disturbance is often called dysphonia, meaning your voice does not sound the way you need it to, or tires easily, causing discomfort or fatigue. This may be a result of neurological disorders, vocal fold paralysis, acid reflux and vocal misuse or overuse. Common symptoms of voice disorders include a hoarse voice, a weak voice, discomfort with speaking, chronic sore throat, chronic cough, a sensation of something in the throat, vocal fatigue, pitch breaks, loss of singing range/quality, and difficulty with breath control/shortness of breath during speech, singing, or exercise.

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Voice Evaluation

In order to determine which voice disorders, if any, you may have a voice specialist will discuss your voice problems, vocal needs, activities, and medical and voice-use history. Additional tests may be recommended.

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Voice Therapy

Individually designed voice therapy is often the best method of treatment for voice disorders. Specific exercises, vocal health education, and improvement in voicing techniques are incorporated into your plan of care. Other treatments may involve surgery, or a combination of voice therapy and surgical management. Many patients undergo voice therapy in preparation for surgery to maximize healing of the vocal folds afterwards. Correct voice usage after surgery speeds healing and is critical to the final voice outcome.

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