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Information for Professionals FVSSC Offers Enhanced Resources For Your Patients / Students With Voice Disorders If you are new to Illinois, contact the Illinois Speech-Language-Hearing Association: Phone: 312-644-0828 E-mail: ckeillor@bostrom.com Website: www.ishail.org An ENT examination determines laryngeal pathology. An examination by a licensed speech-language pathologist (SLP) evaluates laryngeal function for voice production. Referrals to FVSSC may be made for: Voice Analysis and Therapy Voice Analysis, Recommendations & Goals (therapy to be provided elsewhere) Voice Analysis & Initial Therapy (carry-over therapy to be provided elsewhere) Laryngeal Video Endo-Stroboscopy Referrals to FVSSC are indicated for: Anyone with Complaints of voice difficulty (regardless of perceptual judgment or normal laryngeal exam) Patients who are At risk for further injury (pre-/post-surgery and/or known pathology) Voice quality that draws Negative attention The Voice Analysis, performed by a licensed SLP, is a 4-part procedure* designed to objectively and subjectively evaluate voice production, identify/confirm the cause of the voice disorder and plan the most efficient management approach. * The combination of these four approaches yields the accepted standard for the evaluation of voice as suggested by the International Association of Logopedics and the American Speech-Language and Hearing Association (ASHA). (1) HISTORY & ORAL EXAMINATION A complete medical and social history is taken. An oral exam determines the adequacy of the anatomy and physiology of the speech production mechanism. (2) PERCEPTUAL VOICE EVALUATION The appropriateness of respiration, phonation, resonance, pitch, loudness, muscle strength, and tone and rate of speech are all judged perceptually. (3) OBJECTIVE ANALYSIS The computerized phonatory function test assesses the acoustics of vocal fold function. It provides the SLP with measures of fundamental frequency (pitch), range, perturbation, intensity, and noise to harmonic ratio. Other indicators of glottal efficiency include aerodynamic measures such as subglottic pressure, phonation time and respiratory support for speech. (4) VISUALIZATION Laryngeal Video Endo-Stroboscopy (LVES) is necessary in some cases because abnormal vocal fold vibration is an etiological factor in voice disorders. LVES, using a voice-activated stroboscopic light, gives a magnified view of the pattern of vocal fold movement. This enables assessment of 1) synchrony, 2) amplitude, 3) periodicity, 4) integrity of the mucosal wave, and 5) glottic closure. LVES provides a pre- and post-treatment videotaped record. It may also be used for educational counseling and biofeedback in therapy thus increasing understanding and compliance. When the Voice Analysis is completed, a written report with recommendations is sent to you. If LVES was done, the videotape is always reviewed by a physician before results are provided. (Referring agents may receive a photo.) Indicators For Laryngeal Video Endo-Stroboscopy Persistent, unexplained hoarseness (minimum three weeks' duration) with normal appearing larynx during otolaryngologist's indirect examination. Unclear distinction between possible structural and functional causes of the voice disorder. Selection of appropriate medical or rehabilitative treatment plan cannot be determined without proper identification of the changes in the vocal fold vibratory pattern that have disrupted phonatory quality. Whenever phonosurgery is contemplated: to determine the exact pre-operative plan for changes in laryngeal framework or vocal fold structure, post-operative follow-up to determine success of surgical procedure. When additional information is needed about laryngeal and vocal fold function for patients who are professional voice users. When videostroboscopy is not utilized as part of the initial examination, and predicted voice improvement has not been demonstrated after three sessions of voice therapy, even though the patient is compliant. FREQUENTLY ASKED QUESTIONS Will insurance cover Voice Analysis and/or Rehabilitation by a licensed SLP? Usually – individual contracts vary; patients should check with the carrier prior to the appointment. Physician referral and/or pre-authorization may be required. Can patients be referred directly or should they be sent to an ENT doctor first? A patient may receive a voice evaluation by a licensed SLP prior to a medical examination. Patients are referred to an otolaryngologist before therapy is initiated. (Insurance contracts may require physician referral - see above.) Should a letter or records be sent prior to the evaluation? It is always helpful to have the referring diagnosis as well as information on previous treatment. What is the duration of voice therapy? Most therapy requires three to five 45-minute sessions. Some patients need only one session, others as many as twelve. What is the nature of voice therapy? Depending on individual needs patients may receive: 1) educational counseling, 2) specific exercises to address their pathology, 3) biofeedback, 4) establishment of a home/school program, 5) visualization of the larynx during vocalization. If you have more specific questions about FVSSC, please: contact the Center here. FVSSC HOME PAGE VOICE  |  ARTICULATION  |  STUTTERING  |  LANGUAGE  |  SWALLOWING SPECIAL FEATURES  |  OTHER SERVICES  |  LOCATION  |  BILLING  |  PERSONNEL © 2010, Fox Valley Speech and Swallowing Center, LLC - Specializing in Voice, Speech Production, and Swallowing -  Do you have more questions about FVSSC? Check the FAQ. Would you like to contact FVSSC directly? Please read this.

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