Speech Pathology

Dysphagia is difficulty swallowing that can affect the mouth, throat or esophagus. Our team specializes in evaluating and treating swallowing disorders.

Common symptoms of dysphagia include:

• Coughing while eating or drinking
• Difficulty starting a swallow
• Feeling of food or liquid “stuck” in the throat
• Pain with swallowing
• Voice changes while eating or drinking
• Food or liquid leaking from the mouth or nose

If you notice these symptoms, ask your doctor for a referral for a swallowing evaluation.

Evaluation

Assessment may include a clinical exam and/or an instrumental study such as video fluoroscopy modified barium swallow study (MBS), which is performed with a moving X-ray) or flexible endoscopic exam of swallowing (FEES), which is done with a small camera.

Treatment

Care may involve swallow strategies, diet modifications, and exercises to improve safety and efficiency.

Inpatient Care

Illness and hospitalization can temporarily affect swallowing. Aspiration (food or liquid entering the airway) can be more serious when you’re sick.

Evaluation begins with a bedside clinical exam. If needed, instrumental testing (video fluoroscopy or endoscopy) will be completed. Afterward, the speech-language pathologist will review results and coordinate care with you and your medical team.

Dysphonia, or voice disorder, can result from muscle tension, vocal fold injury, paralysis or weakness, dystonia, infection or neurological conditions.

Common symptoms of dysphonia include:

• Hoarseness
• Vocal strain or fatigue
• Difficulty projecting your voice
• Reduced pitch range
• Voice that cuts in and out

Evaluation

Assessment includes a clinical exam, laryngeal stroboscopy; which evaluates vocal fold vibration and acoustic measurements to guide treatment.

Treatment

Our team uses specialized techniques to develop a personalized care plan based on your needs.

Specialized Services

Our specialized dysphonia services include:

• Care for professional voice users (e.g., singers, actors)
• Gender-affirming voice therapy

Our team of voice and upper airway speech-language pathologists specializes in treating chronic cough and functional breathing disorders including paradoxical vocal fold motion (PVFM), inducible laryngeal obstruction (ILO) and irritable larynx syndrome.

Evaluation and Treatment

Assessment includes a clinical exam and laryngeal stroboscopy to identify contributing factors. Your care plan will be reviewed with you at the end of the assessment and will guide individualized treatment plan.

Cognitive-communication disorders can occur after neurological changes and may affect attention, memory, problem-solving, and the ability to understand or express ideas. These skills are essential for participating in your care and communicating with others.

Evaluation & Care

If your cognitive-linguistic skills are impacted, our team will complete a comprehensive evaluation and develop a personalized plan to support effective communication and daily functioning.

Treatment for head and neck cancer can affect speech, swallowing and overall function. At Lahey, we provide personalized, whole-person care to address these changes.

We can help with:

• Voice and swallow preservation
• Dysphagia (swallowing difficulty)
• Xerostomia (dry mouth)
• Pain management
• Voice changes
• Muscle stiffness/fibrosis
• Manual lymphedema drainage therapy

Laryngectomy Services

Our laryngectomy services include:

• Pre- and post-surgical counseling
• Electrolarynx training
• Stoma care, including HME fitting and education
• Tracheoesophageal prosthesis (TEP) management

Our speech-language pathology team supports you at every stage of care and recovery.

An MBS is a swallowing test that uses moving X-ray (fluoroscopy) to record how you swallow. The images allow our team to identify the cause of your swallowing difficulty and guide treatment. The study is completed in the Radiology Department by a speech-language pathologist and radiology staff.

Here's what you can expect during your procedure:

• You will sit or stand for imaging of your mouth and throat
• You’ll swallow small amounts of food and liquid mixed with barium (a contrast material)
• The SLP may trial strategies to improve swallowing during the test
• The exam takes about 15 minutes (plan for ~1 hour total for prep and discussion)
• No special preparation needed; continue medications as usual

FEES is a swallowing test that uses a thin, flexible camera passed through the nose to view your throat while swallowing. It helps identify the cause of swallowing difficulties and guide diet recommendations and treatment.

Here's what you can expect during your procedure:

• Performed in the Voice, Speech, and Swallowing Clinic
• Mild pressure in the nose during the exam
• You’ll eat and drink items colored for visibility
• The exam is recorded for detailed review
• The test takes ~10 minutes (plan for ~1 hour total)
• No special preparation needed; continue medications as usual

Laryngeal stroboscopy is a test used to evaluate voice disorders often performed in coordination with Laryngologist. A thin, flexible camera is passed through your nose to view your larynx (voice box). A strobe light lets us see your vocal folds vibrating in slow motion, helping identify the cause of your voice problem.

Here's what you can expect from your procedure:

• Performed in the Voice, Speech, and Swallowing Clinic
• Optional nasal spray (decongestant and numbing medication) for comfort
• Mild pressure in the nose during the exam
• The study is recorded for team review
• No special preparation needed; continue medications as usual