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Voice and Dysphagia Centre

OVERVIEW

The Voice and Dysphagia Centre at VPS Lakeshore Hospital is a dedicated centre that provides comprehensive care for children and adults with voice disorders. The voice disorders could be uncomplicated or could be as serious as voice box cancer, so a person experiencing trouble should be evaluated promptly by specialists.

The highly experienced professionals at the department cater to the personal requirements of the patients by conducting thorough evaluations. The laryngologists and speech pathologists at the department perform focused physical exam and specialized tests for accurate diagnosis and to determine the nature and extent of the problem and thereby formulate specified treatment plans for each patient. The disorders related to voice box and other speech organs are treated with precise care at the centre. 

The disorders that are in early stage are managed through behavioral therapy sessions and surgical interventions are employed only if the disorder demands it. Voice disorders related to serious issues like vocal cord cancer are treated by head and neck cancer surgeons using endoscopic carbon dioxide laser surgery or open surgery, when required.

Dysphagia means difficulty in swallowing. Swallowing disorders can be due to various problems related to nervous system, throat, voice box or food pipe. Patients with swallowing problems are assessed and treated at the centre. Swallowing problems which require intervention are treated as per the anatomical area of involvement by various specialists. 

The centre is a multi disciplinary one that works in collaboration with the other departments like Neurology, Gastroenterology, Endocrinology, Pulmonologist, and Clinical Psychology/Psychiatry.


Other Information

WHEN TO SEEK HELP

VOICE

If you have;

Sore throat or pain during or after voice use

Hoarse, scratchy, rough voice

Increased effort when producing voice

Decreased loudness or pitch range

Breathiness, weakness or vocal fatigue

Shaky, strained voice or voice cutting off unexpectedly

DYSPHAGIA (swallowing problem)

Pain while swallowing

Inability to swallow

A sensation of food getting stuck in thethroat

Drooling

Hoarseness

Food coming back up (regurgitation)

Frequent heartburn

Food or stomach acid backing up into thethroat

Weight loss

Coughing blood

Coughing or gagging when swallowing

What we treat 

STRUCTURAL PATHOLOGIES OF THE LARYNX

Malignant Lesions

1. Malignant Vocal Fold Lesions

2. Dysplasia/carcinoma in situ

3. Laryngeal Malignancy (Non-Vocal Fold Origin)

4. Oral cancers causing dysphagia

5. Skull base lesions causing dysphagia

Benign lesions

1. Vocal Fold Nodules

2. Vocal Fold Polyp(s)

3. Vocal Fold Cyst

4. Reinke’s Edema

5. Vocal Fold Scar

6. Vocal Fold Sulcus

7. Vocal Fold Granuloma

8. Contact Ulcer

9. Keratosis 

10.  Recurrent Respiratory Papillomatosis (RRP)

11. Globus pharyngeus

Vascular Abnormalities of the Vocal Fold

1. Vocal Fold Hemorrhage

2. Varix and Ectasia of the Vocal Fold(dilated blood vessels) 

Congenital and Maturational Changes 

1. Congenital Webs (Synechia)

2. Cri du Chat Syndrome

3. Down’s syndrome 

4. Puberphonia

5. Androphonia

6. Presbyphonia/Presbyphagia 

7. Choanal atresia 

8. Cleft lip/palate 

INFLAMMATORY CONDITIONS OF THE LARYNX

  • Acute Epiglottitis
  • Cricoarytenoid and Cricothyroid Arthritis
  • Acute Laryngitis
  • Laryngopharyngeal Reflux/GERD
  • Chemical Sensitivity/Irritable Larynx Syndrome

