Voice Disorders - Laryngology

BOTOX injections for dysphonia / laryngeal spasm
Gastroesophageal reflux disease (GERD)
Hoarseness
Professional singers and speakers

 

Gastroesophageal Reflux Disease (GERD)

Although acid reflux (when stomach acid washes up and irritates your throat) is a disorder of the stomach and esophagus, some of its symptoms can present as problems in the throat. Chronic cough, hoarseness, sensation of "a lump in the throat", trouble swallowing, sour or acid taste or recurrent sore throat are some of the symptoms that may lead to a consultation with an otolaryngologist.

You can ease your symptoms by making some simple diet and lifestyle changes. Try these tips:

• Avoid fatty foods and spicy foods; eat fewer acidic foods, such as citrus and tomato-based foods;
• Limit alcohol, caffeine and fizzy beverages and try limiting chocolate.
• Eat dinner 3-4 hours before you lie down and do not snack after dinner.
• Raising your head and upper body by 6" to 8" helps limit reflux when you are lying down. Place a foam wedge under the head of your mattress.
• Lose weight if you need to
• Don't exercise near bedtime
• Limit aspirin and ibuprofen
• Avoid tight-fitting clothes, such as pants or pantyhose with tight waistbands
• Stop smoking

If necessary, there may be medication that can help you. In some cases you may be referred to a general surgeon or a gastroenterologist (a doctor who treats digestive problems) for more tests and treatment.

Botox Injections for Dysphonia

Patients with voice disorders, particularly trouble with swallowing and a condition known as spasmodic dysphonia, are treated in our office.

Spasmodic dysphonia is a neurologic disorder that science does not yet know the cause or exactly how it works. There seems to be some emerging research that points to a problem in the feedback loop between the brain and the voice box. This may result in a spasm of the muscles that bring the vocal folds together for speaking.

We have been treating this disorder with Botox injections for over 15 years and have had over a 90% success rate. These are simple office procedures that are done utilizing the latest equipment, particularly with electromyography to target the specific muscles that are causing the problem. The medication works by weakening the muscle into which it is injected. The botulinum injection is only temporary and you need to make a return trip for another injection.

Care of the Professional Voice

Care of the professional voice is a multifaceted process, starting with state-of-the art diagnostic technique, speech therapy and medical/surgical treatment.

Voice disorders range from overuse of certain muscles, known as muscle tension dysphonia, to scarring of the vibrating membrane of the vocal cord. The latter category includes singers' nodules, vocal cord polyps and tethering of the vibrating membrane to the underlying muscle (sulcus vocalis). Singers' nodules, which are most common, are curable with speech therapy in over 95% of cases. Polyps and sulcus vocalis require out-patient surgery in order to restore the normal vibratory function of the vocal cord. Speech therapy is often used after this surgery to help prevent recurrence.

Our office provides the newest technology in diagnosing vocal cord problems. Along with our laryngologist, we can provide our patients with speech and singing therapy.