Using the latest, innovative technologies and research, we are able to provide you with comprehensive care that is focused on treatment for your mind, body, and spirit. Devoted to the diagnosis, treatment, and prevention of conditions affecting the voicebox (larynx), airway and esophagus, our physician providers offer comprehensive whole patient care using state-of-the-art technology and therapeutic measures to improve our patients' lives. It is our goal to deliver treatment and therapy for patients in the Inland Empire, and surrounding communities, who are suffering from voice, swallowing and airway problems.
Our staff includes two fellowship-trained laryngologists and three specialized speech-language pathologists. Our team treats a large variety of disorders affecting the larynx (voice box) and by using our team approach, we are able to provide treatment options to even those with the most challenging issues affecting their larynx. We also offer services to professional voice users from all walks of life.
Conditions & Treatments
Comprehensive care is provided to patients suffering from voice and swallowing ailments. Conditions ranging from vocal cord dysfunction and paralysis to swallowing disorders are corrected via surgical and therapeutic options.
- Airway problems - glottal, subglottal and tracheal stenosis, bilateral vocal paralysis.
- Chronic cough, paradoxical vocal fold motion, laryngeal hypersensitivity - a spectrum of disorders where the throat is very sensitive - symptoms including severe coughing, trouble breathing, and sometimes pain.
- Dysphagia/swallowing disorders - gastroesophageal reflux and LPR, endoscopic surgery for Zenker’s diverticulum, cricopharyngeus spasm.
- Malignant or pre-malignant neoplasms (leukoplakia, dysplasia, early larynx cancer)
- Reflux Laryngitis - inflammation of the larynx caused by stomach contents.
- Spasmodic dysphonia - a neurologic disorder which is a type of dystonia or involuntary movement of the vocal folds with certain speech tasks.
- Vocal cord (fold) lesions - including polyps, nodules, cysts, fibrous and vascular lesions.
- Vocal cord paralysis and paresis - problems with movement of the vocal folds (cords).
- Vocal cord scarring - any scar tissue of the vocal folds that results in hoarseness or trouble breathing.
- Voice disorders - related to aging -such as vocal cord atrophy.
- Voice disorders (dysphonia) - such as hoarseness.
- Botox injection for the larynx and neck
- Computerized voice analysis - analyzes the quality of the voice and the amount of “noise” or disturbance the voice contains as compared to a normal voice.
- Endoscopic airway surgery - surgery done for limited areas of narrowing or blockage from scar tissue or lesions from above the vocal folds to about 5 cm below the vocal folds.
- FEES: Fiber-optic endoscopic examination of swallowing - asking the patient to swallow different consistencies of blue or green dyed food while have a scope in the throat to observe what happens to the food during the swallow.
- In office laser treatment of vocal fold and airway lesions.
- Laryngeal EMG ( electromyography) - tests electrical activity of the muscles that control the vocal folds.
- Laryngeal framework surgery - Surgical procedure designed to improve the voice by altering the cartilages of the voice box (larynx). Through this procedure, the position of the vocal folds is improved so they vibrate better during speaking or singing.
- Laryngeal function studies - tests vocal efficiency, breath support and airflow analysis of the larynx.
- Microflap excision of vocal cord tumors - A precise procedure using specially designed, tiny instruments to create small incisions and remove tumors from the vocal cords.
- Oropharyngeal pH probe testing - A test in which a catheter is used to evaluate patients for the presenceof laryngopharyngeal reflux disease, a condition that develops when the voice box and esophagus is exposed to stomach acid due to acid reflux.
- Phonosurgery - any surgery using the microscope in which the end goal is improvement of the voice.
- Swallowing therapy
- Transnasal esophagoscopy - A test that examines your esophagus using ultra thin endoscopes to diagnose esophageal-related diseases. The scope goes through the nose into the esophagus to look at the lining of the esophagus and is done without sedation.
- Vocal cord injections - A procedure that can be done in the office an in the operating room. Vocal fold injections are done for a variety of reasons including vocal cord (fold) paralysis or paresis, vocal fold atrophy and disorders of aging, trouble swallowing and aspiration and even chronic cough. The injection basically fattens up or augments the vocal fold to repair vocal cord paralysis or atrophy.
