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New center turns up the volume on voice disorder treatments

Like hearing or vision problems, voice disorders can turn routine activities into agonizing ordeals of embarrassment and frustration.

Simple communications such as ordering food at a restaurant or answering the telephone can become loathsome burdens for people whose voices are damaged by illness, injury, surgery or even improper speaking habits.

Voice disorders also can affect job performance. Virtually everyone – actors, singers, lawyers, teachers, sales people – depends on a strong and clear voice for professional success.

At the Center for Voice Disorders at USC University Hospital, physicians and scientists are using cutting-edge technology and conducting ground-breaking research to improve life for people with voice problems.

Led by physicians Uttam K. Sinha and Dale H. Rice and speech pathologist Daniel Kempler, the center treats disorders caused by conditions ranging from simple laryngitis to cancer surgery.

“Every type of disorder can be treated to some degree,” said Sinha, the center director.

Critical to proper treatment of a voice problem is a definitive diagnosis. Patients at the Center for Voice Disorders are given thorough examinations before being treated with the latest technology.

One frequently used diagnostic device is the videostroboscope – a video strobe light and camera on the end of a probe that allows doctors to freeze-frame vocal cord vibrations on a video monitor.

This procedure helps detect subtle lesions or problems and can be videotaped for review or to chart a patient’s progress.

Patients encounter plenty of compassion and understanding at the Center for Voice Disorders.

The staff members know that conditions such as hoarseness or a tight voice have physical causes and never are figments of the imagination. Once diagnosed, voice disorders are treated in a variety of ways.

Hoarseness and vocal cord nodules often stem from drying of the vocal cords, coughing, throat clearing, muscular tension or speaking in too high or low a pitch, Kempler said.

Through education and special exercises, speech pathologists show patients how to eliminate the patterns of vocal cord abuse that cause these conditions.

“It’s generally not one particular event that causes a voice problem,” Kempler said. “A lot of what we do is educate people about factors that precipitate the voice problem.”

Of course, not all conditions can be treated with therapy alone.

Vocal cord paralysis, a condition resulting from some kinds of throat surgery, requires further surgery to correct.

This problem often manifests itself in a breathy voice, and can lead to aspiration of food or liquids into the lungs. This in turn can cause pneumonia.

Sinha treats vocal cord paralysis by inserting a Gore-Tex implant into a patient’s neck cartilage, which pushes the paralyzed vocal cord closer to the functional one, allowing it to vibrate properly.

The one-and-a-half hour operation is done under local anesthesia, which enables fine-tuning of the patient’s voice, Sinha said.

Older people frequently suffer from atrophy of the vocal cords, which results in a rough-sounding or strained voice.

To treat atrophy, Sinha injects fat or collagen into the tissue adjacent to the cords, which makes them bulkier and allows them to come closer together during speech, making for a clearer and stronger voice.

Physicians at the center can even treat problems caused by radical surgeries.

When Sinha removed a cancerous tumor from the neck of 37-year-old Anselma Benites, he also had to remove one vocal cord, the cartilage that brings the vocal cords together and part of her pharynx.

He then reconstructed her voice box during a 12-hour microvascular surgery by using rib cartilage and tissue and blood vessels from Benites’ forearm. Three years later, Benites is cancer free and doesn’t need breathing or swallowing tubes.

“Her swallowing and speech are almost normal,” says Sinha.

Free Voice Center brochures are available by calling 1-800-USC-CARE.

New center turns up the volume on voice disorder treatments

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