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Comprehensive Testing

The Voice and Speech Laboratory prides itself on a true team approach to voice diagnosis and treatment.

The process starts when patients are referred following an ear, nose and throat workup. The Laboratory will embark on a comprehensive interview and testing program to quantify voice quality and strength – and begin to identify underlying causes.

Information is gathered at a very intensive level. The patient’s history is recorded in great detail using a 13-page medical history form.

Patients then go to an isolated, soundproof testing booth for acoustic and aerodynamic evaluation. For the acoustic evaluation, the voice is recorded to establish a baseline of quality, roughness and strength.

The aerodynamic assessment is non-invasive, with the patient speaking into a mask that measures how much air pressure is being produced to speak.

The third phase of initial evaluation is video stroboscopy. For this test, a small camera is pointed directly at the vocal cords. The vocal cords work by vibrating like stretched rubber bands as we pass air across them. They vibrate on average 100 times a second in men and 200 times a second in women – too fast for examination with the naked eye. Combining video and strobe, the machine accurately shoots ‘freeze frame’ images to reveal the exact shape and position of the vocal cords in motion.

Once the history and testing is complete, the team goes to work. Each case is presented and discussed at “voice rounds,” a weekly meeting of the staff of experts where the treatment strategy takes shape.

Therapy may take many forms, depending on the nature and severity of the problem. The Laboratory maintains a powerful arsenal of tools and techniques of voice rehabilitation and patient training – including leading-edge techniques like Botox injections and LSVT, the Lee Silverman Voice Treatment program.

Therapy will typically combine inpatient work and outpatient visits, combined with a specific home regimen for some number of weeks – with appropriate testing throughout to assess progress.