Speech

Our Speech Pathologists offer more than just speech therapy; they offer restored communication. Following an evaluation with your physician, our Speech Pathologists work with you in the assessment and treatment of voice disorders, swallowing disorders, and post-laryngectomy voice restoration. Each of our Speech Pathologists holds a master's degree in speech pathology with Certificates of Clinical Competency. They are also licensed by the Commonwealth of Pennsylvnia. Whether you are experiencing a change in your natural voice, difficulty swallowing, or require management of post-laryngectomy communication, our speech pathologists will assist in managing your medical care as well as guide you towards the achievement of your communication goals.

What is Speech/Voice Therapy?
Speech/voice therapy is a physical rehabilitation program to improve function of the larynx (voice box).  Voice therapy is usually recommended by your physician to facilitate recovery of adequate function of the voice.  Changes in the structure or function of the voice box can alter the way that the vocal folds/larynx work and can result in symptoms such as:

• Hoarseness
• Throat Soreness/tightness
• Decreased pitch range
• Difficulty projecting the voice
• Decreased Vocal Endurance
• Vocal Weakness

In most cases, the above symptoms are preceded by an exacerbating event, which may include: increased acid reflux, excessive voice use, upper respiratory infections/colds, surgery, and the aging process.

WHO: At Metropolitan ENT Associates, your speech therapy will be performed by a licensed Speech Pathologist who has extensive training and experience in the treatment of voice disorders.

WHEN: Speech therapy sessions are usually scheduled once a week for approximately 8 weeks (based on individual progress).  The therapy sessions last 30 minutes each and are one-on-one with the therapist.  Early morning and late afternoon appointments are available.

WHERE: Speech therapy services are offered in our North Hills Passavant, Wexford, and Allegheny offices.

HOW: When speech therapy is recommended by your physician, Metropolitan ENT Associates will start the process by attempting to contact your insurance company to obtain your speech therapy benefits.  Speech therapy coverage varies with your individual insurance plans.  You are encouraged to contact your insurance coordinator as well to discuss your benefits for therapy.  This can be further discussed when you are contacted by our speech services coordination to schedule appointments.  This process usually takes two weeks from the time therapy is recommended.

What is a VIDEOSTROBE?
A videostrobe may be recommended by your physician to assess the structure and function of the larynx (voice box).  This procedure involves utilizing a strobe light and a high level of magnification to visualize the vocal cords and surrounding structures.  At Metropolitan Ear, Nose and Throat Associates, the videostrobe will be performed by a licensed Speech Pathologist.  No special preparation is necessary for this examination. 

Videostroboscopy is performed by inserting a rigid scope towards the back of the patient’s mouth.  Videostroboscopy is painless and NOTHING IS INSERTED INTO OR DOWN THE THROAT.  If necessary, a topical anesthetic may be applied to inhibit a strong gag reflex (this effect lasts for approximately 10 minutes).  The examination is video recorded utilizing a camera that is attached to the scope.  The video recording allows your medical team to save the examination for future reference.

Indications for Videostroboscopy:

• Hoarseness
• Cough
• Lump in the Throat Sensation (Globus)
• Swallowing Difficulties (Dysphagia)
• Throat Pain or Tightness
• Throat Clearing
• Assessment of Laryngopharyngeal Reflux Changes
• Documentation of Laryngeal Function Prior to Surgery

What is a Swallowing Assessment?
A Swallowing assessment may be recommended by your physician given complaints of dysphagia (swallowing dysfunction) or indications of aspiration (food/liquid goes down the wrong way).  The assessment is completed by both a licensed Speech Pathologist and your physician.

Indications for Swallow Evaluation:

• Recurrent pneumonia
• Food sticking
• Increased cough or throat-clear while eating/drinking
• Weight loss
• Shortness of breathing while eating/drinking
• Food pocketing in oral cavity

A swallowing assessment may include a clinical swallow evaluation in which a Speech Pathologist administers varying consistencies and observes swallow function. A FEES (Fiberoptic Endoscopic Evaluation of Swallowing) may also be recommended.  This examination utilizes a flexible endoscope which is passed through the nose and into the throat. The larynx (voice box) is visualized while eating and drinking varying consistencies. Compensatory strategies will be attempted to improve swallow function during both assessments.

What is Swallowing Therapy?
Swallowing treatment may be recommended by your physician based upon swallowing assessment results and patient reported symptoms.  Swallowing treatment may include training compensatory strategies to improve swallow function and safety, which may include utilizing specific positions or maneuvers while eating and drinking.  Treatment may also include therapeutic techniques and exercises to improve strength and function of swallowing mechanism.  Finally, your Speech Pathologist may recommend diet manipulation which involves altering the consistencies of food and liquids to prevent/decrease aspiration and dysphagia.

WHO: At Metropolitan ENT Associates, your swallowing therapy will be performed by a licensed Speech Pathologist who has extensive training and experience in the treatment of swallowing disorders.

WHEN: Swallowing therapy sessions are usually scheduled once a week for approximately 3-8 weeks (based on individual progress).  The therapy sessions last 30 minutes each and are one-on-one with the therapist.  Early morning and late afternoon appointments are available.

WHERE: Swallowing therapy services are offered in our North Hills Passavant, Wexford, and Allegheny offices.

HOW: When swallowing therapy is recommended by your physician, Metropolitan ENT Associates will start the process by attempting to contact your insurance company to obtain your speech therapy benefit.  Therapy coverage varies with your individual insurance plans.  You are encouraged to contact your insurance as well to discuss your benefits for therapy.  This can be further discussed when you are contacted by our speech services coordinator to schedule appointments.  This process usually takes two weeks from the time therapy is recommended.

What is Post-Laryngectomy Voice Restoration?
Post-laryngectomy voice restoration typically involves a TEP (tracheoesophageal puncture) and placement of a one-way speaking valve known as a voice prosthesis.   This voice prosthesis allows air to be directed into the esophagus for voicing, while at the same time protects material from entering the airway during eating and drinking.  At Metropolitan ENT, the prosthesis will be placed by a licensed Speech Pathologist who has extensive training and experience in the treatment of voice restoration and TEP placement/management. At Metropolitan ENT we place InHealth and Provox products.

Additional TEP treatment is available and includes: education and use of an HME (Heat and Moisture Exchange) as well as Hands Free Speech device training.  These systems can greatly improve the quality of life for an individual with a TEP voice prosthesis by decreasing mucous production and improving voicing.  These devices are worn over the tracheostoma.

Voice restoration may also include use of an electrolarynx, which is a hand-held sound generating device placed on the neck or in the oral cavity.  The device transmits vibration which is then articulated into speech.