The Voice Disorders Center at University of Utah Health provides many management options for voice disorders (behavioral, pharmaceutical, surgical). Our team of specialists is trained in the latest technology in voice, airway, and swallowing disorders.
We treat the following conditions:
- Airway disorders
- Laryngeal papillomatosis
- Laryngeal dysplasia/cancer
- Spasmodic dysphonia
- Vocal fold paralysis
Our services include the following:
- Speech pathology
- Office stroboscopy and endoscopy (larynx, airway, esophagus)
- Office-based procedures of the laryngopharynx
- Vocal fold injection
- Vocal fold microsurgery
- Spasmodic dysphonia care botulinum toxin therapy (vocal fold, jaw, and face)
- Vocal fold paralysis management laryngeal electromyography (EMG)
- Vocal fold reconstruction
- Microsurgery and laser surgery
- Singing voice diagnosis
Schedule an Appointment
We look forward to providing you with an array of voice care services and working closely with your practice. Please fill out our online referring physician information form link to ent physician referral form or referrals can be faxed to this number: 801-587-3569.
What are some examples of voice, airway, and swallowing disorders?
Examples of voice disorders include recurrent laryngitis, vocal fold paralysis, presbylaryngis (aging voice), papilloma, cancer of the vocal folds, benign essential tremor, vocal fold web, muscle tension dysphonia, spasmodic dysphonia, and benign vocal fold growths, such as polyps, nodules, cysts, and granulomas.
There are also breathing disorders that are related to the larynx (voice box), such as paradoxical vocal fold motion (also known as vocal cord dysfunction, laryngospasm), or disorders of the trachea (wind pipe), such as subglottic or tracheal stenosis. These disorders may or may not affect the voice, but are also treated at our center.
Swallowing disorders, also called dysphagia (dis-FAY-juh), can occur at different stages in the swallowing process: oral phase (mouth), pharyngeal (throat) phase, or esophageal (swallowing tube from throat to the stomach) phase and are evaluated and treated in our center. Individuals with chronic cough are also often seen in and treated in our clinic.
What are the symptoms of most voice, breathing, or swallowing problems?
Hoarseness is one of the most common symptoms of voice problems. Other common symptoms of voice disorders include effortful talking, persistent pain or sore throat with voice use, shortness of breath while speaking, reduced volume, reduced vocal endurance, chronic throat clearing, and chronic cough with or without coughing attacks.
Dyspnea (shortness of breath or difficulty breathing) with inhalation, inhalation and exhalation, and/or without exertion but with symptoms of noisy breathing (wheezing/stridor), and throat tightness are symptoms of individuals with breathing difficulties. These are airway disorders, which we also treat.
Coughing during or right after eating or drinking, a wet or gurgly sounding voice during or after eating or drinking, extra effort or time needed to chew or swallow, food or liquid leaking from the mouth or getting stuck in the mouth, throat or chest, recurring pneumonia or chest congestion after eating, and weight loss or dehydration from not being able to eat enough are symptoms of swallowing disorders.
How are voice, airway, and swallowing disorders treated?
The Voice Disorders Center provides a number of different behavioral, pharmaceutical, surgical, and medical management options. A thorough evaluation and proper diagnosis are necessary prior to treatment planning.
For New Patients
To make your appointment the most effective, please read the following information. If you are being seen for breathing problems or cough, be sure to read the "What to Expect" section below.
Forms for new patients are also provided. Note that there are separate/additional forms for patients with breathing, coughing, and/or swallowing symptoms.
What to Bring
- Driver’s license or photo ID
- Insurance card
- Any medical records that are applicable for your appointment (these can be faxed to 801-587-3569)
- List of current medications
- New patient forms
- Copies of previous CT or other imaging scans (on disc), breathing test results and/or swallow studies (on disc), if applicable
- Foods/liquids that cause difficulties (read "What to Expect" below), if being seen for swallowing
What to Expect
You will be seen by an otolaryngologist (ear, nose, and throat physician) and speech pathologist with expertise in voice, upper airway, and swallowing disorders. If you are a singer, please inform us when you schedule your appointment so that you will see the singing voice specialist as well. We will ask you questions about your history of voice, breathing, and/or swallowing problems. If you are being seen for a voice problem, we will identify your current vocal demands. We will ask you to perform a number of tasks that require you to use your voice in different ways. We will also record your voice during these tasks.
