Speech Pathology/ Voice Center

What is the Voice Center?
The Voice Center is composed of six Ear, Nose, and Throat Physicians and two Speech-Language Pathologists (SLP). Together as a team, a Physician and SLP will work to find the cause of a patient’s symptoms and offer the appropriate treatment. Click here to learn how to make an appointment at the Voice Center.

Why should I choose a Voice Center?
Our Center addresses all disorders of the voice - ranging from fairly simple to very complex problems. By having our Speech-Language Pathologists and Physicians together in the same office, they work closely as a team, collaborating and communicating directly. The center also provides state-of-the-art evaluations including high-tech videostroboscopy testing. A commitment to quality completes the picture of a modern-day voice center. The Voice Center is set up to treat all people, ranging from those with a voice disorder affecting their day to day speech, as well as those who use their voice professionally, including public speakers, actors, and singers.

What are some common voice problems?

  • Hoarseness: This can be from changes due to swelling of the vocal folds, muscle tension, a lesion on one or both vocal folds, a paralyzed vocal fold, harmful vocal habits, etc.
  • Chronic throat clearing or coughing: This can be caused from an illness, acid reflux, or even a bad habit.
  • Shortness of breath or noisy breathing
  • A feeling of a “lump in the throat”: This issue is often a result from acid reflux, but can be from a lesion in the voice box.
  • Swallowing difficulties: Can result from a surgery, radiation to the neck, acid reflux, or a lesion in the voice box.

Only a thorough evaluation can successfully uncover these and other causes of voice and swallowing problems.

What is a Videostrobe Evaluation?
Videostroboscopy is a special test that uses the most up-to-date video and digital imaging technology to examine the voice box as the vocal cords are moving. This state-of-the-art equipment is available at Eastern Carolina Ear, Nose, and Throat.
The telescope used for digital Videostrobe examsA Videostroboscopy Examination may be recommended by one of the Eastern Carolina ENT physicians to study the vocal cord appearance and motion. For example, videostroboscopy is very helpful in determining if the edges of the vocal cords are smooth and straight. It also helps determine if the delicate covering of the vocal cords is vibrating properly. Both of these factors, and many others, affect how the voice sounds.

During the examination, a strobe light and camera are used together to record the vocal cords and their movement, making it appear that they are moving in slow motion. The speech pathologist and doctor can see small details about the look and motion of the vocal cords, allowing them to diagnosis many voice problems.

How is a Videostrobe Examination performed?
For the exam, the patient is seated upright in a comfortable chair. The patient leans gently forward and the Speech-Language Pathologist (SLP) uses a thin camera to look into the mouth. This camera is angled down, allowing it to see around and down the back of the tongue. Without having to go deep in the throat, the SLP can photograph the vocal cords. The patient is asked to make an "EEE" sound at various pitches in order to study the vocal cords moving.  The patient is coached throughout the exam and often feels nothing during the examination except the SLP holding the tongue. Most exams take less than a minute to complete, with much more time being spent on setting up the exam, instructing the patient, and going over the results. Generally, the time spent with the SLP for the entire process can take anywhere from 20-45 minutes depending on various factors.

What happens after the Videostrobe Examination?
After the exam, the patient is shown videos and pictures of “normal anatomy” and given a brief summary of how the voice box works. Then they are shown their own video of their voice box with a summary of what the findings are. This gives a more complete understanding of the problem when the patient is able to see the problem in a picture or video. These photos and a detailed report can also be sent to your primary doctor, if desired, so that all involved have a good understanding of the problem.

The speech pathologist looks for brief periods, asking the patient to make an "EEE" sound at various pitches with the voice in order to study the vocal cords in action. Rest breaks are included to keep the patient comfortable.

Who performs the Videostrobe evaluations?
An ENT physician or a Speech-Language Pathologist may perform the exam. At Eastern Carolina ENT, stroboscopic exams are performed by the two Speech-Language Pathologists on staff, Lisa Collins, MS, CCC-SLP and Morgan Greve, MA, CCC-SLP.

What is Speech Therapy and when is it used?
Speech therapy first involves educating the patient about their particular voice problem. Speech therapy exercises are most often presented the same day as the initial videostrobe, with the patient being instructed to practice these at home for a period of time. Occasionally, patients may need more formalized therapy in-office if progress is not made with home exercises. The original and follow-up Videostrobe pictures may be used to demonstrate to a patient the progress that he or she is making.

What are some examples of speech therapy techniques?

  • Identifying vocal abuse patterns which cause excess strain on the voice
  • Education on making healthier choices for overall better health of the vocal folds
  • Exercises to eliminate vocal muscle tension
  • Exercises to target the necessary breath support t and speech breathing patterns during speech
  • Exercises to strengthen the actual vocal fold muscle for a stronger voice

What if my voice needs medical attention?
This is the real beauty of a voice center. Often both the speech pathologist and physician contribute to the care of a particular voice problem. The combined ENT and speech care at Eastern Carolina ENT allows this to be well-coordinated. Sometimes a surgical procedure is recommended; even then, the speech pathologist may be involved in pre- and post-procedure care. Many times, speech therapy after surgery is appropriate to help in the healing process and hopefully stop another lesion from forming in the future. The goal is complete management under one roof with state-of-the-art facilities.


