Voice and Swallowing Treatment Services - Coastal Ear Nose & Throat
                     Voice and Swallowing
The Coastal Voice and Swallowing Center is led by Dr. Pratik B. Patel,  
focusing on the diagnosis and treatment of laryngologic (voice box and 
throat)  conditions. We offer a wide variety of in-office and operative 
procedures, and  partner with speech pathologists in the greater New Jersey 
Shore area to get  you the care you need.
Flexible Laryngoscopy
A small flexible camera is used to visualize the nose, throat, and vocal cords 
after  numbing the nose and throat.
Video Stroboscopy
The vocal cords are examined with a high power camera and strobe light to 
examine  for abnormalities that may be causing voice problems.
Fiberoptic Endoscopic Evaluation of Swallow (FEES)
A test that evaluates your swallowing function using a camera as your swallow 
various  consistencies of food.
Vocal Cord Lesions
Diagnosis begins with a complete history of the voice  
problem and an evaluation of speaking method. The  
otolaryngologist will perform a careful examination of the 
 vocal cords, typically using rigid laryngoscopy with a  
stroboscopic light source. In this procedure, a telescope-  
tube is passed through the patient’s mouth that allows 
the  examiner to view the voice box (images are often 
recorded  on video).  The stroboscopic light source 
allows the  examiner to assess vocal fold vibration.  
Sometimes a  second exam will follow a trial of voice rest 
to allow the  otolaryngologist an opportunity to assess 
changes in the  vocal cord lesion.
Vocal Cord Paresis/Paralysis
Hoarseness and other problems can occur related to 
 problems between the nerves and muscles within 
the  voice box or larynx. The most common 
condition is a  paralysis or weakness of one or 
both vocal cords.
Involvement of both vocal cords is rare and is usually 
 manifested by noisy breathing or difficulty getting  
enough air while breathing or talking. However, one  
vocal cord can become paralyzed or severely  
weakened (paresis) after a viral infection of the  
throat,  after surgery in the neck or cheek,  or for  
unknown reasons.
Presbyphonia (Aging voice)
Causes
As part of the normal aging process,  the muscles that  
sustain and support our vocal folds (cords), as well as 
the  structure of the larynx (voice box), may alter and 
change.  These changes,  that can affect the way we 
use our voice  and the way it sounds,  usually occur 
after age 60.
Treatment
An ENT doctor will first examine the larynx to 
evaluate  the structure and functionality of your vocal 
folds.
Depending on your specific problems, treatment options 
 can include:
Spasmodic Dysphonia
Spasmodic dysphonia, also known as laryngeal  
dystonia, is a rare neurological disorder characterized  
by involuntary muscle spasms of the larynx (voice 
box).  Spasmodic dysphonia causes the voice to 
break,  or to  have a tight, strained or strangled 
quality. Patients  with spasmodic dysphonia may 
have difficulty  communicating clearly. The disorder 
appears most  often in people between 30 and 50 
years of age,  and  more frequently in women. While 
the exact cause of  spasmodic dysphonia is not 
always known, it is  sometimes due to psychological 
stress, however, most  cases result from a problem in 
the brain and nervous  system. Spasmodic dysphonia 
is often a chronic  condition.
Professional Voice
An occupational or professional voice user is anyone whose voice is  
essential to their job. We are all accustomed to thinking of singers,  
actors, actresses, and broadcast personalities as professional voice 
users.  Indeed, special or unique qualities of the voice are often the 
essential  feature of their careers. But what about other occupational 
voice users?
Teachers, clergy, salespeople, courtroom attorneys, telemarketers, and  
receptionists are also people for whom spoken communication is an  
essential part of what they do, and there are countless other 
professions  that rely heavily on the voice. In spite of this era of email 
and Internet  communications, we can’t really imagine an effective 
classroom, pulpit,  or courtroom without voice. Can you imagine the 
difficulties of a  physician conveying sensitive or complex information 
to a patient or  colleague, or a business executive conducting a meeting 
without voice?
Once you pause to consider a world without voice communications, 
you  realize that voice is crucial to many professions.
Vocal Cord Cancer
Tobacco use is the most preventable cause of these deaths.  In the  
United States, up to 200,000 people die each year from smoking-  
related illnesses.  The good news is that this figure has decreased 
due  to the increasing number of Americans who have quit 
smoking.  The  bad news is that some of these smokers switched to 
smokeless or spit  tobacco, assuming it is a safe alternative. This is 
untrue. By doing  this, they are only changing the site of the cancer 
risk from their  lungs to their mouth. While lung cancer cases are 
down, cancers in  the head and neck appear to be increasing. Cancer 
of the head and  neck is curable if caught early. Fortunately, most 
head and neck  cancers produce early symptoms. You should know 
the potential  warning signs so you can alert your doctor as soon as 
possible.
Remember—successful treatment of head and neck cancer depends 
 on early detection. Knowing and recognizing the signs of head and 
 neck cancer can save your life.
Throat Cancer
Throat cancer is a very serious condition requiring immediate  
medical attention. When cancer attacks the vocal cords, the  
voice changes in quality, assuming the characteristics of chronic 
 hoarseness,  roughness,  or raspiness.  These symptoms occur 
at  an early stage in the development of the cancer. It is 
important  to remember that prompt attention to changes in 
the voice  facilitate early diagnosis thus early and successful 
treatment of  vocal cord cancer can be obtained.
Vocal Misuse and Abuse
Improper or poor speaking technique is caused from  
speaking at an abnormally or uncomfortable pitch,  
either  too high or too low, and leads to hoarseness and a 
variety of  other voice problems.
