Clinic
A multi-disciplinary approach is utilized in the evaluation and care of patients with voice, breathing, cough, and swallowing problems. Patients are evaluated by both a laryngologist (ear, nose, and throat surgeon who specializes in voice disorders) and speech language pathologist in order to provide world-class, time-efficient, comprehensive care.
- Vocal fold nodules, cysts, polyps
- Vocal fold cancer, dysplasia, leukoplakia
- Vocal fold paralysis, paresis
- Vocal fold atrophy
- Vocal fold scar
- Vocal process granuloma
- Recurrent respiratory papillomatosis (RRP)
- Paradoxical vocal fold motion (PVFM); vocal cord dysfunction, (VCD)
- Acid reflux, non-acid reflux
- Laryngeal-mediated cough
- Spasmodic dysphonia
- Essential tremor of voice
- Swallowing problems
Adult Airway Clinic
Adult patients with complex upper airway stenosis are evaluated in this clinic. Typical diagnoses treated in this clinic are:
- Subglottic stenosis
- Posterior glottis stenosis
- Tracheomalacia
- Complex tracheotomy care
Awake bronchoscopy can be performed in the office, to provide dynamic upper airway evaluation. This multi-disciplinary clinic is made up of laryngologists, thoracic surgeon, pulmonologist, and rheumatologist.
Botulinum toxin injections
Patients with spasmodic dysphonia, essential tremor of voice, and other laryngeal and head and neck neurologic disorders are treated with botulinum toxin injections. Injections are performed in the office and results typically last approximately three months.
Laryngeal Electromyography (LEMG)
Laryngeal EMG is a diagnostic nerve test to evaluate the neurologic status of the nerves innervating the larynx. This test may provide useful information regarding the potential for spontaneous recovery of vocal fold motion in the setting of vocal fold paralysis and often helps in planning the treatment of patients with vocal fold paralysis.
Vocal fold injections
For patients with glottal incompetence (vocal folds do not come together completely), short and long-term injections can be helpful to improve patients’ symptoms. This procedure could be performed either asleep under general anesthesia vs awake under local anesthesia. Patients who are candidates for an awake vocal fold injection in the office may drive themselves to and from the office, to improve convenience.
Laryngeal laser procedures
A variety of laser treatments (including KTP and CO2 laser) can be used to address certain laryngeal disorders, such as recurrent respiratory papillomatosis (RRP), leukoplakia, dysplasia, vascular lesions, and Reinke’s edema. These procedures have traditionally been performed in the operating room, but also can be applied safely and successfully in the office setting in certain patients.
Transnasal esophagoscopy (TNE)
Patients with symptoms of acid reflux disease (laryngopharyngeal reflux disease and gastroesophageal reflux disease) and dysphagia can be evaluated with TNE. This awake, out-patient procedure is well tolerated and obviates the need for sedation.
Bronchoscopy
Awake, dynamic upper airway evaluation is critical in the evaluation of patients with certain types of breathing problems of the trachea (windpipe).
Surgery
Our laryngologists provide cutting-edge surgical treatment of laryngeal diseases.
- Phonomicrosurgery
- Thyroplasty
- Vocal fold injections
- Laryngeal LASER surgeries
- Open and endoscopic airway surgery
- Tracheotomy
- Laryngeal fractures
Voice Therapy
Voice Therapy involves a patient-centered treatment method to modify behaviors that contribute to voice disorders or in some other way limit normal voice use. Vocal behaviors causing hoarseness are changed in two major ways: (1) rigorous application of vocal wellness principles and (2) a series of therapeutic techniques specifically designed to change the way the vocal folds vibrate and vocal tract resonates. The purpose of this training is to help a person develop an awareness of the new voice and to differentiate the “new” from the “old” voice. Ultimately, this modified voice quality is integrated into conversational speech in an automatic and consistent manner, without conscious use of the voice therapy technique. Common voice disorders such as vocal nodules or muscle tension dysphonia are generally treated in 3-5 sessions, with a very high success rate.
Singing Voice Therapy
Singing Voice Therapy is a type of vocal rehabilitation for difficulties in the singing voice related to a medical diagnosis. The therapy is done by a singing voice specialist (SVS) who is an experienced singing teacher with additional training and experience in the rehabilitation with injured voices. The singing exercises will vary based on the specific laryngeal pathologies as these relate to the singer’s style of music; all aim to modify muscular coordination by optimizing airflow and vocal resonance. Cough suppression therapy is a treatment for chronic cough.
Cough Suppression Therapy
Cough suppression therapy involves a series of techniques to decrease the severity, duration, and frequency of chronic cough. An essential part of cough therapy is to encourage the person to recognize the first symptoms of a cough so that they may try to suppress it. The rest of therapy involves teaching the patients three techniques: 1) how to modify the shape of the throat to decrease the severity, duration and frequency of chronic cough; 2) coordination and relaxation of the respiratory mechanism and head/neck region; 3) systematically desensitize the patient from potential triggers. The average sessions for most cases varies between 1-3 therapy sessions.
Respiratory Retraining
Respiratory Retraining is a treatment for paradoxical vocal fold motion disorder (PVFMD). The treatment helps the patient learn how to control their breathing and prevents or minimizes the severity of PVFMD “attacks.” The keys to therapy for PVFMD include muscle relaxation; training an open throat breathing posture, retraining of the breath cycle to increase the individual’s awareness of relaxed rhythmic cycles, and reduce the effort associated with respiration.
Lee Silverman Voice Treatment ®
Lee Silverman Voice Treatment ® is a proven effective speech treatment program that restores oral communication in individuals with Parkinson Disease (PD) beyond what current pharmacological and surgical interventions can offer. At the University of Pittsburgh Voice Center, we provide a modified version of LSVT®, which focuses on vocal loudness, enhancing sensory awareness of disordered movement parameters and “re-calibrating” the sensorimotor system for appropriate movement dynamics. Generally, at the end of one month of individual treatment, patients are able to self-generate improved loudness resulting in dramatically improved functional communication.
Transgender Voice Therapy
Coming soon!