- Voice therapy - Individualized evaluation and training to improve, modify or maintain vocal function for professionals including performing artists, public speakers, teachers and salespeople.
- Videostroboscopy - The videostroboscopy examination is designed to examine vocal fold vibration and vocal fold closure, using a strobe light that is linked to the frequency of the patients voice. A camera is used to view the vocal folds while flashing the strobe light at certain frequencies so we view vibration of the vocal folds in slow motion.
How can I care for my voice on a regular basis?
Our voice works best when our whole body is healthy. Therefore getting enough sleep, eating healthy, and regular exercise all contribute significantly to vocal health. Some more specific things to keep your voice in good health are:
- drink plenty of water and avoid drinks with caffeine or alcohol as they pull water out of your body
- adjust your environment to be free of pollutants like smoke, dust, & chemicals
- use alternatives to throat clearing, such as humming or a hard swallow
- use clapping, whistling, or other means to attract attention or express excitement rather than yelling
- take a voice break any time you feel a strain
- let your voice be carried on your breath, breathing frequently and not talking on the end of your breath
- speak with melody in your voice, avoiding letting your voice drop so low that it sounds gravelly (“glottal fry”)
- manage stress levels
- release tension in your jaw, upper chest, shoulders, neck, and throat
- when your voice is even a little bit hoarse, do not push to force your voice out and make it sound better as this can create more irritation of your vocal folds
- singers should sing in a comfortable pitch and loudness range, avoiding prolonged use outside of that range
- rest your voice when you have a cold or are tired
How do I know if I have a problem with my voice?
Voice problems can build up over time or appear suddenly. If you feel a change in your voice, such as hoarseness, breathiness, strain, or pain, follow the guidelines for caring for your voice. If your voice problem persists for 10 days or more, consult your doctor.
Who evaluates voice problems?
A laryngologist is a doctor that specializes in problems of the voice box (larynx), such as swallowing difficulties or hoarseness. They will ask questions, as well as look directly at your vocal folds in order to determine the best course of action.
A speech-language pathologist that specializes in voice often works with a laryngologist to provide behavior modification training to improve vocal function. Voice therapists teach people how to best care for their voice as well as train how to use breath support and voicing strategies to get the most out of your voice. The American Speech Language and Hearing Association explains, “Speech therapy is a term that encompasses a variety of therapies including voice therapy. Most insurance companies refer to voice therapy as speech therapy, but they are the same if provided by a certified and licenses speech-language pathologist."
What treatment options are there for voice problems?
Treatment options include lifestyle changes, medication, surgery, and behavioral voice use changes. Lifestyle changes are simple changes to your environment or daily routine that can improve your voice (e.g., drinking more water). Medication can be used to help an infection heal or help protect your voice box from irritating acid. Surgery is used when the structure of the larynx or vocal fold needs to be changed, such as removing a growth. It is also possible to retrain a person to use a more effective breathing pattern or speak with less effort.
Does insurance cover treatment by a speech-language pathologist?
Typically, when a referral is received from a physician, such as a laryngologist, some amount of therapy is covered. Medicare generally covers treatment by a certified and licensed speech-language pathologist. Medicaid and private insurance coverage vary. It is best to contact your Medicaid state office or insurance company regarding your policy.
Are speech therapy and voice therapy the same?
Speech therapy is a term that encompasses a variety of therapies including voice therapy. Most insurance companies refer to voice therapy as speech therapy, but they are the same if provided by a certified and licensed speech-language pathologist.
What does it mean if I have a “lump in my throat” sensation?
A ”lump in the throat”sensation, known medically as globus, can be a symptom of either a voice or a swallowing problem. There are numerous causes for this symptom but the majority of the time, it is not an indication of a serious medical problem. However, if the globus sensation is accompanied by signs such as weight loss, neck or throat pain, choking or regurgitating, muscle weakness or an actual lump which is felt on the outside of the neck, it should be evaluated promptly by a doctor.