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Voice & Swallowing Disorders / Laryngology 4

Click on a topic below to learn more:
Care of the Professional Voice Glottic Insufficiency
Acute and Chronic Hoarseness Spasmodic Dysphonia
Laryngopharyngeal Reflux / LPR /GERD Swallowing Disorders / Dysphagia
Laryngeal Examination Methods Speech Therapy Services
Vocal Cord Masses Singing Voice Therapy / Vocal Pedagory Services
Vocal Cord Paralysis

Spasmodic Dysphonia Treatment

iStock_000009317797SmallSpasmodic dysphonia is a form of dystonia, a group of neurological disorders characterized by involuntary muscle spasms. It is a voice disorder involving involuntary spasms of the voice box muscles and causing the voice to break or to have a tight, strained, or strangled quality. Patients with spasmodic dysphonia may have difficulty communicating clearly.

There are two types of spasmodic dysphonia. In adductor spasmodic dysphonia, the vocal folds come together (adduct) tightly at the wrong time during speech, making it difficult to produce voice. In the more common abductor spasmodic dysphonia, the vocal folds move apart (abduct) at the wrong time during speech, causing air leaks. There may also be a combination of the two called mixed spasmodic dysphonia.

BOTOX® Injection

Although most commonly known for its cosmetic indications, botulinum toxin, also known as Botox, is a synthetic chemical that can be used to block nerve signal for treatment of a wide range of conditions, including voice disorders such as spasmodic dysphonia or vocal cord paralysis.

Injected directly into the vocal cords, Botox relaxes the muscles to relieve symptoms such as difficulty speaking and a tight, strained, or strangled quality to the voice. The medication weakens the vocal cord muscle to interrupt nerve signals for effective symptom relief.

Laryngeal Electromyography (EMG)

Laryngeal electromyography (EMG) is a diagnostic exam that evaluates the health of the vocal cord muscles and the nerves that control them by measuring muscle electrical activity. This test is most commonly performed to determine the cause of muscle weakness, as well as to predict recovery from vocal cord paralysis and other related conditions. It is often performed with Botox injections to ensure that the medication is injected into the proper muscle.

During the EMG exam, thin needle electrodes are inserted through the skin and into the muscle, where they detect electrical activity while the vocal cord muscle is at rest and contracting. Patients may experience mild pain when the electrodes are inserted, but this is tolerable for most. This test is usually performed in conjunction with a nerve conduction velocity test.

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Swallowing Disorders / Dysphagia Treatment

p-iStock_000012716055SmallDysphagia, or swallowing disorder, is a term used to describe the inability to move food from the mouth to the stomach. This condition can accompany a neurological disorder such as stroke, Parkinson’s disease, cerebral palsy, Lou Gehrig’s Disease, or others, as well as bacterial, viral, or fungal infections. Dysphagia can occur at any of the 3 stages of swallowing: oral, pharyngeal, and esophageal.

Depending on the type of swallowing disorder, changing a person’s diet by adding thickeners and physical therapy may help alleviate the problem in noninvasive ways. Sometimes drug therapy helps relieve symptoms of the underlying neurological cause, and thus relieves the swallowing problems. Less commonly, botulinum toxin injections can be used when food or liquid cannot enter the esophagus. Severely affected individuals may require surgery or feeding tubes.

Flexible Endoscopic Evaluation of Swallowing (FEES)

Flexible endoscopic evaluation of swallowing (FEES) is a test performed to diagnose swallowing difficulties. FEES is performed with a thin, lighted camera known as an endoscope. The endoscope is placed into the throat before the patient consumes several different foods with food coloring that can be easily monitored as they travel down the throat. After the test, your doctor will discuss the results with you. If any issues were found, a customized treatment plan will be created for your individual condition.

Modified Barium Swallowing Study

Also known as a cookie swallow or a videofluoroscopy, a modified barium swallowing study is performed to diagnose swallowing or speaking problems. You are not to eat or drink anything for a few hours before the exam. When you arrive for your modified barium swallowing study, you will be given a contrast solution to swallow, which will highlight the various structures associated with swallowing and speaking onto the fluoroscope used during this exam. To further pinpoint your exact condition, you will be asked to swallow numerous barium preparations of differing consistencies so that your doctor can watch the barium travel down your esophagus.

Swallowing Therapy Services

Patients experiencing swallowing difficulties can benefit from swallowing therapy. Working with a speech pathologist, the patient will learn special exercises to improve functioning of the muscles associated with swallowing. Depending on the individual patient, swallowing therapy may also include changes in diet.

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Speech Therapy Services

Speech disorders can cause embarrassment to those suffering from them. Speech therapy aims to resolve speech disorders through individualized treatment plans. Breathing exercises, tongue placement, and other strategies may be used to ensure clear speech and allow patients to lead, healthy, successful lives. We offer effective speech therapy services at our Los Angeles area office.

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Singing Voice Therapy / Vocal Pedagogy Services

p-iStock_000005209436MediumSinging voice therapy is highly beneficial for singers; however, public speakers and other professionals constantly using their voice can benefit as well. Through various breathing techniques, singing voice therapy can help all professionals use their voice more powerfully.

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