What is the Voice Center?
The Voice Center is composed of six ear, nose,
and throat doctors and two speech pathologists.
Together as a team a doctor and speech pathologist
work to find the cause and offer treatments for
voice problems. Although a patient may see only
the doctor or the speech pathologist, commonly
both the E-N-T doctor and the speech pathologist
will evaluate and treat voice disorders. Click
to learn how to make an appointment in the Voice
Why should I choose a Voice Center?
The Center has been set up to address virtually
all disorders of the voice - ranging from fairly
simple to very complex problems. By having the
speech pathologist and physician under one roof,
the communication and coordination are improved.
The center also provides state-of-the-art evaluations
including high-tech Videostrobe testing. A commitment
to quality completes the picture of a modern-day
voice center. The Voice Center is set up to treat
people with voice disorders affecting their everyday
life as well as those who use their voice in performances,
such as speaking, acting, and singing. Professional voice users may seek care through the Voice Center
What are some common voice problems?
One common cause for a hoarse voice includes
swelling of the vocal cords. This can be caused
by many factors. For example, heavy use of the
voice or misuse of the voice can create swelling
of the vocal cords. Another common cause is acid
reflux (acid coming up from the stomach). This
acid can cause significant irritation of the vocal
cords, sometimes causing them to contract (close)
too vigorously and can even contribute to spasms
(spasmodic dysphonia). Chronic muscle tension
can also cause hoarseness. Only a thorough evaluation
can successfully uncover these and other causes
of voice problems.
What is a Videostrobe
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 E-N-T.
During the examination, a special strobe light
is used to light up the voice box. This rapidly
flashing light makes the vocal cords appear to
move in slow motion. The speech pathologist and
doctor can see small details about motion of the
vocal cords, allowing them to diagnosis many different
The telescope used for digital Videostrobe exams
A Videostroboscopy Examination may
be recommended by one of the Eastern Carolina
E-N-T physicians to further study the vocal cord
appearance and motion. For example, the Videostrobe
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-this is important
in producing a 'normal' sounding voice.
How is a Videostrobe Examination performed?
For the exam, a patient is seated upright in
a comfortable chair. The patient leans gently
forward, then the speech pathologist uses a thin
fiberoptic camera to look into the mouth. This
camera has an angled prism at the tip, allowing
it to see around the back of the tongue. So without
having to go deep in the throat, the speech pathologist
can photograph the vocal cords. The exam is well-tolerated
and generally not at all painful.
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.
What happens after the Videostrobe Examination?
Afterwards, the whole exam is summarized along
with a review of the video and pictures. This
gives a more complete understanding of the problem
when the patient is able to see the problem in
a picture or video. 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.
Who performs the Videostrobe evaluations?
An E-N-T physician or a speech-language
pathologist may perform the exam. At Eastern Carolina
E-N-T, stroboscopic exams are most commonly performed
by Kathleen T. Cox, PhD, CCC-SLP,
a research consultant from East Carolina University.
What is Speech Therapy and when is it used?
Speech therapy first involves educating the patient
about their particular voice problem. Then the
speech pathologist teaches the patient techniques
or exercises to help fix their particular problem.
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 example of speech therapy techniques?
- Identifying vocal abuse patterns which cause
excess strain on the voice
- Learning what the Voice Center calls vocal hygiene
(how to take care of your voice)
- Special exercises to maintain enough breath
support (getting enough wind behind your words)
- Special exercises to improve strength and endurance
of the voice
- Many other techniques as well…
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 E-N-T and speech care at Eastern Carolina
E-N-T 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. The goal is complete
management under one roof with state-of-the-art
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
The Voice Center provides a team approach to
evaluation and treatment of professional voice
users. They have the opportunity to receive speech
therapy and singing therapy at The Voice Center. Its
team prides itself in helping singers out of what
they believe to be dire circumstances. The perception
among singers is that a voice disorder or vocal
cord lesions are 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.
What are the research activities of the Voice
One new program being developed at the Voice
Center is the further development of a long-time
partnership with the Department of Communication
Sciences and Disorders (CSDI) at East Carolina
University (ECU). ECU has cutting edge research
and academic programs throughout the university
that are making news around the world for their
innovative and exciting research projects. Dr.
Kathleen T. Cox, assistant professor in the Department
of CSDI, is a part of that exciting innovation
and will be directing a research program within
the Voice Center. ECVC is committed to this research
effort. Dr Cox's program is designed to ensure
that the advancement of knowledge about the voice,
voice disorders, and singing occurs through an
active research program. Dr. Cox has experience
in directing research projects within the areas
of voice and swallowing and will be coordinating
research experiments, training doctoral students
who will be performing research studies, as well
as acquiring external funding to enhance ECVC's
research capabilities. Research goals include
conducting "clinical trials" for new
and unique treatments, designing training programs
for doctoral students in the CSDI department who
are interested in a career in voice and voice
care, and disseminating research findings through
publications in scholarly research journals.
How do I make an appointment?
If you have already seen an E-N-T physician, you
can make an appointment by calling
252-752-5227 and requesting a stroboscopic or
If you have not already seen an E-N-T, you can make
an appointment with one of the physicians at the
Eastern Carolina Voice Center and the physician
will determine if you should be recommended for
If you have seen another physician (pulmonologist,
allergist, family doctor), and that physician
has recommended the examination, then you can
call 252-752-5227 for an appointment. Please bring any medical records regarding
your voice problem to the appointment.
The Speech Pathology Team:
Melissa Carter, MS, CCC- SLP
Elizabeth Ramsey, MS, CCC-SLP
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
The Voice Problem Website
National Organization for Rare Diseases
American Academy of Otolaryngology
International Association of Laryngectomees