Voice & Swallowing

Conditions We Evaluate

  • Dysphagia (Swallowing Difficulties)
  • Hoarseness
  • Laryngeal Cancer
  • Laryngitis (Vocal Fold Inflammation)

  • Laryngopharyngeal Reflux (LPR)
  • Spasmodic Dysphonia
  • Vocal Fold Lesions
  • Vocal Fold Paralysis / Weakness

Common Voice Disorders

Laryngitis: Laryngitis is an inflammation of the voice box. The most common symptoms are hoarseness, voice loss, and throat pain.

Vocal fold lesions (such as nodules, polyps, and cysts): Benign laryngeal lesions are abnormal growths of the vocal folds or the larynx (voice box) that are NOT cancerous.

Laryngopharyngeal reflux (LPR): LPR occurs when acid reflux makes it up to the throat and/or into the larynx or voice box regions.

Contact ulcer/granuloma: Contact granulomas develop due to persistent tissue irritation in the posterior larynx. Signs and symptoms may include hoarseness or a feeling of a lump in the throat. They are commonly seen in people use their voice excessively.

Laryngeal papilloma: Laryngeal papilloma are growths on the larynx caused by the human papilloma virus.

Hyperkeratosis/leukoplakia: This is a condition where thick, white patches or leaf like growths develop on the vocal folds. They are considered pre-cancerous.

Muscle tension dysphonia: Muscle tension dysphonia is voice change due to excessive muscle tension in and around the voice box. It can develop during laryngitis and remain even after the vocal cords have healed. It can also be caused by stress, over use of the voice, and often co-occur with other voice disorders.

Spasmodic Dysphonia (SD): Spasmodic dysphonia is a neurological voice disturbance that causes spasming of the vocal folds. It is also considered a focal dystonia of the larynx. The cause is not known, but it is believed to be caused by a lesion in the brain involving the basal ganglia, which is responsible for coordinating movement.

Vocal fold paralysis or paresis: Vocal fold paralysis is a condition where either one or both of the vocal folds are completely immobile. This can be caused by disease, trauma, or as the result of a previous surgery. Paresis is a weakness in one or both of the vocal folds where the movement of the vocal folds may be reduced or the movement pattern shows weakness.

Laryngeal cancer: Laryngeal cancer is when malignant cells grow on the larynx. It is often caused by smoking, tobacco use, excessive alcohol consumption or a combination of these habits.

Laryngectomy: Laryngectomy is the surgical removal of the larynx.

Shortness of breath: Shortness of breath has many causes, including but not limited to asthma, bronchitis, COPD, pneumonia, irritable larynx, and cancer. It may be also caused by, disordered breathing patterns in general or during exercise.

Hyperventilation syndrome: Hyperventilation syndrome is a respiratory condition that involves breathing too deeply or too rapidly. There may be medical, physical, or psychological causes.

Hyper/hyponasality: Hypernasality occurs when too much airflow and sound production moves through the nasal passages during connected speech. Hyponasality occurs when too little airflow and sound move through the nasal passages during speech.

Dysarthria: Dysarthria is a speech disorder caused by weakness of the lips, tongue, palate, and facial muscles as well as the respiratory system. It can be caused by stroke, brain injury, tumors, surgery, Parkinson’s disease, Amyotrophic lateral sclerosis (ALS), Huntington’s disease, multiple sclerosis among other neurological conditions.

Common Symptoms of Voice Disorders

  • Hoarse voice
  • Weak voice
  • Discomfort with speaking
  • Chronic sore throat
  • Chronic cough
  • Sensation of something in the throat
  • Vocal fatigue
  • Pitch breaks
  • Loss of singing range/quality
  • Difficulty with breath control/shortness of breath during speech, singing, or exercise

Common Swallowing Disorders

  • Weakness of the lips, tongue, or jaw
  • Weakness of the throat
  • Aspiration
  • Reflux
  • Reduced motility of the esophagus
  • Esophageal stricture
  • Zenker’s Diverticulum
  • Cricopharyngeal Muscle Spasm
  • Fibrosis following radiation treatment for head and neck cancer

Common Symptoms of Swallowing Disorders

  • Difficulty swallowing food or liquid
  • Coughing during or after eating or drinking
  • Pain while swallowing
  • Food feeling stuck in the throat
  • Difficulty chewing
  • Choking while eating
  • Regurgitation of food into the throat or mouth
As a result of swallowing disorders, adults may develop additional medical complications such as poor nutrition or dehydration and risk of aspiration (food or liquid entering the airway), which can lead to pneumonia and chronic lung disease. Patients may also report that they no longer enjoy meal times, and they may be embarrassed to join others during meals leading to social isolation.

Patient Education & Resources

Hoarseness: http://www.entnet.org/?q=node/1450

Swallowing Trouble: http://www.entnet.org/?q=node/1453

Voice Box (Laryngeal) Cancer: http://www.entnet.org/?q=node/1445

Vocal Cord Paralysis: http://www.entnet.org/?q=node/1448