Central Ohio's only Voice and Swallowing Clinic is at Ohio State

Physicians who specialize in voice and swallowing disorders at The Ohio State University Wexner Medical Center are highly trained fellowship surgeons. These specialists receive training above the level most ENT specialists receive. Half of the fellowship specialists in all of Ohio can be found here at OSU Wexner Medical Center.

Our patients range from anyone who’s coughing more than they should be to nationally renowned touring singers with vocal impairment. In fact, we see more patients for paradoxical vocal cord motion disorder (PVCMD) – a vocal cord abnormality that mimics asthma – than any other facility in the U.S. We’re considered among the world’s experts on PVCMD, partly because our academic affiliation enables us to conduct research that leads to better diagnosis and treatment.

We offer patients treatments others don’t even know about

Where your only option elsewhere may be surgery, we often offer various other safe and effective alternatives. For example, we helped develop an in-office injection procedure that has enabled patients with vocal cord paralysis avoid more invasive surgery.

Conditions

Difficulty breathing

Speaking, breathing and eating are related functions in that they all use the throat in their operation. You can have an issue with one of those functions without having it affect the other functions, or you can have a disorder that affects all or some the functions. 

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Hoarseness/voice disorders

Hoarseness occurs when the vocal cords, located in your throat’s voice box (larynx), become inflamed, swollen or irregular. The swelling that results is what causes hoarseness, a rough and raspy sound to your voice.

Cold and sinus infection are usually to blame for hoarseness. It takes about two weeks for hoarseness to clear up, and it usually does so on its own. A rare and serious cause of hoarseness is cancer of the voice box, which requires much more serious long-term attention and treatment.


Laryngitis

Laryngitis Inflammation of the voice box (larynx) accompanied by hoarseness or loss of voice is laryngitis. Viral infection from a cold of flu is usually to blame for laryngitis. It may also be caused by:

  • Acid reflux
  • Allergies
  • Bacterial infection
  • Bronchitis
  • Chemical or environmental irritants
  • Injury
  • Pneumonia

Laryngocele (bulging of air sac in voice box or neck)

Laryngoceles are bulges of the air sac in your voice box that can obstruct your airway or create hoarseness. When they bulge outward, a visible lump is seen in the neck. Musicians who play wind or brass instruments have a higher risk of developing laryngoceles.

Aside from some discomfort, annoyance and physical abnormality, laryngoceles can be relatively benign. However, if they should become infected or complicated in another way or in association with another condition, they can be more problematic and may need to be removed surgically.


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Professional voice disorders

Those who use their voice in a professional setting can be more at risk for disorders including nodules, polyps and lesions on the vocal cords. 

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Spasmodic dysphonia

When the condition called spasmodic dysphonia exists, muscles that control the vocal cords spasm due to overactive signals from the brain. Botulinum toxin (BTX) is injected into the muscles to block the signals, which reduces the intensity and amount of spasms.

Swallowing disorders and throat discomfort

Throat and swallowing issues are commonly caused by viral infection, but other causes include allergies, infection with strep bacteria or the upward movement of stomach acids into the esophagus, called gastric reflux. 

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Throat cancer/tumors

Using tobacco and excessively using alcohol are the greatest risk factors for laryngeal cancer that affects more than 12,000 people in the United States each year. 


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Tracheal diseases/narrowing of trachea

Your trachea, or windpipe, is one part of your airway system. Airways are pipes that carry oxygen-rich air to your lungs. They also carry carbon dioxide, a waste gas, out of your lungs. When you inhale, air travels from your nose, through your larynx, and down your windpipe. The windpipe splits into two bronchi that enter your lungs.

Problems with the trachea include narrowing, inflammation and some inherited conditions. You may need a procedure called a tracheostomy to help you breathe if you have swallowing problems or have conditions that block your airways. You might also need a tracheostomy if you are in critical care and need to be on a breathing machine.

Source: NIH: National Heart, Lung, and Blood Institute

Vocal cord disorders including cancers

Using tobacco and excessively using alcohol are the greatest risk factors for laryngeal cancer that affects more than 12,000 people in the United States each year. 


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Vocal cord dysfunction/paradoxical vocal cord motion disorder (PVCMD)

Vocal cord dysfunction or paradoxical vocal cord motion disorder (PVCMD) is when your vocal cords have episodes of closing instead of opening as you breathe. This condition makes getting air in and out of your lungs difficult and mimics asthma.

Breathing technique, vocal exercises and relaxation methods can help, but surgery may be needed. The specialists at OSU Wexner Medical Center see more patients for PVCMD than any other facility. We’re considered the worldwide experts on PVCMD, partly because our academic affiliation enables us to conduct research that leads to better diagnosis and treatment.

