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Voice and Swallowing (Throat Problems)

Diagnostic Tests

The Center offers diagnostic options for papillomas and early stage larynx cancer, and for swallowing and voice problems due to Parkinson's disease, stroke and other neurological disorders.

This state-of-the-art voice center provides the full scope of diagnostic testing including:

  • Videolaryngostroboscopy

    Video laryngoscopy is a form of indirect laryngoscopy in which the clinician does not directly view the larynx. Instead, visualization of the larynx is performed with a fiberoptic or digital laryngoscope inserted through the nose or mouth.

  • Acoustic Analysis
  • A variety of in-office laryngeal procedures

The swallowing center provides comprehensive swallowing evaluation including:

  • Fiberoptic Endoscopic Evaluation of Swallowing (FEES)

    FEES is a procedure that allows physicians to assess areas surrounding the voice box and opening of the esophagus, through the use of a small flexible telescope. The telescope is passed through the nose after anesthetizing this area to minimize pain or discomfort. Once the telescope is in position, you are given various foods to eat. The physician observes and evaluates the swallowing process.

    infographic describing how BMC physicians approach FEES testing
  • Transnasal Esophagoscopy (TNE)

    TNE uses a camera that is passed through the nose as a way to examine the esophagus in patients at risk for esophageal cancer and other disorders. TNE doesn’t require sedation, unlike other techniques widely used to look into the esophagus. 

  • Pharyngeal Manometry

    This test evaluates your swallowing. Pharyngeal and upper sphincter manometry can detect the sphincter’s (muscle that maintains constriction of a natural body passage) failure to relax and assess the coordination between the contraction of the pharynx and the relaxation of the upper esophageal sphincter.

  • Barium Swallow

    A barium swallow (also called a contrast esophagram), is a series of x-rays of your esophagus. For the test, you will drink a barium-containing liquid, which coats the inside of the esophagus and makes its shape and contours appear on x-rays. As the liquid moves from the mouth down to the esophagus, the physician can assess any narrowing, enlargement or abnormalities. You will most likely be asked not to eat or drink for 8 to 10 hours before the test.

  • Esophagram

    An esophagram, or contrast esophagram (also called a barium swallow), is a series of x-rays of your esophagus. For an esophagram, you will be asked to drink a barium sulfate liquid while x-rays are taken of the swallowing process. As the liquid moves from the mouth down to the esophagus, the physician can assess any narrowing, enlargement or abnormalities. You will most likely be asked not to eat or drink for 8 to 10 hours prior to the test.

  • Modified Barium Swallow Study (MBS)

    This test is used to view your swallowing function. You will be asked to swallow a variety of barium-coated substances, such as liquid, applesauce, and a cracker. Barium is a whitish paste that allows the substances to light up under an X-ray so the examiner can determine how these substances are moving through your mouth, pharynx, and esophagus. It is different from a Barium Swallow in that it analyzes the swallowing function, specifically, which the Barium Swallow does not do. You can eat or drink before this exam.

    infographic describing how BMC physicians approach MBS testing
  • Pharyngeal pH Reflux Testing

    Pharyngeal pH monitoring is a test used to evaluate for effects from gastroesophageal reflux disease that could be affecting the throat and result in swallowing, breathing, or voicing problems. This test measures the amount of acid that is refluxed into the throat while the probe is in place. It involves the placement of a tiny probe into the throat that is worn over a period of time. You can breath, talk, eat, and sleep with the probe in place, as it is meant to capture the amount of acid your throat is exposed to during a regular day. Depending on the clinical questions to be answered, the test may include wearing the probe 24-hour or 48-hour period of time. The pharyngeal pH probe is different than an esophageal pH study, which measures acid exposure in the esophagus alone, and not the pharynx. The pharyngeal pH probe is also different from an esophageal Bravo pH study, which also measures acid exposure in the esophagus alone.

Voice Screenings

Performers generally look upon vocal problems with dread. There are few things worse than having to walk in front of an audience with the fear that your voice may not function properly. A routine examination by a voice care team can often make the difference between a successful performance and a canceled one.

The Voice Treatment Program at the Boston Medical Center specializes in state-of-the-art diagnostic and therapeutic services to individuals of all ages who present with a variety of voice disorders. The patients of the voice treatment program include professional and non-professional singers, public speakers, teachers, clergy, attorneys, sales associates and actors.

Seeing a doctor when something is wrong is important before a minor issue becomes a major one.

A voice screening can help:

  • Determine the presence of a potential laryngeal pathology.
  • Determine a risk for throat problems.
  • Provide a baseline image of a healthy larynx to use as a source of comparison if you experience voice problems in the future.
  • Provide education on the normal functioning of the larynx to understand how the voice works, how to control it and to prolong and enhance your career as a professional voice user.
  • Identify habits for optimal vocal use to help you meet the demands of your lifestyle.