For breathing problems, we may attempt to provoke your breathing problems by walking/running on a treadmill or by presenting strong odors/perfumes, if applicable to your symptoms. If you have a specific trigger for your breathing problems, please bring it with you during your appointment, if possible.
If you are being seen for a swallowing problem, an in-office swallow evaluation will be performed. If you have certain type of food or liquid that you have problems swallowing, please bring it with you to your appointment.
Laryngostroboscopy (laryngoscopy with a strobe light) is necessary to clearly identify any lesions or growths on your vocal folds as well as any abnormal vibratory patterns. Rigid or flexible endoscopes are used during this examination. Laryngoscopy is also used to assess upper airway breathing problems and swallowing problems affecting the throat. This is not a painful procedure and most individuals report little or no discomfort. We can use topical anesthetic as needed. You will be able to eat, drink, drive, and return to home or work following your appointment.
The entire care team will explain the results of testing to you and will allow you time to ask questions. We will provide you with treatment options and explain the benefits and potential risks of each option. We may also refer you for further testing. If additional testing is needed, our office will help you schedule those appointments.
Singing Voice Services
If you are a singer or if your singing voice is of concern to you, our Singing Voice Specialist (SVS), Faye Muntz, MM, will see you during the initial evaluation with the voice team. An SVS provides a separate focus from a singing coach or teacher. She has expertise in the rehabilitation of singing voices, which is usually outside the scope of regular voice lessons. Faye has extensive experience and expertise in rehabilitating singers who have suffered laryngeal injury or muscular imbalances. Frequently the voice teachers in the community refer their students to be seen by Faye when they have concerns. Faye’s evaluation and recommendations are necessary in order for us to provide an accurate treatment plan for you.
Singing voice services are not covered by insurance and fees are due at the time of your appointment. Most of the patients who are singers require sessions with our singing voice specialist, and we find that it is actually less expensive and time-consuming for the singer if the singing voice specialist is present at the initial evaluation.
Faye Muntz received a BA degree from the University of Cincinnati as a voice major at the College-Conservatory of Music and her master’s degree in vocal performance with a pedagogy emphasis from Southern Illinois University at Edwardsville. Before moving to Salt Lake City, she was a featured soloist and professional member of the Bach Society of St. Louis and has produced and directed several musical productions there. She has served as a clinician and lecturer for the Salt Lake Jazz Festival, given lectures on vocal hygiene at the University of Utah School of Music as well as at Utah State University, performed in the Temple Square Artist Series concerts, and judged local, regional, and national vocal competitions for numerous organizations, including the Utah Symphony-Utah Opera Salute to Youth competition.
She has been the singing voice specialist for University of Utah Health Voice Disorders Center, a vocal teacher, and has continued her education through clinical observation, seminars, coursework, and workshops throughout the country since 2000.
For Professional Voice Users
People who use their voice for a living are more at risk for developing voice problems. Occupations that require significant voice use include the following:
- Customer service
Avocational Voice Use
Recreational activities can also be vocally demanding:
- Sporting events (yelling at the football game)
- Public speaking
- Volunteer work (that requires extended voice use)
- Voice problems
- Hoarseness or undesirable voice quality
- Vocal fatigue (voice wears out or worsens with use)
- Fluctuating voice quality
- Reduced volume or pitch flexibility
- Pain or soreness associated with voice use
Cause for Concern?
Any sudden or severe voice changes should be evaluated immediately. Gradual onset of hoarseness, vocal fatigue, or other symptoms of laryngitis that persist for longer than three weeks should be evaluated as well.
Increased Vocal Demands
- Any profession that requires three or more hours of speaking or singing per day is considered to be vocally demanding.
- Greater stress on the voice occurs when working in noisy environments such as construction sites, factories, or classrooms.
- Speaking or singing for greater than one hour at a time is also considered to be extended voice use.
- Even highly trained voice users (professional singers, actors) can develop voice problems, despite good vocal technique.
Vocal Cord Disorders
What are vocal cord disorders?
