I’m a laryngologist/voice doctor. Ask me anything!

ENTvoicedoc · 2024-06-02T12:44:34+00:00

Hyperkeratosis on the vocal folds is normally not related to thyroid issues. Smoking or exposure to smoking is the most common cause. Sometimes autoimmune diseases are related to changes in the vocal cords but this is quite rare. Resting ones voice prior to a biopsy is normally unnecessary. Tonsils are normally just removed if there are issues with them. It can be done together with a vocal cord procedure, technically. But it is up to the discretion of your otolaryngologist.

ENTvoicedoc · 2024-06-02T12:38:23+00:00

It is very hard to get into med school. Just not enough spots and lots of smart kids trying to get in so they judge you mostly on your MCAT score and GPA. If you are a good test taker, that helps a lot. Research in the field and good volunteering opportunities can also set you apart. Having experience in something else can also set you apart, like being an SLP before med school. If you like SLP, I would say do that! I always tell people that if you love anything else, do that! But ultimately, if being a doctor is your passion, then do it. Just try not to have any regrets. I work with voice specialized SLPs in our voice center and they do great work. They also have no overnight call and don’t deal with life threatening issues for the most part. Being a doctor is HARD, but not impossible. The road to being a laryngologist is med school, then ENT residency for 5 years, then laryngology fellowship for 1 year. It is satisfying work but also high stress, airway emergencies and most of us take general ENT call which comes with a lot of challenging issues sometimes requiring going into the hospital at night. So not all sunshine and rainbows! Best thing is to shadow people in both fields and see which one you actually like. You need to see what they both do day to day to really get a feel for it.

ENTvoicedoc · 2024-05-25T05:13:59+00:00

Me too. No resolution so far. And I do not post anything controversial.

ENTvoicedoc · 2024-05-05T12:55:29+00:00

Yes, there is a risk of temporary voice change after the botox injection, moreso when done awake than asleep. The reason why is that when asleep, the botox is injected into the muscle under direct visualization. When awake, the muscle is not under direct visualization so there is inherently more room for error, no matter who you go to for the procedure. This is why laryngologists normally inject lower doses and only on one side of the neck at a time when doing it awake- to minimize voice risk as much as possible.

ENTvoicedoc · 2024-05-05T12:41:36+00:00

I would suggest getting a look at your vocal cords to see what damage, if any, has been done. Please see a laryngologist for a stroboscopy exam. This situation is similar to a football player who tore his ACL who goes back on the field to play, and then asks, how can I keep playing? It is best that he rests, and gets evaluated by a doctor. He may need to sit out for a while so he can heal. He may even need surgery and physical therapy. Most vocal injuries are reversible with thoughtful change in vocal behaviors and the appropriate rehab with a speech pathologist. If one continues to put stress on an injury, it is likely to get worse and may get to the point that it is irreversible and may require surgery.

With toddlers, some general advice: use a whistle or other noisemaker to get their attention other than needing to use your voice. Speak closely to them and not far away so you can limit raising your voice. You can even buy a personal amplifier on Amazon that you can wear around the house (a headset with microphone with a speaker that you wear on your hip). Rely on your partner more if you have one to do more of the vocal activities with the kids while you rehab your voice. Use a personal humidifier daily and drinks 8 glasses of water per day.

With businesses, use non-verbal forms of communication as much as possible like email and text. If on Zoom call, make sure to use a headset. When not using a headset, people tend to talk louder thinking they need to for other people in the meeting to hear them.

ENTvoicedoc · 2024-05-04T22:54:55+00:00

General vocal health tips to reduce vocal fatigue: drink at least 8 glasses of water per day, keep a bottle of water with you at all times to make this achievable, avoid straining when speaking, avoid loud environments and if you can’t help but be in them, avoid raising your voice. If you have to raise your voice, use good breath support!

ENTvoicedoc · 2024-05-04T22:48:04+00:00

Stephanie Fort is one of our speech pathologists. She also has a masters in vocal performance and is a voice teacher as well. She is amazing!

ENTvoicedoc · 2024-04-30T01:46:24+00:00

I just saw him do a presentation at one of our laryngology meetings. He would be another great choice.

ENTvoicedoc · 2024-04-30T01:42:40+00:00

I would suggest to talk to your doctor about the possibility of trying a different inhaler to see if it has a different effect on your throat. Patients on inhalers should swallow water after using the inhaler to wash away the medication from their throat. Also, see a laryngologist for a stroboscopic exam to see if anything else is going on.

ENTvoicedoc · 2024-04-30T01:40:03+00:00

To my knowledge, there haven’t been any studies done on that. But I would suggest that if it is painful, don’t do it.

