CENTER FOR VOICE AND SPEECH DISORDERS

Approximately 7.5 million people in the United States have trouble using their voices, while an estimated 8 million individuals have some form of speech impairment. Since the ability to hear and speak affects how well a person can communicate with the outside world, any problem affecting an individual’s voice or language capabilities can have a major impact on relationships, education, career opportunities and self-image. The Center for Voice and Speech Disorders at UC Irvine Medical Center is dedicated to providing state-of-the-art diagnostic and therapeutic services for people who are trying to overcome these difficulties.

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Staff

Assessing voice problems and speech disorders requires state-of-the-art technology and a staff experts specializing in the physical and emotional aspects of these conditions. Our staff includes:

• Board-certified otolaryngologists (physicians specializing in the ear, nose and throat) who have special training in voice and speech disorders
• Therapists with expertise in speech and voice problems, as well as rehabilitation after larynx (voice box) cancer surgery
• Psychologists, social workers and other professionals who offer emotional and strategic support for patients

Evaluations

A wide range of conditions can affect a person’s ability to use his or her voice with ease. Among the many disorders our staff evaluates are:

• Essential voice tremor, a condition characterized by involuntary rhythmic changes in voice pitch and volume
• Granuloma, vocal cord ulcers
• Hemorrhage, or bleeding in the vocal cord
• Laryngitis, an inflammation or infection of the voice box (larynx) and adjacent tissue
• Laryngopharyngeal reflux disease (LPRD), an excess of gastric acid causing throat irritation
• Papilloma, wart-like growths on the larynx caused by a virus
• Reinke’s edema, a buildup of fluid underneath the lining of the vocal cords
• Spasmodic dysphonia, involuntary movements of muscles of the larynx
• Sulcus vocalis, a reduction or absence of vocal cord tissue
• Transgender voice, a pitch that is too high or low to be appropriate for a person’s gender
• Laryngeal cancer, a malignancy affecting the voice box
• Vocal cord paralysis
• Vocal cord lesions, including polyps, nodules, cysts and scars affecting the ability of the vocal cord to vibrate properly

Diagnosis

To diagnose voice problems, our otolaryngologists review the patient’s medical history and perform a detailed physical exam, including voice-specific screenings. This may include several state-of-the-art tests, including:

• Videostroboscopy to record and observe the motion of the vocal cords, anatomy of the voice box, and function of the sinuses, throat and mouth while producing or attempting to produce sound.
• Laryngeal electromyography to pinpoint motor activity abnormalities in the muscles that control the vocal cords
• Acoustical tests to measures airflow and voice quality

Treatment

A majority of voice and speech disorder patients make significant progress by working with our speech pathologists during vocal therapy and voice behavioral modification sessions. Other treatments may include:

• Injections of botulinum toxin (Botox) to correct or improve conditions affecting the laryngeal nerves.
• Laser sculpting of the vocal cords     
• Thyroplasty, or surgical alteration of the laryngeal framework, which entails strengthening the voice box of patients with vocal cord paralysis by implant insertion
• Microlaryngoscopy, which employs an endoscope to visualize the vocal cords and remove abnormalities using tiny surgical instruments and/or lasers
• Microsurgery of laryngeal nerves
• Arytenoidectomy, the removal of one of the two triangular-shaped cartilages in the larynx
• Microdissection techniques to remove of nodules, polyps and other growths

 Voice therapy

Speech therapists can play a key role in helping patients regain full use of their voice. These professionals teach patients how to change the methods they use in voice production. Often, the therapeutic techniques used in voice therapy facilitate healing after vocal cord injury or surgery. Voice therapy is often used as the sole strategy to correct voice disorders, but is often combined with other therapeutic modalities such as surgery or medications.