TRAUMA OR INJURY OF THE LARYNX

1. Laryngeal Mucosa Trauma (Chemical and Thermal)

2. Intubation/Extubation Injuries of the Laryngeal Mucosa

3. Arytenoid Dislocation

SYSTEMIC CONDITIONS 

Endocrine

1. Hypo/Hyperthyroidism

2. Sexual Hormone Imbalances

3. Growth Hormone Abnormalities (Hyperpituitarism)

Immunologic

1. Allergic Diseases of the Upper Respiratory Tract

2. HIV and AIDS

3. Chronic Fatigue Syndrome

4. Sjogren’s Syndrome

NEUROLOGIC DISORDERS AFFECTING VOICE

Peripheral Nervous System Pathology

1. Superior &Recurrent Laryngeal Nerve Paralysis

2. Myasthenia Gravis

3. Peripheral Neuropathy 

Movement Disorders Affecting the Larynx

1. Spasmodic Dysphonia(Abductor&Adductor, Mixed)

2. Essential Tremor Affecting Voice

3. Meige’s Syndrome (Orofacial dystonia)

4. Tourette’s Syndrome


CENTRAL NERVOUS SYSTEM DISTURBANCE

1. Amyotrophic Lateral Sclerosis (ALS; Lou Gehrig’s Disease)

2. Wallenberg Syndrome (Lateral Medullary Syndrome/Infarct)

3. Parkinson Disease

4. Multiple Systems Atrophy (Shy-Drager Syndrome,Striatonigral Degeneration, Sporadic Olivoponto- cerebellar Atrophy)

5. Progressive Supranuclear Palsy (Includes Pseudobulbar Palsy and Steele-Richardson-Olszewski Syndrome)

6. Multiple Sclerosis

7. Cerebellar Disorders

8. Huntington’s Chorea

9. Myoclonus

10. CVA(stroke )

PSYCHIATRIC AND PSYCHOLOGICAL DISORDERS WHICH AFFECT VOICE AND SWALLOWING 

OTHER DISORDERS 

  • Muscle Tension Dysphonia (Primary)
  • Muscle Tension/Adaptive Dysphonia (Secondary)
  • Ventricular Dysphonia
  • Paradoxical Vocal Fold Movement Disorder (Vocal Cord Dysfunction)
  • Laryngeal spasm /esophageal spasm 


Airway related disorders 

1. Airway masses, cysts, tumors and cancers

2. Laryngeal clefts

3. Laryngomalacia

4. Sleep apnea and airway obstruction related to craniofacial disorders, including micrognathia, Pierre Robin syndrome

5. Stridor or noisy breathing 

6. Subglottic hemangiomas 

7. Subglottic stenosis

8. Tracheal stenosis

9. Tracheomalacia and tracheobronchomalacia.

10. Vascular rings and complete tracheal rings

11. Tracheoespophageal fistula

Services offered 

  • Rigid/Flexible laryngoscopy 
  • Laryngeal videostroboscopy 
  • Narrow Band Imaging (NBI)
  • Laryngeal Electromyography
  • Functional Endoscopic Evaluation of Swallowing (FEES)
  • Flexible endoscope assisted biopsy of laryngeal lesion
  • Botox injection for spasmodic dysphonia 
  • Fat injection for vocal cord palsy
  • Kashima cordectomy 
  • Laser (Carbon dioxide) cordectomy for early vocal cord malignancy
  • Conservative laryngeal surgeries (Partial laryngectomy, near total laryngectomy)
  • Total laryngectomy with reconstruction and TEP valve insertion
  • Airway reconstruction 
  • Tracheal/ laryngeal stenosis surgeries
  • Treatment for all kinds of dysphonia (voice disorders)
  • Phonosurgery for all benign lesions of larynx
  • Management of laryngopharyngeal reflux disease
  • Treatment for granulomatous conditions of larynx
  • Laryngeal Framework Surgery
  • Tracheostomy- Management 
  • Care for professional voice users
  • Surgeries for reconstruction of food pipe damaged by conditions like corrosive poisoning. Eg: Colonic interposition, free jejunal flap reconstruction.
  • Laryngeal suspension procedures for swallowing
  • Cricopharyngeal myotomy

Voice and swallowing therapy

Speech-language pathologists (SLPs) specializing in voice therapy are involved in the diagnosis, assessment, planning, and treatment of individuals with voice disorders. SLPs are trained to evaluate voice use and vocal function to determine the cause of reported symptoms and to determine optimal treatment methods for improving voice production.

Voice therapy is a behavioral intervention technique that makes use of vocal hygiene, breathing exercises and exercises that facilitate better voicing.

