1301 20th Street, Suite 300, Santa Monica, CA 90404

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Voice & Swallowing Disorders / Laryngology

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

Care of the Professional Voice

iStock_000007492315SmallSingers, actors, and others whose professions heavily depend on their voice need specialized care to ensure that their voice remains healthy and they are performing at their best. Professionals require examination of the vocal cords and surrounding structures before every performance to prevent unnecessary damage to their voice. In between performances, preventive care is necessary to ensure that the voice is being used properly and to detect and correct poor speaking habits, ultimately leading to healthy lives and successful careers. At Southern California Head and Neck, we offer comprehensive care of the professional voice to patients throughout the greater Los Angeles area.

Laryngology is a subspecialty within otolaryngology that encompasses the diagnosis and treatment of disorders the larynx related to voice, swallowing and breathing. Vocal professionals need to have a laryngologist who understands the importance of vocal health to the longevity of their careers. This involves both prevention and maintenance as well as the treatment of voice disorders. Professional voice users benefit greatly from a baseline evaluation, including a vocal history and digital laryngeal stroboscopy, for the assessment and management of potential problems before they result in a loss of vocal quality.

In addition to our laryngology services, we have a team of skilled and experienced speech and singing voice therapists who can work with the patient and their vocal pedagogue to provide comprehensive preventative and therapeutic voice care. Regular evaluations and ongoing preventative care are very important to maximize the long-term performance of vocal professionals.

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Acute and Chronic Hoarseness Treatment

Hoarseness refers to any abnormality of the voice and can manifest as changes in vocal characteristics resulting in a breathy, rough, raspy or strained quality with differences in vocal projection or pitch. These changes can occur as a result of many different causes, both acute and chronic, such as laryngitis or inflammation of the vocal folds, laryngopharyngeal reflux (LPR, acid reflux), vocal overuse, muscle tension and vocal fold masses (polyps, cysts, nodules).

Most treatment is conservative and involves medication, speech and/or singing voice therapy and temporary modifications in voice use. Even with conservative management, some conditions will require surgery. Our fellowship-trained laryngologist, Dr. Andrews, has extensive experience in treating these conditions and will make every effort to ensure the best possible result so our patients can resume their normal professional and social activities as soon as possible.

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Laryngopharyngeal Reflux / LPR / GERD Treatment

p-iStock_000002310118SmallGastroesophageal reflux disease (GERD) and laryngopharyngeal reflux (LPR), commonly known as acid reflux, are acute or chronic conditions associated with frequent heartburn, cough, throat clearing, dysphagia or difficulty swallowing, dyspnea or difficulty breathing, choking and/or hoarseness. GERD occurs when acidic content from the stomach regurgitates, or refluxes, into the esophagus, larynx or trachea causing inflammation or damage to these structures.

The cause of GERD is unknown, but doctors believe it is the result of multiple factors, including abnormal movement in the lower esophageal sphincter and a hiatal hernia. Heartburn, nausea and difficulty swallowing are common symptoms of GERD, while ulcers, asthma and esophageal cancer can also occur in severe cases.

Some patients with GERD may also experience LPR, which occurs as acid from the stomach rises to the esophagus and enters the back of the throat. Patients suffering from LPR often report a bitter taste in their mouth, hoarseness and the feeling that mucus or phlegm is caught in the back of their throat. In some cases, LPR can cause breathing difficulties. LPR may also be a contributing factor in the development of laryngeal cancer.

GERD and LPR can often be treated through lifestyle changes and medication. Surgery may be required for more severe cases. Our doctors can determine the most effective treatment option for your LPR or GERD symptoms at our Los Angeles area office.

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Laryngeal Examination Methods

Flexible Fiberoptic Laryngoscopy

Flexible fiberoptic laryngoscopy or laryngeal endoscopy is a diagnostic examination to view the throat and its surrounding structures. During a flexible fiberoptic laryngoscopy, topical anesthesia is applied to the nasal cavity and a small endoscope is inserted through the nostril to examine the throat and larynx. It is performed using a thin, flexible endoscope attached to a fiberoptic light source and digital camera, which enables the doctor to complete a comprehensive evaluation of the throat and larynx. When necessary, biopsies of the throat can be taken during the examination.

A fiberoptic laryngoscopy can be performed as part of a regular office visit. Since topical anesthesia is used to numb the affected area, the patient remains fully awake during the procedure and can review the digitally recorded findings with the doctor immediately afterward. It also allows for a resumption of normal activities with no delay.

Rigid Laryngoscopy

Rigid laryngoscopy is very similar to the flexible laryngoscopy, but it is performed through the mouth using a rigid scope. It is a minimally invasive procedure that provides visual access to the vocal cords in order to diagnose and treat conditions such as hoarseness, weak voice, polyps, difficulty swallowing or laryngeal cancer. During this procedure, a rigid fiberoptic tube is inserted into the throat to evaluate the area. This procedure is conducted without anesthesia or using topical anesthesia, depending on the patient’s preferences, in our Los Angeles area office.

Digital Laryngeal Stroboscopy

Similar to flexible fiberoptic laryngoscopy and rigid laryngoscopy, digital laryngeal stroboscopy utilizes a state-of-the-art laryngeal strobe, digital camera and computer processer to obtain slow motion, high resolution images of vocal fold vibration. This allows evaluation of subtle or complex conditions that may affect vocal cord vibration and cause changes to the voice. This procedure may also be used to compare the appearance and movement of the vocal cords before and after treatment for any detected problems.

Digital laryngeal stroboscopy is performed on an outpatient basis in our Los Angeles area office, and involves inserting an endoscope through the nose and into the throat, where it is led to the vocal cords. The stroboscope technology used will capture slow-motion images of the vocal cords while the patient speaks to provide clear, informative photos of the rapidly moving structures, which can be viewed in real-time by the doctor and patient.

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