Therapy Services

At the Texas Center for Voice we offer much more than your typical doctor’s visit. Dr. Anderson and her team and here to truly make you sound and feel the best that you can. Our commitment to “Caring for the Voice of Texas” is evident in the many therapy services we offer.

Speech & Language Therapy

A certified Speech and Language pathologist (CCC-SLP) is critical to the multidisciplinary team approach to the patient with voice and swallowing disorders. The speech pathologist works with the otolaryngologist/laryngologist to determine causes of vocal damage, document accurately voice changes, provide therapy recommendations, and assist in the care of the voice patient.

The training of the Speech Language Pathologist allows them to help the laryngologist with voice and swallowing evaluations in the clinic. Discussing vocal habits and vocal use during employment as well as the special vocal needs of each patient is part of the speech pathologist’s evaluation. Computerized voice analysis which gives an accurate acoustic “fingerprint” of the voice from visit to visit is crucial to document improvement or to point out areas that need further work. Speech pathology involvement in the patient with a swallowing disorder is necessary to determine the exercises that will be helpful during rehabilitation and develop a comprehensive treatment plan for the fastest recovery.

Angie Galatas MA, CCC-SLP works in tandem with Dr. Anderson to provide the most comprehensive, patient-centered care available to the patient with voice and swallowing disorders. She has a special interest in adult voice disorders and is certified in FEESST, or flexible endoscopic swallowing evaluations with sensory testing. This test is crucial for the patient with dysphagia, or swallowing problems. She also is certified in stroboscopy to evaluate the vocal fold anatomy and motion. She is a delightful addition to the Voice Center team and has worked alongside Dr. Anderson since 2012.

Vocal Cord Abuse

Am I Abusing My Voice?

Potentially, yes! Vocal Abuse/Misuse is also known as phonotrauma. The primary component of phonotrauma is prolonged, effortful, and compromising vocal behaviors that compromise the vocal folds. Many behaviors are a result of slamming the vocal cords together very hard. If done frequently, you may become hoarse, raspy or breathy because your vocal cords have become swollen.

Vocal Cord Spasm

What Is Vocal Cord Spasm?

Vocal cord spasm is a very scary condition that occurs when the larynx is very irritated. The vocal cords are designed to protect the lungs from irritants so if they become very inflamed they can close, which can lead to a sensation of not being able to get air in the lungs. Sometimes no air is able to get in. This condition can last for a few seconds or up to two minutes. Simple maneuvers like breathing through a straw or slow nasal breathing may relax the spasm and the vocal cords will open.

Treating the spasm effectively usually involves treating any infection, control of inflammation, treatment of allergies, appropriate hydration and humidification, and occasionally medications to reduce nerve irritability. If the underlying inflammation is treated, this condition is usually temporary. Reflux can cause spasm as well, often in the middle of the night, so if reflux is present it is important to treat it appropriately.

Paradoxical Vocal Fold Movement

Paradoxical vocal fold movement is a lesser form of spasm where the vocal folds narrow but do not close completely. It may be mistaken for asthma and may cause noisy or restricted breathing. Treating effectively usually involves treating any infection, control of inflammation, treatment of allergies, appropriate hydration and humidification, and occasionally medications to reduce nerve irritability. If the underlying inflammation is treated, this condition is usually temporary. Reflux can cause spasm as well, often in the middle of the night, so if reflux is present it is important to treat it appropriately.

Occasionally speech therapy may be helpful to teach the patient relaxation breathing techniques.

Laryngeal Spasm

Laryngeal spasm is when the vocal cords narrow or close inappropriately. It can cause problems speaking or breathing, or can make a person feel like they are choking or that their “air is being cut off.” It is usually treatable with medication or therapy (or a combination). It is usually caused by an underlying medical problem in the throat or airways.

You may require medication, therapy, or a combination of the two to help with your spasm. Dr. Anderson also performs Botox injections in the clinic to treat spasm. If you are a patient that has received Botox before for spasmodic dysphonia, you will be pleased with the ease of treatment and quick office visit for your injection.

Vocal Cord Weakness

What Can I Do To Help With My Vocal Cord Weakness?

Vocal cord spasm is a very scary condition that occurs when the larynx is very irritated. The vocal cords are designed to protect the lungs from irritants so if they become very inflamed they can close, which can lead to a sensation of not being able to get air in the lungs. Sometimes no air is able to get in. This condition can last for a few seconds or up to two minutes. Simple maneuvers like breathing through a straw or slow nasal breathing may relax the spasm and the vocal cords will open.

Treating the spasm effectively usually involves treating any infection, control of inflammation, treatment of allergies, appropriate hydration and humidification, and occasionally medications to reduce nerve irritability. If the underlying inflammation is treated, this condition is usually temporary. Reflux can cause spasm as well, often in the middle of the night, so if reflux is present it is important to treat it appropriately.

Taking Care of Your Voice

Everyone can take some easy steps to protect your voice and prevent problems:

  1. Do not smoke. Exposure to smoke and other airborn particles can lead to throat cancers and at the very least is a continual irritation to the throat and vocal cords. Assistance with smoking cessation can be found on the internet or through your family physician.
  2. Avoid noxious fumes, allergens, and secondary smoke.
  3. Keep yourself hydrated. You should drink 8 glasses of water a day. If you drink caffeine or perform strenous physical activity, you’ll need more. Chewing gum and sucking on hard candies will also help. You should keep your environment humid.
  4. Avoid caffeine and alcohol. These cause the body to lose water and have a high acid content.
  5. Treat Gastroespohageal Reflux Disease (GERD) if present.
  6. Avoid loud or prolonged voice use.
  7. Do not clear throat.
  8. Get plenty of sleep.
  9. Avoid over the counter antihistamines that cause dryness.
  10. Avoid lozenges and sprays containing menthol or phenol that dry and irritate the throat.
  11. “Warm up” vocal muscles prior to prolonged use.
  12. Rest your voice after vigorous use. Avoid excessive social voice use if you have increased your performance or rehearsal schedule.
  13. Use a microphone where you need to project your voice or if you are being treated for horseness.

Parkinson's Disease

What is Parkinson's Disease?

Parkinson’s Disease is a slowly progressive hereditary condition caused by loss of cells in a part of the brain called the substantia nigra that helps to control movement. Patients with this disorder can have slowed movements, rigidity of the movement of arms and legs, hoarseness or weak voice, and swallowing problems. The hoarseness is usually caused by thinning or bowing of the vocal folds so that there is a gap in between them during sound production (when normally they would touch completely).

Voice Hoarseness & Weakness Treatment

Breath support exercises (such as Lee Silverman Voice Therapy or LSVT) can help vocal projection in Parkinson’s. Vocal cord injection or medialization with a thyroplasty operation can also help the vocal cords to approximate which can improve volume and projection. Swallowing problems can arise from weakness of throat muscles as well as failure of the cricopharyngeus muscle (the “drain at the bottom of the throat”) to open. Swallowing therapy with strengthening exercises, diet modification, and airway protection techniques during eating can be of benefit in most cases. Dilation or division of the cricopharyngeus muscle may improve swallowing when dysphagia is severe.