When should a hoarse voice be evaluated?

Hoarse voice lasting 2 weeks or more should be properly evaluated. Hoarseness includes alterations in voice quality, pitch, loudness and effort on speaking or singing. There are numerous causes ranging from common cold to voice box tumours. Comprehensive assessment involves taking a history of the voice problems and its degree of disability, and examination of the vocal folds (vibrating part of voice box) and surrounding structures. Detailed examination includes videostroboscopy using a telescope passed through the nose or mouth to visualise the vocal folds and their vibration in slow motion. Other tests sometimes include ambulatory pH monitoring to test for acid reflux and laryngeal electromyography to test nerve function. Dr. Lau manages the full spectrum of voice problems and hoarseness including occupational and professional voice.

What treatments are available for voice problems?

The choice of voice treatment and vocal surgery depend on accurately identifying the cause, and may involve:

  • Medication, including management of acid reflux
  • Speech therapy (we work closely with skilled speech therapists and offer home therapy)
  • Manual therapy (manual release of muscle tension)
  • Psychological therapy in specific instances
  • Botulinum toxin (Botox) injection for spasmodic voice disorders (electromyography guided)
  • Injection medialisation and injection laryngoplasty for vocal paralysis (office-based or in-patient, using a variety of fillers and techniques).
  • Laryngeal framework surgery including medialisation thyroplasty for vocal fold paralysis
  • Surgery for spasmodic dysphonia
  • Microlaryngeal surgery (microsurgery of the voice box) for lesions on the vocal folds.
  • Laser surgery for benign and malignant conditions (e.g. laryngeal papillomatosis and early laryngeal cancer)
  • Outpatient secondary tracheoesophageal puncture (Dr Lau has developed a specialised technique for this)
  • Gender reassignment surgery

Voice disorders are an area of special interest to Dr Lau, who is one of the region’s leading ENT specialists in this field.

What can be done for swallowing and airway (breathing) problems?

The voice box plays a critical role in breathing and swallowing in addition to voice. Dr Lau’s expertise extends to include management of swallowing disorders (dysphagia), and disorders affecting the upper airway such as bilateral vocal fold paralysis, and laryngotracheal stenosis.

Services for swallowing and airway (breathing) problems

Services for swallowing and airway (breathing) problems include:

  • Interdisciplinary assessment
  • Functional endoscopic evaluation of swallowing
  • Transnasal esophagoscopy (in-office examination of food passage and stomach)
  • Swallowing rehabilitation (we work closely with skilled speech therapists and offer home therapy)
  • Preventative swallowing program for patients undergoing radiotherapy
  • Surgical treatment of dysphagia including vocal fold medialisation procedures, cricopharyngeal dilatation, botulinum toxin injection, and endoscopic cricopharyngeal myotomy
  • Surgery for bilateral vocal paralysis (including endoscopic laser surgery & suture lateralisation)
  • Endoscopic laser treatment and dilatation of laryngeal stenosis
  • Open airway reconstruction
  • Small incision tracheostomy and tracheostomy management

Voice, swallowing and upper airway disorders are an area of special interest to Dr Lau, who is one of the region’s leading specialists in this field.

Below are the Throat, Voice and Swallowing services provided in our centre:

  • Comprehensive outpatient assessment and management
  • Sore throats
  • Chronic cough
  • Hoarseness
  • Occupational and professional voice
  • Dysphagia (swallowing difficulty)
  • Stroboscopic laryngeal examination
  • Functional endoscopic evaluation of swallowing
  • Interdisciplinary rehabilitation of voice and swallowing disorders (including home therapy)
  • Transnasal esophagoscopy
  • pH monitoring for acid reflux
  • Diagnostic laryngeal electromyography (EMG)
  • Office-based laryngeal injections including vocal fold augmentation and botulinum toxin (Botox)
  • Removal of foreign bodies e.g. fish bone stuck in the throat
  • Drainage of peri-tonsillar abscess
  • Adult tonsillectomy
  • Vocal fold paralysis (outpatient and inpatient treatment)
  • Surgery for unilateral and bilateral vocal paralysis
  • Surgery for unusual disorders e.g. spasmodic dysphonia
  • Microlaryngeal surgery (microscopic surgery to the larynx)
  • Laser surgery including early laryngeal cancer and laryngeal papilloma
  • Endoscopic and open airway reconstruction
  • Gender reassignment
  • Small incision tracheostomy and tracheostomy management
Kara ThroatSlide1The esophagus and stomach can be examined with a thin flexible endoscope (camera) in the clinic.

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