About Us
Voice Pathology Services is an integrated program within the Division of Otolaryngology, providing evaluation and treatment for a broad range of problems which affect the throat and voice. Services include laryngeal videostroboscopy (magnified, “slow motion” imaging of the larynx, or voice box) as well as perceptual and objective voice assessment. Specialized clinical programs are available for problems such as chronic laryngitis, vocal misuse and overuse, aging voice, voice weakness from neurological problems, spasmodic dysphonia, and benign lesions of the vocal cords such as nodules and polyps. Programs are also provided for symptoms of irritable larynx, such as repetitive throat clearing and cough, as well as vocal cord dysfunction (paradoxical vocal fold movement).
Voice Pathology Services also participates with the Head and Neck cancer team at Brigham and Women’s/Dana Farber Cancer Institute to provide preoperative counseling and communicative rehabilitation for patients with laryngeal cancer. For laryngectomized patients, this includes training in electrolarynx and esophageal speech as well as voice restoration via tracheo-esophageal puncture prosthetics.
Click here to learn about our Voice Pathologists: Pamela Harvey, M.A., CCC-SLP and SHIRLEY GHERSON, M.A.,CCC-SLP
What is a Voice Problem?
The American Speech, Language and Hearing Association defines a voice problem as having a pitch, loudness or vocal quality which draws attention to itself rather than to what the speaker is saying. A voice problem may also include pain, discomfort or fatigue in voicing. Any hoarseness or voice change which persists for longer than three weeks should be medically evaluated. Voice-speech pathologists also treat some breathing issues, such as vocal cord dysfunction and symptoms of irritable larynx, such frequent throat clearing and cough.
What is a Laryngeal Videostroboscopy?
Laryngeal videostroboscopy (LVS) provides a “slow-motion” view of the vocal folds as they vibrate. LVS is an excellent tool for assessing factors which may contribute to voice problems and assists in detecting and/or differentiating lesions and describing muscle movement patterns and the vibratory characteristics of the vocal folds. This can facilitate more accurate diagnosis and efficient treatment planning.
The exam is painless. During the exam, the patient is seated upright, with the feet flat on the floor and leaning a little bit forward from the hips. The voice-speech pathologist will hold the tongue gently with a piece of gauze and a thin camera will be placed into the mouth. This camera rests above the tongue and only goes as far back as the molar teeth. There is a special lens on the end of the camera that can see down into the voice box while the patient produces an /eeeeeee/ sound. On occasion, to get adequate pictures a flexible thin telescope will by passed through the nose into the upper throat to visualize the vocal cords. LVS films are reviewed in detail by an otolaryngologist and the voice-speech pathologist who performs the exam.
What is Voice Therapy?
Voice therapy is rehabilitative; its goals are to restore the health of the larynx (voice box) and to allow the patient to resume full vocal function. An analogy which is often helpful in understanding voice therapy is to compare rehabilitation of the injured knee to rehabilitation of the injured voice. Like the knee, the larynx is comprised of muscles, ligaments and cartilages. Following knee injury, a series of systemic physical therapy exercises may be implemented as primary rehabilitation. Voice therapy is designed to improve the strength, flexibility and endurance of the muscles of the larynx and improve muscular coordination and balance needed for healthy voice production. Voice therapy is usually short term, 4 - 10 sessions, over a 6 - 8 week period. Length of therapy is determined by diagnosis, the condition of the vocal folds, vocal habits, motivation, and compliance with the therapeutic program.
To schedule an appointment with Voice Pathology, please call (617) 525-7801.
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