Voice & Swallowing
Though we often take our ability to eat and speak for granted, many people have difficulty with these tasks and may experience pain, discomfort and lack of control when trying to speak. Swallowing is a very complex bodily function, requiring the active response of several nerves and muscles, two muscular valves, and the esophagus, or swallowing tube. The swallowing process follows a long path from the mouth to the stomach, and is vital to gastrointestinal health.
Causes of Voice and Swallowing Disorders
Voice and swallowing problems, or dysphagia, can develop as a result of a wide number of conditions:
- Overuse or sudden injury, such as stroke
- Lifestyle conditions such as drinking and smoking
- Esophageal narrowing, such as those caused by acid reflux
- Progressive neurological diseases, such as multiple sclerosis or Parkinson's disease
- Medical conditions, such as rheumatoid arthritis, diabetes or scleroderma
These conditions may lead to a range of swallowing and voice problems, which may require the consultation with either an otolaryngologist who specializes in ear, nose and throat or a gastroenterologist.
Diagnosis of Voice and Swallowing Disorders
In order to determine which type of treatment is most appropriate for each patient's individual condition, the doctor will first administer a series of diagnostic exams related to the symptoms. The physician will begin to diagnose conditions of the voice by taking a complete medical history and physical exam of the throat. Based upon the initial exam, the physician may recommend one or more further exams in order to make a thorough diagnosis:
- Upper endoscopy, a small camera which allows the doctor to observe the inside of the pharynx and esophagus
- Cineradiography, a video X-ray imaging test which observes movement of the esophagus
- Manometry, which tests the muscular strength and timing of the esophagus
- Impedance and pH tests for acid reflux
Types of Voice and Swallowing Disorders
There are a number of medical issues that may include symptoms of voice and swallowing disorders, such as: diabetes, laryngitis, spasmodic dysphonia, vocal cord paralysis, cancer of the mouth or throat, benign growths and more. Swallowing disorder, or dysphagia, is a symptom that accompanies a wide range of neurological conditions. For some neurological conditions, such as oculopharyngeal muscular dystrophy, swallowing disorder is a primary symptom. Voice disorders that may be diagnosed include the following:
- Nodules, Polyps and Cysts
- Muscle Tension Dysphonia
- Reinke's Edema or Polypoid Corditis
- Cancer of the Larynx and Vocal Folds
- Scar and Sulcus Vocalis
Treatment of Voice and Swallowing Disorders
If treatment is needed, it varies depending upon the type, size, and location of the condition. In some cases, swallowing disorders can be partially or completely corrected using diet manipulation or non-invasive methods such as voice therapy. In others, especially when the swallowing disorder is causing breathing issues and weight loss, it may require aggressive intervention such as a feeding tube or surgery. A specialist or group of specialists may be required to make an effective treatment plan which may restore healthy swallowing and voice function. It is important for patients with swallowing problems to chew slowly, avoid difficult foods, swallow frequently, and drink plenty of fluids.
Many voice problems are also accompanied by a cold, infection or other minor condition which may require additional treatment and/or medication from the primary physician. Patients may benefit from voice therapy, medicine or surgery, depending on their individual condition. It is also important for patients to protect their voice by practicing breathing techniques, avoiding smoking, alcohol and caffeine and by drinking plenty of water.
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