Voice / Vocal / Speech / Language
The human voice is a sound produced by air passing through the vocal folds (aka: vocal cords). The airflow is produced by the lungs, which act as a pump that forces air through the voice box (larynx). The muscles in the larynx, primarily under the control of the tenth cranial nerve (laryngeal nerve), cause the vocal cords to open and close, resulting in audible sound pulses. The laryngeal muscles adjust the length and tension of the vocal cords to fine-tune the tone and pitch. The tongue, cheeks, lips and palate filter the sound and are the final modifiers of speech. In fact, they are referred to as the "articulators."
Hoarseness, coughing, frequent throat clearing, and a sensation of something stuck in the throat (globus sensation) are the most common symptoms observed when there is a vocal cord problem. The most common causes of these symptoms are: acid reflux, infection (laryngitis), voice abuse (common in singers and screamers), vocal cord paralysis, smoking (smokers polyps), vocal cord nodules, swallowing a foreign body (i.e. fish bone), and vocal cord cancer. If there is not a serious underlying cause, the symptoms will usually go away in a few days. Any time they last for more than a few days, the vocal cords need to be examined.
We have special equipment that allows us to view the vocal cords in the office. The procedure is typically well tolerated and does not require general anesthesia. Many times, vocal cord problems can be treated with medication. However, if the vocal cords have an abnormal appearance, then a biopsy of the vocal cord tissue is mandatory to rule out cancer.
We use a laser to biopsy and remove abnormal tissue from the vocal cords. The procedure is performed while the patient is asleep. Typically, the patient is able to go home on the day of surgery with minimal discomfort and minimal bleeding.
Frequent coughing associated with eating or drinking, a hoarse or breathy voice, and recurrent lung infections are the most common symptoms of vocal cord weakness (paralysis). We specialize in the medical and surgical treatment of vocal cord paralysis.
We evaluate and treat speech disorders caused by abnormal tongue, palate, lip, or cheek movement. For example, "tongue tie" is a frequent cause of speech and feeding problems in children and is easily treated with a procedure that removes a band of tissue from under the tongue. Many speech problems require detailed evaluation and coordination of treatment with a speech therapist.