Authors (including presenting author) :
Kwan KCP(1), Choi NSF(2), Cheung CSA(1), Tong FM(1), Ngan YHC(3), PUN YHE(2)
Affiliation :
(1)Department of Ear, Nose and Throat, Pamela Youde Nethersole Eastern Hospital
(2)Department of Speech Therapy, Pamela Youde Nethersole Eastern Hospital
(3)Department of Speech Therapy, Ruttonjee & Tang Shiu Kin Hospitals
Introduction :
The diagnosis of some voice disorders are challenging. They can only be accurately diagnosed after comprehensive evaluation including subjective perceptual analysis by experienced professionals, often a team comprised of otorhinolaryngologist and speech therapist highly specialized in the field of laryngology and speech and language pathology. Useful operative treatment and voice therapy can be offered to these patients according to the diagnosis. Before the start of this project, most patients with voice disorders were assessed by otorhinolaryngologists of different experience level in general clinic and were then assessed and managed by speech therapist in other separate sessions. Accurate diagnosis and the effective treatment of certain challenging voice disorders were occasionally missed or delayed.
Objectives :
Enhance the quality of diagnosis and management to patients with challenging voice disorder and facilitate staff professional training in this highly specialized area in ENT and Speech Therapy services
Methodology :
Patients with challenging voice disorders attending ENT general clinic and speech therapy session were identified and referred to an enhanced combined voice clinic attended by both experienced laryngologist and speech therapist. Comprehensive pre-clinic voice assessment including acoustic evaluation, aerodynamic evaluation, perceptual analysis and voice recording would be performed. Systematic assessment including videoendoscopic and stroboscopic assessment would then be done in the combined voice clinic. According to the diagnosis and assessment results, multidisciplinary management plan would be tailor-made and offered to the patient.
Result & Outcome :
59 patients with challenging voice disorders attended during the project period. Diagnosis made included spasmodic dysphonia, muscle tension dysphonia, vocal tremor, glottic insufficiency, vocal nodules, Laryngopharyngeal reflux with pseudosulcus and infiltrative cancer of larynx. Some of these diagnoses were significantly different from the initial diagnosis or impression made by the referring doctors. Medical treatment, surgical procedures (including injection augmentation of vocal folds and laryngeal Botox injection) and individualized voice therapy were offered to these patients accordingly.
Co-location with:
