Speech Pathology/ Voice Center

What is the Voice Center?
The Eastern Carolina ENT Voice Center is composed of six Ear, Nose, and Throat physicians and three speech-language pathologists (SLPs). A physician and SLP will work together as a team to identify the source of a patient's symptoms and offer appropriate treatment options.

Why should I choose The Voice Center?
Eastern Carolina ENT Voice Center offers evaluations for a broad range of voice disorders with corresponding treatment options as indicated. By having our speech-language pathologists and physicians together in the same office, they work closely as a team by collaborating and communicating directly to provide comprehensive and quality care. The Center also provides state-of-the-art evaluations including high-tech Videostroboscopy examinations to assess vocal pathologies in great detail. Our Voice Center was established to meet the needs of those whose voice disorders affect 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
  • Chronic throat clearing or coughing
  • Shortness of breath or noisy breathing
  • A feeling of a “lump in the throat”
  • Swallowing difficulties
  • Laryngeal Spasm
  • Muscle Tension

What is Videostroboscopy?
Videostroboscopy is a unique test that uses high tech digital imaging technology to examine the larynx (voice box) as the vocal cords are moving. This state-of-the-art equipment is available at Eastern Carolina Ear, Nose and Throat. Videostroboscopy may be recommended by one of the Eastern Carolina ENT physicians to examine the patient's vocal cord appearance and motion in great detail. For example, a Videostroboscopic examination is very helpful in determining if the edges of the vocal cords are smooth and straight and if the delicate covering of the vocal cords is vibrating properly.

During the examination, a strobe light and camera are used to record the vocal cords, making them appear as if they are moving in slow motion. The speech-language pathologist and physician are able to view both the structure and function of the vocal cords, allowing them to accurately diagnose a variety of voice disorders.

How is a Videostroboscopy performed?
During the exam, the patient is seated upright in a comfortable chair. The patient leans gently forward, and the speech-language pathologist uses a thin, rigid scope attached to a camera to view the vocal cords over the back of the patient’s tongue. Then, the patient is asked to make an “EEE” sound at various pitches in order to capture an image of the vocal cords moving. The patient is coached throughout the exam and often feels nothing during the examination except the SLP holding the tongue. Rest breaks are included to keep the patient comfortable. 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 pictures of “normal anatomy” and provided with a brief summary of how the vocal cords produce sound. Then, the patient is shown a video of his/her own voice box with a summary of the SLP’s findings. This will provide the patient with a better understanding of the problem as the patient is able to see his/her vocal pathology in the form of a picture or video. These photos and a detailed report may 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 Videostroboscopy?
A physician or speech-language pathologist may perform the exam. At Eastern Carolina ENT, stroboscopic exams are performed by the three speech-language pathologists on staff, Ashley K. Abel, M.S., CCC-SLP, Susan S. Hollowell, M.S., CCC-SLP, and Kathryn F. Waugh, M.S., CCC-SLP.

What is Speech Therapy and when is it used?
Speech therapy first involves educating the patient about his/her particular voice problem. Speech therapy exercises are most often presented the same day as the initial Videostroboscopy, with the patient being instructed to practice these exercises 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 Videostroboscopy pictures may be used to demonstrate the patient’s progress.

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 muscle tension in the voice box
  • Exercises to target the most efficient breathing patterns during speech
  • Exercises to strengthen the vocal fold muscles for a stronger voice

What if my voice needs medical attention?
Often both the speech-language pathologist and the physician contribute to the care of a particular voice problem. The combined medical and speech services at Eastern Carolina ENT provide the patient with comprehensive care. Sometimes a surgical procedure is recommended, and the speech-language pathologist may be involved in pre-and post-procedure care. Many times, speech therapy after surgery is warranted to help in the healing process and hopefully prevent another lesion from forming in the future. Our goal is to provide quality care under one roof with state-of-the-art services.

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. Once the Videostroboscopic examination is performed, the physician and speech-language pathologist are able to target the specific pathologies that may be contributing to the changes in the patient's voice. Patients have the opportunity to receive speech therapy geared towards the unique issues many professional voice users experience in their daily lives. Often, singers perceive a voice disorder or vocal cord lesions as career-enders. Very often this is not true, as the problem is usually treatable. A visit to Eastern Carolina ENT Voice Center helps the professional voice user understand that the voice box is not only an 'instrument,' but also a system of muscles that 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 with one of our Physicians. You may also request to be seen by one of our speech-language pathologists for a Videostroboscopy as well; ultimately, your physician will determine if this type of evaluation is warranted during your appointment. Please bring any medical records regarding your voice problem to the appointment.

Meet Our Speech Pathology Team

Ashley K. Abel, M.S., CCC-SLP
Ashley has been working at Eastern Carolina ENT since June 2015. She completed her undergraduate coursework at the University of Wisconsin-Madison. Ashley then completed her graduate coursework at East Carolina University, receiving a Master of Science in Communication Sciences and Disorders. She previously worked at Vidant Medical Center for three years in acute care. Ashley is a licensed SLP in the state of North Carolina and holds her Certificate of Clinical Competence (CCC) in Speech-Language Pathology.

Susan S. Hollowell, M.S., CCC-SLP
Susan joined the staff at Eastern Carolina ENT in June 2015. She completed her undergraduate and graduate coursework at East Carolina University, where she recieved a Bachelor of Science in Communication Sciences and Disorders and a Masters of Science in Communication Sciences and Disorders. Susan previously worked at Hunter Holmes McGuire Veterans Administration Medical Center in Richmond, VA as well as Vidant Medical Center in Greenville, NC. She has been practicing since 2003 with experience in outpatient and acute care settings. Susan is a licensed SLP in the state of North Carolina and holds her Certificate of Clinical Competence (CCC) in Speech-Language Pathology.

Kathryn F. Waugh, M.S., CCC-SLP
Kathryn began working at Eastern Carolina ENT in June 2015. She completed her undergraduate coursework at the University of North Carolina at Chapel Hill, where she recieved a Bachelor of Arts in History and Communication Studies with a concentration in Speech and Hearing Science. Kathryn then completed her graduate coursework at East Carolina University, receiving a Master of Science in Communication Sciences and Disorders. She completed her Clinical Fellowship at the Durham VA Medical Center in both acute care and outpatient rehabilitaion settings. Kathryn is a licensed SLP in the state of North Carolina and holds her Certificate of Clinical Competence (CCC) in Speech-Language Pathology.

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

  • Functional voice disorders
  • Structural/ Anatomical voice disorders
  • Paradoxical Vocal Fold Dysfunction
  • Subglottic Stenosis/ Airway competency
  • Frenulectomy
  • 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 © 2015