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Services We Provide at the Voice Center

University of Pittsburgh Voice Center

An interdisciplinary approach is used in the evaluation and care of patients with voice, breathing, and cough problems. Patients are evaluated by both a laryngologist (ear, nose, and throat surgeon who specializes in voice disorders) and a speech-language pathologist with special training in voice disorders to provide world-class, time-efficient, comprehensive care.

Adult Airway Clinic

Adult patients with complex upper airway stenosis are evaluated in this clinic. Typical diagnoses treated in this clinic are:

  • Subglottic stenosis
  • Posterior glottis stenosis
  • Tracheomalacia
  • Complex tracheotomy care

Awake bronchoscopy can be performed in the office to provide dynamic upper airway evaluation. This multi-disciplinary clinic is made up of laryngologists, a thoracic surgeon, a pulmonologist, and a rheumatologist.

Botulinum toxin injections

Patients with spasmodic dysphonia, essential tremor of voice, and other laryngeal and head and neck neurologic disorders are treated with botulinum toxin injections. Injections are performed in the office and results typically last approximately three months.

Laryngeal Electromyography (LEMG)

Laryngeal EMG is a diagnostic nerve test to evaluate the neurologic status of the nerves innervating the larynx. This test may provide useful information regarding the potential for spontaneous recovery of vocal fold motion in the setting of vocal fold paralysis and often helps in planning the treatment of patients with vocal fold paralysis.

Vocal fold injections

For patients with glottal incompetence (vocal folds do not come together completely), short and long-term injections can be helpful to improve patients’ symptoms. This procedure can be performed either while asleep under general anesthesia or awake under local anesthesia. Patients who are candidates for an awake vocal fold injection in the office may drive themselves to and from the office, to improve convenience.

Laryngeal laser procedures

A variety of laser treatments (including KTP and CO2 laser) can be used to address certain laryngeal disorders, such as recurrent respiratory papillomatosis (RRP), leukoplakia, dysplasia, vascular lesions, and Reinke’s edema. These procedures have traditionally been performed in the operating room but also can be applied safely and successfully in the office setting in certain patients.

Transnasal esophagoscopy (TNE)

Patients with symptoms of acid reflux disease (laryngopharyngeal reflux disease and gastroesophageal reflux disease) and dysphagia can be evaluated with TNE. This awake, outpatient procedure is well tolerated and obviates the need for sedation.

Bronchoscopy

Awake, dynamic upper airway evaluation is critical in the evaluation of patients with certain types of breathing problems of the trachea (windpipe).

Surgery

Our laryngologists provide cutting-edge surgical treatment of laryngeal diseases.

  • Phonomicrosurgery
  • Thyroplasty
  • Vocal fold injections
  • Laryngeal LASER surgeries
  • Open and endoscopic airway surgery
  • Tracheotomy
  • Laryngeal fractures
  • Vocal Fold Lipoinjection

Voice Therapy

Voice Therapy involves a patient-centered treatment method to modify behaviors that contribute to voice disorders or in some other way limit normal voice use. Vocal behaviors causing hoarseness are changed in two major ways: (1) rigorous application of vocal wellness principles and (2) a series of therapeutic techniques specifically designed to change the way the vocal folds vibrate and vocal tract resonates. The purpose of this training is to help a person develop an awareness of the new voice and to differentiate the “new” from the “old” voice. Ultimately, this modified voice quality is integrated into conversational speech in an automatic and consistent manner, without conscious use of the voice therapy technique. Common voice disorders such as vocal nodules or muscle tension dysphonia are generally treated in 3-5 sessions, with a very high success rate.

Singing Voice Therapy

Singing Voice Therapy is a type of vocal rehabilitation for difficulties in the singing voice related to a medical diagnosis. The therapy is done by a singing voice specialist (SVS) who is an experienced singing teacher with additional training and experience in the rehabilitation with injured voices. The singing exercises will vary based on the specific laryngeal pathologies as these relate to the singer’s style of music; all aim to modify muscular coordination by optimizing airflow and vocal resonance. Cough suppression therapy is a treatment for chronic cough.

Learn more about the journey of Pittsburgh Blues Legend Billy Price, who has worked with the University of Pittsburgh Voice team.

Cough Suppression Therapy

Cough suppression therapy involves a series of techniques to decrease the severity, duration, and frequency of chronic cough. An essential part of cough therapy is to encourage the person to recognize the first symptoms of a cough so that they may try to suppress it. The rest of the therapy involves teaching the patients three techniques: 1) how to modify the shape of the throat to decrease the severity, duration, and frequency of chronic cough; 2) coordination and relaxation of the respiratory mechanism and head/neck region; 3) systematically desensitize the patient from potential triggers. The average therapy for most cases varies between 1-3 sessions.

Respiratory Retraining

Respiratory Retraining is a treatment for paradoxical vocal fold motion disorder (PVFMD) and Exercise-Induced Laryngeal Obstruction (EILO). The treatment helps the patient learn how to control their breathing and prevents or minimizes the severity of PVFMD “attacks.” The keys to therapy for PVFMD include muscle relaxation; training an open throat breathing posture, retraining of the breath cycle to increase the individual’s awareness of relaxed rhythmic cycles, and reducing the effort associated with respiration.

Voice and Communication for Transgender and Non-binary People

The UPMC Voice Center provides a welcoming environment for comprehensive assessment and treatment of individuals across the gender spectrum who seek voice and communication training.

Individuals will work one-on-one with a Speech-Language Pathologist (SLP) who specializes in voice to address self-identified communication needs. Your SLP can assist you in addressing concerns regarding the sound and/or feel of your voice as well as making sure it authentically reflects your identity. The UPMC Voice Center provides a welcoming environment for comprehensive assessment and treatment of individuals across the gender spectrum who seek voice and communication training.