Voice therapist  provides prevention information to individuals and groups known to be at risk for voice disorders, as well as to individuals working with those at risk, detail voice evaluation, including clinical and instrumental evaluation, identify normal and abnormal vocal function, describe perceptual qualities of voice, and assess vocal habits, make decisions about management of voice disorders to improve the quality of life, counsel patients and provide education aimed at preventing further complications from voice disorders.

Speech and swallowing pathologist is responsible for the diagnosis of swallowing problems and determining a course of treatment. Speech pathologists work as part of a multidisciplinary team to support people with dysphagia. The role of the speech pathologist is to evaluate swallowing dysfunction and difficulties using tools such as a bedside dysphagia evaluation, Modified Barium Swallow evaluation (MBS), or Fiberoptic Endoscopic Evaluation (FEES).

 Once an evaluation has been completed the role of the speech language Pathologist is to determine not only the safest diet for the patient in order to reduce their risk of aspiration also to provide support to ensure that mealtimes are safe and enjoyable for children and adults with dysphagia .SLP develops a mealtime          management plan for people with swallowing difficulties following the texture and consistency guidelines.


News & events

Dr. Rajesh Simon writes about Charcot Foot

15

Nov

Dr. Rajesh Simon writes about Charcot Foot

Dr. Rajesh Simon, Senior Consultant - Orthopaedics, Trauma & Foot and Ankle writes in detail for the New Indian Express about the Charcot Foot.

Burjeel Holdings gets listed on Abu Dhabi Securities Exchange (ADX)

14

Nov

Burjeel Holdings gets listed on Abu Dhabi Securities Exchange (ADX)

Burjeel Holdings has successfully listed on the Abu Dhabi Securities Exchange (ADX) on Monday.

VPS Lakeshore conducted a flat foot camp in association with the Indian Foot and Ankle Society

08

Nov

VPS Lakeshore conducted a flat foot camp in association with the Indian Foot and Ankle Society

VPS Lakeshore hospital conducted a flat foot camp as part of Indian Foot and Ankle Society week.

ലഹരിവിമുക്ത സന്ദേശവുമായി കൂട്ടയോട്ടം

29

Oct

ലഹരിവിമുക്ത സന്ദേശവുമായി കൂട്ടയോട്ടം

കേരള സർക്കാരിന്റെ 'എല്ലാവർക്കും ആരോഗ്യം' ലഹരി വിരുദ്ധ പ്രചാരണം, ഫിറ്റ്‌ ഇന്ത്യ ഫ്രീഡം റൺ എന്നിവയുടെ ഭാഗമായി വിപിഎസ് ലേക്‌ഷോർ ഹോസ്പിറ്റൽ,

Dr. Shwetha Shenoy receives Prof ND Purushottam Award

20

Oct

Dr. Shwetha Shenoy receives Prof ND Purushottam Award

Dr. Shwetha Shenoy - Consultant, ENT, receives the Prof ND Purushottam Award for innovation in ENT and Head & Neck Surgery at the South Zone AOICON 2022 at Manipal.

DR. MOHAN A MATHEW RECEIVES THE "LEGEND IN ANAESTHESIA" AWARD

19

Oct

DR. MOHAN A MATHEW RECEIVES THE "LEGEND IN ANAESTHESIA" AWARD

Dr. Mohan A. Mathew, senior anaesthetist, and critical care physician received the "Legend in Anaesthesia" award for his valuable contributions to the field spanning over five decades.

Bahrain Keraleya Samajam presents the Arogyamitram Award to Dr. VP Gangadharan

12

Oct

Bahrain Keraleya Samajam presents the Arogyamitram Award to Dr. VP Gangadharan

Dr. VP Gangadharan - Senior Consultant and HOD of Medical & Paediatric Oncology has been felicitated with the ‘Arogyamitram‘ award

Second batch EMT students graduated and employed

01

Oct

Second batch EMT students graduated and employed

The second batch of Emergency Medical Technician students (EMTs) graduated, in toto, earning their certificate and full-time employment on 24 September 2022.