Dysphonia/Hoarseness of the Voice
The voice is a highly individual part of how we perceive ourselves and how others perceive us. The Grabscheid Voice and Swallowing Center of Mount Sinai was one of the first dedicated voice clinics in the country. It continues to be at the forefront of the latest diagnostics and treatments for all patients with voice problems. Our voice specialists all have many years of experience treating professionals, such as salespeople, actors, singers, teachers, and presenters, who encounter voice difficulties. While our specialty is with those who rely on their voices for their livelihood, the same type of focused, individualized care is given to anyone who is having difficulty with their voice.
Multidisciplinary Team at the Grabscheid Voice and Swallowing Center
A person’s voice can change for many reasons. Emotion and fatigue are common conditions that we can perceive in someone’s voice. However, changes that are caused by infections, trauma, neurological issues, and muscle patterns require the kind of help that we can provide. At the Grabscheid Voice and Swallowing Center of Mount Sinai, you will be evaluated by our voice team that includes laryngologists, phonosurgeons, voice therapists (vocologists), and singing/acting voice specialists. We also have neurologists, pulmonologists, and gastroenterologists who work with our team if needed. This level of collaboration is necessary because a voice problem is rarely caused by just one factor. It takes the input from you and the whole team to see and understand the entire picture of your dysphonia.
Diagnosing a Hoarse Voice (Dysphonia)
Diagnosing voice problems requires a special set of tools. Usually when something in your body is not working properly, the physician must rely on symptoms, visual inspection, or biochemical analysis (i.e. bloodwork) to make a diagnosis. Voice problems are almost always caused by several different factors. It’s rarely that the tissue alone is causing your voice to sound different. Voice use patterns, emotions, stress, general health, breathing problems and normal changes due to age or hormones all affect your voice. To discover these different contributors to your dysphonia we use various diagnostic tools:
- Stroboscopy is the only way to observe the vibration of the vocal folds. It requires a strobe light source synched to the vibratory rate of your voice to give us an image of vibration. Recording this exam and playing it back is critical so that we and you can look closely at such important characteristics as symmetry, amplitude, and pliability. This allows us to help you understand the nature of your voice problem.
- Acoustic analysis is used to determine the efficiency with which the voice changes aerodynamic energy into acoustic energy. There are many different algorithms we use to measure different characteristics. The Grabscheid Voice and Swallowing Center specializes in voice range profiles that are used to analyze the special characteristics of the singing voice.
- Experienced, intelligent listening is essential for us to hear what is going on, as the voice is unique because it actually talks to us. The laryngologists and vocologists at the Grabscheid Voice and Swallowing Center have decades of experience in listening to your symptoms, listening to your voice, and putting it through its paces.
Members of our multidisciplinary team who help us determine what may be affecting your voice include neurologists, pulmonologists, and gastroenterologists. We have specialists in these fields who understand the complexities of the human voice, and can make quick diagnoses and help you get you voice back on track.
Treatments for Dysphonia
Just as there are many contributors to a hoarse voice, there are many different types of treatments. It is not uncommon for a patient with a voice problem to have a treatment plan that may include medications, therapy, and/or surgery. Our phonosurgeons specialize in novel techniques for restoring the vibratory characteristics of the vocal folds, not just in eliminating pathologies. And our vocologists create individual voice therapies that help you regain an efficient voice that enables you to use the voice you need.
The Grabscheid Voice and Swallowing Center is regarded as one of the nation’s foremost centers for treating the voice problems of professional singers and actors, and our singing voice therapists and laryngologists have years of experience in understanding and treating these unique populations. For most benign lesions that singers encounter we do not immediately jump to a surgical treatment option. Often, singing voice therapy can reverse or eliminate such debilitating lesions on the vocal folds by eliminating the behaviors that can cause them. Our team also prides ourselves on our ability to guide the recovery of your voice after surgeries. Just as you need to work with a physical therapist after a knee or shoulder surgery to make sure it heals correctly, your vocal folds need to be stretched and eased back into shape. Each case is unique, and our voice recovery protocols are tailored to your particular needs and surgery.