Examples of this condition are when young adult females,  
in a work environment,  consciously or subconsciously  
choose to speak at a lower than appropriate pitch and with 
a  heavy voice.
Percussive speaking,  a voice too loud or focusing on 
the  first syllable of each word, is another improper 
speaking  technique that may result in injury or trauma 
to the vocal  cords and muscles causing “vocal fatigue”.
Laryngitis
Voice problems result when the lungs,  voice box 
(larynx),  or  mouth are damaged.  If you have a voice 
problem, you may  experience discomfort or pain in 
your neck as you speak,   trouble reaching proper pitch, 
quality, or loudness of your  voice.
Anybody can acquire a voice problem, but there are 
specific  occupations that make it more likely. For instance, 
 teachers, preachers, singers, or jobs that require you to 
talk  or project your voice for long periods,  can be rough 
on your  vocal cords. As you age, vocal cords will be 
naturally strain.  Talking loudly, screaming, and yelling will 
also increase  your probability of developing voice 
complications. If you  are a smoker, had throat cancer, or 
have ever had surgery  in your throat and neck, you may 
develop voice problems.
Swallowing Difficulty 
(WDheny dsyspphahgiaa isg peirsaist)ent and the cause is not apparent, the  
otolaryngologist—head and neck surgeon will discuss the 
history  of your problem and examine your mouth and throat. 
This may be  done with the aid of mirrors. Sometimes a small 
tube (flexible  laryngoscope) is placed through the nose and the 
patient is then  given food to eat while the scope is in place in the 
throat. These  procedures provide visualization of the back of the 
tongue, throat,  and larynx (voice box). These procedures are 
called FEES (Fiber  optic Endoscopic Evaluation of 
Swallowing) or FEESST (Flexible  Endoscopic Evaluation of 
Swallowing with Sensory Testing). If  necessary, an examination 
of the esophagus, named TransNasal  Esophagoscopy (TNE), may 
be carried out by the otolaryngologist.  If you experience 
difficulty swallowing, it is important to seek  treatment to avoid 
malnutrition and dehydration.
Pain with 
Swallowing  
The lar(ynOx hdas ymunltioplep fuhncatiogns,i ianc)luding 
voice  production, cough, and airway protection. 
The  larynx also acts as a conduit for 
breathing.
Pathologic conditions that affect normal 
laryngeal  function can result in poor cough 
production,  aspiration with subsequent 
pneumonia, change in  phonation, and 
dysphagia. Chondronecrosis of  the larynx is a 
rare complication encountered in  
otolaryngology.
Laryngopharyngeal /  
 Gastroesophageal Reflux 
DisLaeryangsopeharyngeal reflux, also known as LPR, is a 
condition  that can occur in patients who have been 
diagnosed with  gastroesophageal reflux disease, also 
known as GERD. Acid  from the stomach rises upward, 
towards the esophagus, and  enters the back of the throat. 
Patients with LPR report  experiencing a bitter taste and 
the feeling that something is  caught in the back of their 
throat. In some cases, LPR can  cause breathing 
difficulties.
Zenker's 
ZenkDer’s iDviveertircutluimc isu a dlisuordmer characterized by 
 the formation of pouches on the esophagus, most  
typically in older people. The pouches vary in size,  
but can cause swallowing problems, irritation,  
regurgitation and bad breath due to food trapped  
within the pouches. Traditional surgical treatment  
for Zenker’s Diverticulum requires an incision in the 
 neck to access the esophagus, resulting in a hospital 
 stay and an inability to eat solid foods until the  
healing is complete. Now, however, minimally  
invasive endoscopic procedures make treatment 
of  Zenker’s Diverticulum much easier. Performed 
on an  outpatient basis, no incision is necessary and  
patients may resume eating food the very next day.
Know About 
A Ccouogh uis ag reahction to an airway irritation. It is  
generally the symptom of an illness or allergy. Some  
coughs are considered productive, which means 
they  help to remove mucus from the lungs usually 
due to  respiratory infections such as pneumonia 
and  bronchitis. Others are considered 
nonproductive, and  these are dry coughs that 
typically occur in response to  exposure to an irritant 
such as smoke or because of a  cold. Coughs may also 
be brought on by persistent  problems including 
asthma, chronic obstructive  pulmonary disease 
(COPD) or gastroesophageal reflux  disease. The type 
of treatment for a cough will vary  depending on its 
cause. Most coughs respond well to the  use of a 
humidifier and increased fluid intake.
Parkinson's Disease 
Related  Voice 
Disorder
It has been estimated that more than 
70% of patients with  Parkinson’s 
disease experience voice and speech 
disorders.  Some report that 
dysphonia, impairment in the ability 
People with Parkinson’s induced dysphonia are 
to  speak normally, is one of the 
described as  having a harsh, weak or breathy quality to 
disease’s most disruptive  symptoms.
their voices. There  are, however, medical and behavioral 
treatments that may  lead to voice improvements. Both 
vocal chord injections and  voice therapy have shown 
some of the most positive results  with the least amount 
of patient discomfort.
Contact 
Us
Coastal Ear, Nose Coastal Ear, Nose Coastal Ear, Nose 
and and and
Throat Throat Throat
Address: 3700 Route Address: 1301 Route Address: 100 
72
33 Commons
Unit 340
Neptune, NJ 07753 Way #210
Manahawkin, NJ 08050 Holmdel, NJ 07733
(732) 280-7855 (main)
(609) 978-0590 (732) 280-7855
(732) 280-7815 (732) 280-7815 (732)-280-7815
For More Details Visit Us:
https://coastalearnoseandthroat.com/services/voice-and-
swallowing/