Vocal cord lesions

Vocal cord lesions are noncancerous (benign) growths inside or outside of the vocal cords. They are one of the most common causes of voice problems and can be cysts, nodules or polyps. Lesions that are a result of trauma and located opposite existing vocal cord lesions are called reactive.

Voice rest and other therapy usually is effective in reducing and healing these lesions. Surgery called microlaryngoscopy can effectively treat the condition if necessary.

Vocal cord paralysis

When nerve impulses in your voice box (larynx) are interrupted, then your vocal cord muscle can become paralyzed. When this happens, speaking and breathing can both be affected. Damage to nerves during surgery, infection, neurological disorder and cancer can be the cause of vocal cord paralysis. Treatment includes voice and swallow therapy and other therapy. Surgery may be necessary, depending on the nature and cause.

Tests and Treatments

BOTOX®

When overactive signals from the brain cause vocal cord muscles to spasm, it is called spasmodic dysphonia. Botulinum toxin (BTX) is injected into the muscles to block the signals, which diminishes the intensity and amount of spasms.

DML/direct microlaryngoscopy (endoscopic surgery to remove vocal cord lesions)

During the DML procedure, a small telescope is inserted through the mouth to examine your throat and larynx. Images of your larynx are magnified with a microscope and projected to enable the surgeon to diagnose and, if necessary, remove vocal cord lesions.

Esophagoscopy

Esophagoscopy is examination of the esophagus using a thin, tubular instrument fitted with a laminated lens. The instrument, called an esophagoscope, may also be fitted with other equipment to extract a tissue sample (biopsy) in order to analyze it for disease.

Flexible endoscopic evaluation of swallow (FEES)

A specialized test using a small camera inserted through the nose to the throat to evaluate a swallowing problem and determine the safest diet.

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KTP (potassium titanyl phosphate) laser treatments

KTP lasers are usually used in Lasik eye surgery. KTP lasers have been applied to ENT surgical procedures to destroy unwanted tissues or masses (photoablation). The procedure is relatively painless, allowing recovery within weeks.

Laryngoscopy (examination of larynx)

Laryngoscopy enables a surgeon to examine the larynx (voice box) for abnormality. A mirrored, tubular instrument with an illuminated lens is inserted through the mouth to analyze the larynx. The instrument, called a laryngoscope, can also be used to remove tissue samples for further analysis (biopsy).

Speech therapy

Voice therapy

Voice therapy can be used to treat various issues that affect the throat, vocal cords and other parts of the voice box. Exercises are usually engaged to help strengthen the vocal cords, improve breathing and modify voice usage.

Swallowing therapy

This therapy is performed to help patients maximize their nutrition and provides a safe means of swallowing when they have swallowing dysfunction.

Laryngeal control therapy (specialized therapy for vocal cord dysfunction/paradoxical vocal cord motion disorder)

Laryngeal control therapy (LCT) is a method in which participants learn how to relax the vocal cords and retrain the way they breathe. In a study of 36 subjects who attended at least one LCT session, 25 reported improvement of symptoms (69 percent). Other patients who attended two or more sessions were more likely to experience symptom improvement.

Tracheotomy/tracheostomy (tracheal surgery/construction of artificial opening in the neck/trachea)

Tracheotomy involves making an incision in the front of the neck in order to insert a breathing tube into the trachea. The tube bypasses the normal breathing process that occurs through the nose and mouth and allows the breathing to take place through the tube.

Vocal cord injections

Where your only option elsewhere may be surgery, OSU Wexner Medical Center often offers various other safe and effective alternatives, as we do for vocal cord paralysis. By using an in-office/outpatient injection procedure we conducted leading research on, patients with vocal cord paralysis often can avoid other, more invasive surgery.

Vocal cord injection is also used to treat a condition called spasmodic dysphonia, where muscles that control the vocal cords spasm due to overactive signals from the brain. It may also be used to treat paradoxical vocal cord motion disorder (PVCMD) – a vocal cord abnormality that mimics asthma.

Tips from our experts

How can I protect my voice from injury?

Dr. deSilva offers tips for proper vocal hygiene to keep your voice in optimal condition.

Do I need to see a voice specialist?

Dr. Matrka explains when to see a voice specialist and the importance of getting symptoms checked early.

What's causing this chronic cough?

Throat clearing and cough are very common issues. Dr. deSilva explains potential cause of these symptoms and additional problems throat clearing and cough can create.

What does it mean if my vocal cords aren't working properly?

Vocal fold paralysis is when one or more of the vocal cords aren't working properly. Dr. deSilva explains the causes of this common condition and treatment options offered at Ohio State.

What vocal cord issues should I be concerned about as someone who smokes?

Smoking can have lasting effects on the vocal cords. Dr. Matrka explains some of these common vocal issues and Ohio State's expertise in treating them.

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