Voice & Swallowing Disorders 

Our office specializes in the diagnosis and management of patients with voice, airway, speech and swallowing problems.

Voice Care

Professional voice users such as teachers, telephone operators, physicians, singers and actors depend on their voices in their vocation. Disturbances of the voice – such as vocal fold paralysis, laryngopharyngeal reflux and airway stenosis – can signal serious illness, alter quality of life and cause occupational disability. Voice care at our office is tailored to your acute needs and long-term goals.

Swallowing Care

Swallowing is a complex function involving the mouth, throat and esophagus. Common swallow complaints include chronic cough, gagging and choking, aspiration, painful swallowing and a feeling of a lump in the throat. Stroke, gastroesophageal disease (GERD) and cervical spine disease can also affect your swallowing function. Dr Srour will evaluate your condition and provide the right treatment plan for you. 

New treatment methods

Our office is also involved to integrate new treatment methods for voice and swallowing disorders, including vocal cord lesions & paralysis, spasmodic dysphonia,  chronic cough and aspiration ( a condition where food passes to airway instead of the digestive tract )

Videostroboscopy for the Larynx

Videostroboscopy fulfills several important requirements of a complete voice examination. It provides useful, real-time information concerning the nature of vibration, an image to detect vocal pathology, and a permanent video record of the examination. As important as any of these aspects, stroboscopy substantially improves the sensitivity of subtle laryngeal diagnoses over techniques, such as rigid or flexible transnasal laryngoscopy, with continuous light sources.

Conditions That we treat 

•Hoarseness & laryngitis 
•Effortful or painful speech 
•Vocal fatigue 
•Inability to project Voice
•Frequent throat clearing 
•Persistent voice changes, instability or cracking 
•Strained or strangled voice 
•Breathy or soundless voice 
•Low, raspy or rough voice 
•Wobbly, shaky or irregular voice 
•Double or “gargle” voice 
•Age-related vocal changes 
•Persistent choking or coughing 
•Neurological voice disorders 
•Polyps, cysts, nodules & lesions 
•Vocal-fold impairment, paresis & paralysis 
•Laryngeal cancer 
•Laryngopharyngeal reflux 
•Swallowing difficulty 
•Intubation trauma

Hoarseness & Chronic Cough 
Voice is a part of our identity, like finger prints. Losing a speaking or a singing voice is detrimental for the quality of life. Chronic cough is embarrassing and annoying for patients and their surroundings. Chronic cough can lead to social isolation, hernias, ribs fracture, damage to vocal cords and loss of bladder control. Chronic cough often coexists with vocal cords problems and hoarseness .
Most causes of hoarseness and cough are not serious and tend to go away in a short period of time. If they  persist for more than 1-2 weeks the cause needs to be identified and treated before permanent damage take place.  Most common causes of hoarseness reflux disease, post nasal drip and vocal cord damage from prolonged vocal abuse. Other causes are benign lesions like nodule and warts on the vocal cords. Most common causes for chronic cough are allergies, asthma and Reflux disease. Many times more than one factor can be identified. Malignant lesions, although rare, always needs to be excluded especially in smokers and alcohol consumers.
The typical examination for hoarseness and chronic cough includes a full head, neck and chest exam as well as visualization of the vocal cords. Video-stroboscopy, a high speed camera connected to a scope that goes down gently through the nose to see the vocal cords. Vibration of the cords is too fast to be seen by a human eye. With the use of high speed camera, a video of the vibrating cords is taken and reviewed by the doctor in slow motion to identify the problem. 
Medical treatment is successful in most cases after identification of the cause, this could be combined with speech therapy ( voice exercises ). If medical treatment failed, procedures on the vocal cords will help restoring normal function. Procedures can be either with removal of the lesions or restoring normal function by injecting medication in the vocal cords.

Vocal Cord Injections
Dr. Srour has been performing Vocal Cords Injections for more than 10 years. There are an  extensive number of conditions that can be treated with different types of injections.  

 
Vocal cord paralysis (or weakness) can be caused by aging process, intubation, thyroid and neck surgery and stroke. Patients with this problem often also have difficulty protecting their airway during swallowing and can aspirate food which can lead to repeated chest infections. This is one of the most common reasons for chronic cough. A procedure can be done to augment the vocal cord and to restore the normal position and volume of the vocal cords.  A vocal cord injection with a filler, similar to collagen, can offer up to 2 years of good voice quality and protection of the lungs from aspiration. This is the same filler material that we use for cosmetic enhancement of the lips and cheeks.

 Spasmodic Dysphonia, is a condition were the vocal cord muscle is very tense and spastic. Patients will have a strangulated and rough voice. Botox injection to the vocal cords will help to relax the spasm and allows normal speech. Botox injection also could be used for treatment of chronic cough.

Laryngeal Warts ( Recurrent Laryngeal Papillomatosis) , is a condition where the Wart virus reached the vocal cords. Lesions will affect voice, swallowing and breathing. Vocal cord injection with specialized medicine and laser treatment is the best option of treatment.

Dr Srour has performed hundreds of successful cases of vocal cord injection with no complications. The procedure is fast, takes only few minutes, with no recovery time. This procedure has been very rewarding for the patient's life style and is covered by health insurances. For more information or consultation you can call Dr Srour's office at 717-62-2221.
When should I see an otolaryngologist (ENT doctor)?
       Hoarseness lasting longer than two weeks especially if you smoke
       Cough persists for more than 2 weeks
       Unexplained coughing up blood
       Difficulty swallowing or noisy breathing

       Lump in the neck or the throat