Breathing & Swallowing Conditions

Breathing Conditions
Swallowing Conditions

Important Functions of the Vocal Folds (vocal cords)

The vocal cords are the “gateway” to your trachea (windpipe) and lungs. The larynx is a complex and dynamic organ comprised of muscle and cartilage. The vocal cords are housed within the cartilages of the larynx and are responsible for these important functions:

• giving us the “sound” behind our speech and singing
• protecting our lungs from food, liquid, and saliva when we swallow
• opening for us to take air into the lungs.

Certain medical conditions which affect the vocal cords can lead to breathing and/or swallowing difficulties. Here are a few examples:

Breathing Conditions (Related to the Larynx):

For many people, a primary care or family physician may treat their breathing condition. Others will see a pulmonologist (lung specialist), allergist, or cardiologist (heart specialist) to treat shortness of breath and other breathing conditions.

However, occasionally the breathing difficulty arises from the upper trachea, larynx (voice box including the vocal cords), or the pharynx (throat). When this happens, voice specialists will treat the condition.

Some examples of conditions in the “upper airway” treated by the Duke Voice Care Center include:

• Vocal Cord Dysfunction …learn more about VCD
• Subglottic stenosis
• Tumors in the Throat (link to Laryngeal Cancer)
• Respiratory & Laryngeal Papillomatosis
• Bilateral Vocal Cord Paralysis
  

Swallowing Disorders (Dysphagia)

Swallowing disorders can be broken down into 2 main origins:

• Oropharyngeal Dysphagia: Any problem in swallowing resulting from impairment in the sensation, coordination, or strength of the muscles in the mouth, throat, and larynx (voice box). Aspiration (entry of food, liquid, saliva, etc into the trachea) can occur and can lead to pneumonia and malnutrition.
• Esophageal Dysphagia: Any problem with transit or motility/movement of food/liquid from the food tube or esophagus or any problem with food/liquid coming back into the esophagus from the stomach.

Evaluation of Swallowing Disorders

Evaluation may involve a barium swallowing evaluation, a modified barium swallowing evaluation, and/or a fiberoptic endoscopic evaluation of swallowing. An otolaryngologist and speech pathologist will evaluate the specific function of swallowing, determine the causes, and provide a treatment plan to meet your goals (and provide safety and comfort with swallowing).

Treatment of Swallowing Disorders

Treatment may consist of a combination of swallowing therapy, medical management, and/or surgical management. Many swallowing disorders do not require surgery. Swallowing exercises are often given by the speech pathologist to address strengthening and coordination of swallowing musculature. Compensatory swallowing strategies may be provided as well. Neuromuscular electrical stimulation may be recommended along with swallowing treatment.