Swallowing Disorders

At MedStar Health, our physicians evaluate and treat the spectrum of common disorders and diseases that affect the larynx, including:

Dysphonia is a medical term for voice disorders and hoarseness. Hoarseness that lasts more than four weeks can sometimes indicate a more serious problem. Symptoms of dysphonia may include:

Depending on the cause, your doctor will order more tests, or prescribe a regimen of medical and speech therapies for treatment. If it is a symptom of a more serious condition, your doctor will guide you in seeking treatment from our other experienced specialists.

Laryngopharyngeal reflux occurs when the sphincter, a ring of muscle that helps keep the acidic contents of the stomach out of the throat, does not work properly. It can be caused by:

Other factors may include diet choices, including chocolate, citrus, fatty foods, and spices; overeating; alcohol and tobacco abuse; and sometimes pregnancy. People with laryngopharyngeal reflux frequently do not have the typical symptoms associated with heartburn (burning pain in the chest after meals). Instead, they may experience:

Your doctor will most likely prescribe a medication to decrease acid production in the stomach, as well as suggest certain dietary and lifestyle changes that will help in reducing the reflux symptoms.

This condition is caused by swelling of the vocal cords due to trauma, misuse of the voice, irritating conditions (like gastric reflux), and cigarette smoking. It results in a deep, husky voice and typically occurs in middle-aged/post-menopausal women who have a long-term history of smoking cigarettes.

Your doctor will try to address the underlying cause of Reinke's edema. If you are a smoker, you will be strongly encouraged to stop. If your condition is caused by gastric reflux, your doctor will prescribe treatment to treat that problem. Speech therapy is also prescribed to encourage proper use of your voice and vocal folds.

In some cases, surgery is recommended. The surgery performed to treat this condition is called vocal fold phonomicrosurgery, a surgery of the vocal folds using endoscopic tools, microlaryngeal instruments, and techniques to repair the vocal folds.

The subglottis is the area of the voice box below the vocal folds. Subglottic stenosis is a narrowing of this area, which can make breathing difficult. It is commonly misdiagnosed as asthma, as both are due to trouble breathing. However, with asthma, patients usually have trouble breathing out, while patients with subglottic stenosis usually have trouble breathing in.

Depending on the degree and level of the narrowing, different treatments may be recommended. These include:

Vocal fold nodules are benign growths on both vocal folds. Repeated misuse of the vocal folds results in swollen spots on each vocal fold that develop into harder, callus-like growths. The nodules will become larger and more rigid the longer the vocal abuse continues.

Polyps can take a number of forms and are frequently caused by vocal abuse. Polyps appear on either one or both of the vocal folds and present as a swelling or bump, a stalk-like growth, or a blister-like lesion. Most of them are larger than nodules. Nodules and polyps cause similar symptoms and include:

Nodules are most frequently caused by vocal abuse or misuse. Polyps may be caused by vocal abuse over a long period of time, but may also occur after trauma to the vocal folds. Other causes of polyps include:

Nodules can be treated medically and with behavior modification, while polyps usually require surgery followed by speech therapy. The underlying cause will be addressed first with medicine and speech therapy. Voice therapy includes learning proper vocal techniques, eliminating behaviors that harm the voice, and stress-reduction techniques.

The vocal cords are two elastic bands of muscle tissue located in the voice box (larynx) directly above the windpipe (trachea). These cords allow you to speak because when air held in the lungs is released and passed through the closed vocal cords, it causes them to vibrate. When you are not speaking, the vocal cords remain apart so you can breathe.

Vocal cord paralysis occurs when one or both of the vocal cords (vocal folds) do not open or close properly. The paralyzed cord or cords remain open, leaving the airway passage and the lungs unprotected. The condition makes it difficult to swallow or cough because food or liquids slip into the trachea and lungs.

Symptoms include:

Speech therapy from a speech-language pathologist is a critical part of any treatment and may be the only treatment you will need. Speech therapy for vocal fold paralysis includes learning proper vocal techniques, eliminating behaviors that harm the voice, and stress reduction techniques.