The vocal cords (also called vocal folds) are 2 bands of smooth muscle tissue found in the larynx (voice box). The larynx is set in the neck at the top of the trachea (windpipe). The vocal cords vibrate and air passes through the cords from the lungs to produce the sound of your voice. The sound is then sent through the throat, nose, and mouth, giving the sound "resonance." The sound of each person's voice is determined by the size and shape of the vocal cords and the size and shape of the throat, nose, and mouth. Vocal cord disorders affect the vocal cords.
Some of the more common vocal cord disorders include the following.
Laryngitis causes a raspy or hoarse voice due to inflammation of the vocal cords. Laryngitis can be caused by excessive use of the voice, infections, inhaled irritants, or gastroesophageal reflux (GERD, or heartburn).
Vocal nodules are noncancerous growths on the vocal cords caused by vocal abuse. Vocal nodules are often a problem for professional singers. The nodules are small and callous-like. They most often grow in pairs (one on each cord). The nodules most often form on parts of the vocal cords that get the most pressure when the cords come together and vibrate. Vocal nodules cause the voice to be hoarse, low, and breathy.
A vocal polyp is a soft, noncancerous growth, similar to a blister. Voice polyps cause the voice to be hoarse, low, and breathy.
Vocal cord paralysis
Paralysis of the vocal cords may happen when one or both vocal cords doesn’t open or close properly. A common disorder, this condition can range from relatively mild to life-threatening. When one or both vocal cords are paralyzed, food or liquids can slip into the trachea and lungs. A person may have trouble swallowing and coughing. Vocal cord paralysis may be caused by the following:
Treatment may include surgery and voice therapy. Sometimes, no treatment is necessary and a person recovers on his or her own.
What causes vocal cord disorders?Vocal cord disorders are often caused by vocal abuse or misuse. This includes excessive use of the voice when singing, talking, coughing, or yelling. Smoking and inhaling irritants are also considered vocal abuse.
What are the symptoms of vocal cord disorders?Symptoms vary, based on the type of vocal cord disorder. They include changes in your normal voice such as: a raspy or hoarse voice; or, a hoarse, low, and breathy voice. Vocal cord paralysis may also cause trouble swallowing and coughing.
How are vocal cord disorders diagnosed?
Any hoarseness or change in voice that lasts longer than 2 weeks should be brought to the attention of your healthcare provider. (Sometimes the hoarseness may be from laryngeal cancer.)
In addition to a complete medical history and physical exam, the healthcare provider may examine the vocal cords internally with a small scope called a laryngoscope. In the case of paralysis, your healthcare provider may also do a laryngeal electromyography that measures the electrical current in the vocal cords.
How are vocal cord disorders treated?
Vocal cord disorders caused by abuse or misuse are easily preventable. In addition, most disorders of the vocal cords can be reversed. Your healthcare provider will figure out the best treatment based on:
- How old you are
- Your overall health and medical history
- How sick you are
- How well you can handle specific medicines, procedures, or therapies
- How long the condition is expected to last
- Your opinion or preference
Treatment may include any of the following:
- Resting the voice
- Stopping the behavior that caused the vocal cord disorder
- A referral to a speech-language pathologist who specializes in treating voice, speech, language, or swallowing disorders
- Surgery to remove growths
Key points about vocal cord disorders
- Vocal cord disorders can affect your voice or ability to talk.
- Some of the more common vocal cord disorders include laryngitis, vocal nodules, vocal polyps, and vocal cord paralysis.
- Vocal cord disorders are often caused by vocal abuse or misuse.
- Symptoms may include a raspy, hoarse, low, or breathy voice, or trouble swallowing or coughing.
- Any hoarseness or change in voice that lasts longer than 2 weeks should be brought to the attention of your healthcare provider.
- Vocal cord disorders caused by abuse or misuse are easily preventable.
Next stepsTips to help you get the most from a visit to your healthcare provider:
- Know the reason for your visit and what you want to happen.
- Before your visit, write down questions you want answered.
- Bring someone with you to help you ask questions and remember what your provider tells you.
- At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
- Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
- Ask if your condition can be treated in other ways.
- Know why a test or procedure is recommended and what the results could mean.
- Know what to expect if you do not take the medicine or have the test or procedure.
- If you have a follow-up appointment, write down the date, time, and purpose for that visit.
- Know how you can contact your provider if you have questions.