Laryngology Clinical Care

For individuals who rely on their voice for their profession, such as performers, singers and lecturers, the laryngologists and voice specialty speech pathologists at IU School of Medicine provide an advanced array of services aimed to prevent, preserve and rehabilitate the voice. The additional vocal performance experience of providers also gives an extra degree of insight into the needs of vocal professionals.

Vocal cord nodules, cysts, and polyps are common lesions that significantly impact voice, particularly for professional voice users. Some lesions resolve with the work of voice therapists, while many require surgical removal. The interdisciplinary laryngology team ensures that vocal outcomes are optimized.

Laryngeal dysplasia is a precancerous growth, and squamous cell carcinoma is the most common cancer of the larynx (throat). Voice changes are a first symptom of cancer, so patients should visit a laryngologist if they experience voice changes that lasts more than four weeks. Treatment includes surgery, radiation and/or chemoradiation, and laryngologists at IU School of Medicine are experts in minimally invasive techniques as a means for cure. Patients enjoy a high rate of success when throat cancers are detected early.

Patients may develop a hoarse voice, weak cough and difficulty with swallowing due to weak movement of the vocal cord. Vocal cord paralysis is often resolved with a quick, office-based procedure to reposition the vocal cord in a more favorable position.

Laryngeal papilloma is a condition where benign growths can develop on the vocal cords and lead to significant hoarseness. This condition is treated through surgical removal plus medications to prevent regrowth. Many patients can transition to treatment with an office-based technique that avoids general anesthesia.

Neurological problems that affect the voice include spasmodic dysphonia, vocal tremor and Parkinson’s hypophonia. Spasmodic dysphonia is caused by involuntary, irregular spasms of the vocal cords. Laryngologists can significantly improve symptoms for patients through injections and therapy in order to calm spasms and improve voice quality.

Scarring on the voice box could prevent its ability to open normally. The voice box is part of the upper airway, leading to breathing difficulty. Laryngologists offer several options for treatment that help open the area to improve breathing.

Narrowing of the windpipe is usually caused from trauma or an inflammatory problem. Endoscopic surgery can improve the airway, and open procedures can cure the problem permanently.

Benign growths can develop in the larynx and other upper airway regions. Growths are sometimes caused by human papilloma virus (HPV). Patients with large growths blocking the airway or pushing from the outside may experience limited breathing ability. These are treated with surgical removal and subsequent medications to prevent future growth.

In order to swallow, pressure is generated in the throat to move food and liquid into the stomach. Sometimes, this pressure pushes through a weak area and creates a small out-pouching, called a diverticulum. A Zenker’s diverticulum is specifically associated with difficulty of swallowing solid food and sometimes coughing up food after a meal. Laryngologists can treat this condition through a minimally invasive procedure that resolves symptoms.

Reflux refers to material coming from the stomach and into the esophagus and upper throat. Patients can feel heartburn, indigestion, chronic cough, and chronic throat clearing. Unmanaged reflux can lead to more severe symptoms that affect the nose and sinus or precancerous changes in the esophagus. Laryngologists can intervene with a customized plan to manage reflux through diet, medications, and surgery.

The esophagus is surrounded by a ring of muscle, called the cricopharyngus muscle, that acts like a belt to keep food and liquid from coming up from the stomach. If this muscle is overactive or “tight,” patients experience difficulty in eating solid foods. Laryngologists use dilation and/or surgery in order to help release this muscle.

Narrowing of the esophagus could lead to higher risk of food and liquids to enter the lungs. Laryngologists are able to open the esophagus within an outpatient office setting.

Patients may experience progressive issues in swallowing as they age. Examples include problems with swallowing liquid, solid food and pills. Laryngologists can perform a full evaluation and create customized treatment to the individual. Interventions often include swallowing therapy, medication and surgery.