Our speech language pathologists, as part of a comprehensive multidisciplinary team, work closely with head and neck surgeons, radiation oncologists, nutritionists, and other specialists to develop an individualized treatment plan to ensure the best possible outcome for each patient.
Our goal is to restore and maximize communication and swallowing function through a variety of specialized programs.
Our highly experienced speech pathologists have expertise in the following services:
Swallowing Assessment and Treatment
A swallowing disorder, also called dysphagia, means you have difficulty or discomfort with swallowing food or liquids. The following specialized assessment and treatment options are offered:
- Clinical Swallow Evaluation: The first step is a thorough evaluation of the individual’s current swallow function. Our speech language pathologist is able to make a comprehensive plan for therapy after the evaluation. Rehabilitation includes exercises to stretch and strengthen the muscles involved in swallowing.
- Modified Barium Swallow Study (MBS): During the study, the patient swallows various consistencies of food ranging from liquids to solids that contain a substance called barium, which shows up on the x-ray. By watching the swallowing process on an x-ray, the speech language pathologist is able to identify any problems and make a plan for treatment.
- Fiberoptic Endoscopic Evaluation of Swallowing (FEES): During the evaluation, a thin, lighted tube, called an endoscope, is inserted through the patient’s nose and guided into the throat. A camera at the tip of the tube allows the team to evaluate any issues in the throat as the patient swallows various liquid and food consistencies.
- Myofascial Release and Manual Techniques in dysphagia Management: This therapy targets the release of muscle tension to improve strength, range of motion, and coordination of the muscles of the mouth and throat to achieve functional swallowing.
Voice Assessment and Treatment
A voice disorder, also known as dysphonia, means you have difficulty achieving a functional voice to communicate. Sometimes people develop problems with their voice as a result of cancer or its treatment. Surgery or radiation therapy may cause the voice to become hoarse, weak, or completely lost.
- Evaluation: Our speech pathology team provides complete voice evaluations; including analyses of vocal cord function and voice production, once cleared by a physician.
- Treatment: Voice therapy uses exercises to strengthen the vocal cords as well as other approaches to compensate for an affected vocal cord. Our rehabilitation plans may include exercises, biofeedback techniques, and devices to increase and maximize muscle strength in your vocal cords, as well as improve breath support for the voice.
Speech Restoration after a Laryngectomy
Laryngectomy is a surgery to remove the larynx (voice box). As part of their recovery, people who have their larynx removed will need to learn a new way to produce speech. Our speech pathologists have particular expertise in working with people to regain their ability to communicate after laryngectomy. They provide comprehensive rehabilitation to patients before and after surgery, counseling them about their options and working closely with them and their families throughout the recovery process.
Ways we can help people communicate after laryngectomy include:
- Electrolarynx: This is a device that allows for artificial voicing. You place it against your throat, push a button, and the machine transmits a vibration noise to your throat which you then form into words and sounds with your lips, teeth, and tongue. Many people are able to use the device within three to five days after surgery, using an adaptor for the mouth initially.
- Esophageal speech: This is an alternative way of producing speech which involves swallowing air into the esophagus and then pushing it back up through the throat and mouth.
- Tracheoesophegeal (TEP) speech: In order to perform TEP speech, the head and neck surgeons must create a small opening between the esophagus and the trachea and place a small one-way valve there. This procedure is called tracheoesophageal puncture. The valve keeps food out of the trachea but allows air into the esophagus to allow people to use their voice.
Management of Head and Neck Lymphedema
Head and neck lymphedema is a very common late side effect of treatment for head and neck cancer. It is a condition with potentially severe implications for quality of life. The gold standard treatment for lymphedema is complete decongestive therapy. Therapy is provided by certified therapists, and includes manual lymphatic drainage, compression (bandages / garments), exercise program, and education on skin care and infection precautions. Patient education also includes self-massage guidance, and flare-up prevention practices.