How do Professional Singers and Speakers benefit from the Voice Center?
Professional singers and speakers often seek medical intervention to enhance voice quality and performance. They can get baseline pictures of the vocal cords taken. In other words, a documentation of where you are now. This can be useful for later comparison.

The Voice Center provides a team approach to evaluation and treatment of professional voice users. They have the opportunity to receive speech therapy geared towards many issues professional voice users experience. Often, singers perceive a voice disorder or vocal cord lesions as career-enders. Very often this is not true, and the problem is treatable. A visit to the Voice Center helps the professional voice user understand that the voice box is not only an 'instrument' but also a system of muscles which can be rehabilitated.


How do I make an appointment?
To make an appointment at Eastern Carolina ENT, please call our office at 252-752-5227 and request an appointment be made with one of our physicians. You may also request to been seen by our speech-language pathologist for a videostroboscopy evaluation as well, but the physician you will be seeing will ultimately decide if he feels this type of evaluation will be appropriate for you during your appointment. Please bring any medical records regarding your voice problem to the appointment.


Meet Our Speech Pathology Team

Lisa Collins, MS, CCC-SLP
Lisa Collins, MS, CCC-SLP earned her BS from the Richard Stockton College of New Jersey with a major in speech-language pathology, a minor in biology, and a minor in theater arts.  She worked for Marine Corps Community Services while attending East Carolina University where she earned her MS in speech-language pathology.  She completed an internship focusing on voice disorders, laryngectomee care, pediatric voice diagnostics, pediatric frenulectomy diagnostics, and swallowing disorders for head & neck cancer patients at Eastern Carolina ENT Head & Neck in Greenville, NC.  Lisa worked as a pediatric therapist with focus on providing augmentative & alternative communication for children with disabilities and early intervention services until her return to the specialty of voice at Eastern Carolina ENT in 2012.  She has completed FEES training and the Advanced Stroboscopy Workshop.  She currently holds ASHA Certificate of Clinical Competence, North Carolina licensure, and New Jersey licensure.  She has found enjoyment in the challenge of being the supervisor of clinical fellows, interns, and observing students while providing patients personalized diagnostic and therapeutic intervention. 

Morgan Greve, MA, CCC-SLP
Morgan has been with us at Eastern Carolina ENT since September 2013. She completed her undergraduate and graduate coursework at Central Michigan University, receiving a Bachelor of Science (minors in American Sign Language and Psychology) and a Masters of Arts in Speech-Language Pathology. She completed her internship at Charlotte Eye, Ear, Nose, & Throat Associates, Inc. in Charlotte, NC, and her Clinical Fellowship at Eastern Carolina ENT Head & Neck Surgery. She is a licensed SLP in the state of North Carolina and holds her Certificate of Clinical Competence (CCC) in Speech-Language Pathology.

Throughout her coursework and further training, Morgan has gained extensive knowledge in evaluating and treating voice and swallowing disorders in all age groups with the use of videostroboscopy and fiberoptic endoscopic evaluation of swallowing (FEES). She has also attended many courses for laryngectomy care and has a strong background in speech rehabilitation for this population. Morgan has a vast skill set in providing speech therapy, including therapeutic techniques with Resonant Voice Therapy, Vocal Function Exercises, work with pediatric voice disorders, and various breathing exercises to treat Paradoxical Vocal Fold Dysfunction.

Our Clinicians provide evaluation and treatment for the following disorders/patients (not an exhaustive list):

  • Functional voice disorders (i.e., muscle tension)
  • Structural/ Anatomical voice disorders (i.e., vocal fold polyp)
  • Paradoxical Vocal Fold Dysfunction
  • Subglottic Stenosis/ Airway competency
  • Frenulectomy evaluations
  • Spasmodic Dysphonia
  • Swallowing Disorders as a result of head and neck cancer intervention
  • Laryngectomy care
    • Pre-op/post-op counseling with patient and family
    • Voice rehabilitation with tracheo-esophageal speech (In-Health and Provox) and electrolarynx
    • General support with stoma management

Online Resources
National Spasmodic Dysphonia Association
Voice Academy for Teachers
American Speech-Language and Hearing Association
The National Association of Teachers of Singing
The National Center for Voice and Speech
National Organization for Rare Diseases
American Academy of Otolaryngology

Laryngectomy Resources
Web Whisperers
Provox Supplies
InHealth Supplies
International Association of Laryngectomees

Tri-monthly support group meetings and newsletters

 
Eastern Carolina E•N•T Head & Neck Surgery © 2014