Laryngology Surgery & Voice Care

Thorough history on voice usage, frequency, duration, and severity of voice change will be documented.  These include its first occurrence, progression, relieving and worsening factors, and how much it affects the patient's job or their quality of life.  Voice Handicap Index (VHI) [Jacobson, Johnson, Grywalski, et al.] is commonly used to describe the voice and its effects on patient's lives.  Excessive or prolonged talking, talking in a noisy environment, and continued talking during viral laryngitis are amongst the known adverse factors. 

Associated symptoms are difficulty in swallowing, feeling of lump in the throat, throat constriction or strangled sensation, frequent throat clearing, choking or coughing upon drinking or eating, noisy or difficulty in breathing, fever, neck lump, and loss of appetite or weight. 

Inadequate fluid intake and caffeinated drinks can potentially predispose or exacerbate conditions like reflux laryngitis, contribute to dryness, and could affect healing process after laryngeal surgery. 

Smoking and alcohol intake are important social habits which need to be addressed and tackled wisely.  It predisposes to reflux laryngitis, chronic laryngitis, leukoplakia, and malignant change.

Anxiety, stress, depression, and other psychiatric disorders can contribute or precipitate dysphonia and need to be determined.  Muscle tension dysphonia and functional aphonia are some relevant example to the afore-mentioned conditions.

Chronic medical conditions and past surgical history such as thyroidectomy, neck and chest operation, and endotracheal intubation will be documented. 

Audio recording upon reading the standard “rainbow passage” and video recording of endoscopic findings are usually done in established voice centre for the purpose of detail voice analysis, documentation, and as bio-feedback materials during follow-up sessions.