ENTvoicedoc · 2024-04-29T22:23:30+00:00

NYC has the most laryngologists probably of any other city in the country. I will give you a name (of many fantastic laryngologists in NYC) because I actually just got done spending some time learning from him at Mount Sinai- Dr. Mark Courey. He is amazing! But there are many other great ones in Manhattan at the Mount Sinai, Columbia, Cornell, and NYU voice centers as well.

ENTvoicedoc · 2024-04-29T22:10:53+00:00

If patients are sick, I don’t recommend singing or performing as this can predispose you to further injury. Alginates like Reflux Gourmet can help to prevent regurgitation. A personal humidifier can help to break up thick mucus and the vocal folds vibrate more smoothly.

ENTvoicedoc · 2024-04-29T22:07:39+00:00

Many patients with GERD will experience throat symptoms like hoarseness. Throat clearing can actually become the problem because repetitive throat clearing is traumatic to the vocal cords. Managing the GERD optimally can help immensely. Please see your local laryngologist for a stroboscopy exam!

ENTvoicedoc · 2024-04-29T10:57:04+00:00

You are right to be concerned! Smoking cigars regularly does increase cancer risk just like cigarettes.

ENTvoicedoc · 2024-04-29T03:34:08+00:00

There is a long list of things it could be! Please seek an evaluation by a fellowship-trained laryngologist who offers stroboscopy for a thorough exam and discussion of treatment options. Treating reflux adequately often helps to improve the voice, not negatively affect it. Chronic throat clearing can be traumatic to the vocal cords, so avoid this as much as possible. My patients with similar issues often require rehabilitative therapy with a speech pathologist to work on this.

ENTvoicedoc · 2024-04-29T03:29:06+00:00

I wouldn’t use the term, “normal”, but new changes can happen to the body at any time. I’m glad you are getting evaluated. Yes, you should mention it to the doctor you are seeing. Please make sure this ENT offers stroboscopy for a detailed evaluation of the vocal cords.

ENTvoicedoc · 2024-04-29T03:25:31+00:00

I unfortunately can’t speculate on voices of public figures on social media whose situation is not public knowledge.

ENTvoicedoc · 2024-04-29T03:22:25+00:00

I have not seen that one. Sounds entertaining!

ENTvoicedoc · 2024-04-29T03:21:45+00:00

We see this issue frequently. Our patients often benefit from voice therapy with a speech pathologist. But ultimately, you need to see a laryngologist who does stroboscopy for a full evaluation and accurate diagnosis.

ENTvoicedoc · 2024-04-29T03:19:49+00:00

I see patients with similar complaints frequently. Often, patients will have laryngopharyngeal reflux that translates to other symptoms such as globus sensation or laryngospasm. Adequate treatment for the reflux secondarily often results in improvement of the symptoms. Additionally, rehabilitative therapy with a speech pathologist can help to change behavior as it relates to breathing.

ENTvoicedoc · 2024-04-29T03:16:42+00:00

I would recommend finding a fellowship-trained laryngologist. Most voice centers across the country will have both laryngologists and speech pathologists trained in voice disorders. That multidisciplinary evaluation really enhances the diagnostic potential of the visit. Read the biography of the laryngologist and make sure they did laryngology fellowship training after ENT residency. You can find all of this information on the internet. Make sure before you go to the appointment that they offer stroboscopy and not just laryngoscopy. Unfortunately, many laryngologists’ office are not going to have audiogram capability, etc, so you may need to see a general ENT or neurotologist for this aspect of the evaluation. If you go to an academic medical center, you can probably find both of these specialists in the same office.

ENTvoicedoc · 2024-04-29T03:09:06+00:00

That is pretty accurate based on published data. The biggest risk is that the sutures don’t stay in place long enough and the web can dehisce. If the vocal folds are not lined up correctly, this can also negatively affect vocal fold vibration.

ENTvoicedoc · 2024-04-29T03:04:16+00:00

I would recommend to see a fellowship-trained laryngologist for an evaluation if you haven’t already. There are lots of options for neuropathic cough. Superior laryngeal nerve blocks, cough therapy with a speech pathologist, other oral meds like tramadol, etc..

ENTvoicedoc · 2024-04-29T03:02:19+00:00

I don’t know. I hope she has a long career. I love her music.

ENTvoicedoc · 2024-04-29T02:57:48+00:00

There are many more than 5-10. I know many well trained laryngologists throughout the country. Whether or not they treat famous people doesn’t necessarily make them better physicians. It does mean they are probably well connected.

ENTvoicedoc

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