Voice Lab Services & Procedures
Perceptual Clinical Assessment of the Vocal Mechanism
The Speech Pathologists at Deaconess utilize advanced techniques designed by recognized experts in the field of voice management to evaluate and treat voice disorders.
The Visi-Pitch can be used as a diagnostic tool to obtain quantitative data on the acoustic characteristics of a patient’s voice/speech. It provides a means for accurately measuring and describing aspects of dysphonia related to frequency (such as pitch range, habitual pitch, optimal pitch), intensity and phonation time. This is an extremely useful adjunct to assessment, which also provides enhanced feedback for therapy.
Lee Silverman Voice Therapy (LSVT) for Patients with Parkinson’s Disease
Voice deficits affect at least 98% of individuals with Parkinson’s disease. Reduced loudness may be one of the first signs of Parkinson’s disease and is a classic voice symptom together with a hoarse voice quality, monotony of pitch and imprecise articulation. These symptoms may reduce speech intelligibility in patients with Parkinson’s disease and may limit their full participation in society. The goal of the LSVT is to teach patients with Parkinson’s disease to improve functional, intelligible oral communication by increasing vocal loudness. This is accomplished through training in high-phonatory-effort tasks, which stimulate increased vocal fold adduction and respiratory support and have an immediate impact on functional, intelligible speech.
Communication Systems for Tracheostomized Patients
Passy-Muir Tracheostomy and Ventilator Speaking Valves (PMVs) are designed to eliminate the necessity of finger occlusion for patients with a tracheostomy tube while allowing full-power, uninterrupted speech. Research has validated additional significant benefits with the use of PMVs, including improved speech production, improved swallowing, reduced aspiration, easier secretion management, easier weaning, and more rapid decannulation.
Tracheoesophageal Speech versus Alternative Communication System for Total Laryngectomy
The goal of speech rehabilitation for laryngectomized patients is to find an appropriate source of sound production that can be articulated for communication purposes. The most efficient and effective type of sound source varies with each patient. Sources include communication training using an electrolarynx, esophageal speech or tracheoesophageal puncture/prosthesis. Our therapists are available to assist with acquiring appropriate devices. Loaner equipment is available if needed. Our professionals, who were personally trained by Eric Blom (designer of the Blom-Singer tracheoesophageal voice prosthesis), have advanced skills in fitting and managing both interchangeable and indwelling voice prostheses.
Videostroboscopy was designed to provide speech-language pathologists with a convenient and powerful means of examining laryngeal anatomy and vocal fold physiology. Both constant and strobe light sources are provided for either general endoscopic viewing or stroboscopic evaluation of the vocal folds during phonation. Both flexible and rigid endoscopes can be used with the system.
The vocal folds vibrate too rapidly for observation of the dynamic aspects of phonation by the unaided eye. During stroboscopy, the rapidly vibrating vocal folds are illuminated with brief pulses of light. The timing of these flashes can be regulated through electronic circuitry to produce an image of the vocal folds vibrating slowly to permit detailed observation of vocal fold movement or “standing still” at various positions. Through the use of video stroboscopy, laryngeal disease can be detected earlier, functional disorders can be diagnosed with greater accuracy, and patient performance can be documented clearly before and after surgery or voice rehabilitation.
Paradoxical Vocal Fold Dysfunction (PVFD) is a common condition that can be observed via visualization of the vocal mechanism. PVFD is an impairment of breathing caused by upper airway obstruction of vocal folds adducting when they should be abducting. Breathing impairment may be on inspiration, expiration or both.
PVFD can be induced by exercise, reflux and/or by panic. PVFD co-occurs with approximately 30 percent of patients suffering from asthma. Onset can occur at any age, but it is seen most commonly in teenagers, young adults, college athletes and women in their fifth decade. PVFD varies from relatively mild dyspnea to total respiratory obstruction resulting in multiple emergency room visits and possible hospitalizations.
Our specially trained clinicians have implemented a successful protocol for treating this potentially serious and activity-limiting condition. The typical duration of treatment is approximately six therapy sessions. During treatment, we are able to monitor patients’ respiratory status via a pulse oximeter. The goal of treatment is to increase patients’ independence in controlling this disorder and to restore their livelihood.