My friend and colleague, a pediatric allergist, sat across from me frantically scribbling notes. She had lost her voice two days before from an unusual type of laryngitis. As a consequence, she was unable to work for an entire week. As arrangements were made to reschedule her patients for the week, I was reminded that the professional voice user is not limited to the actor or singer but includes a myriad of professions all of which depend on the voice.

Care of the professional voice is a major component of Laryngology, a subspecialty of Otolaryngology, or “Ear, Nose & Throat.” Our voices are the basic component of human communication and an expression of our personality. In the modern world, relationships are forged based on person-to-person communication whether that be in person or on a telephone line. Many, if not most, jobs are dependent on voice communication at some level. Some, such as classroom teachers and telephone operators depend heavily on being able to maintain a normal voice on a day to day basis. Similarly, entertainers have complex vocal demands that require good vocal health.

Care of the voice professional includes diagnosis and treatment of acute and chronic complaints, addressing long-term goals, as well as managing the possible effects of other illnesses. The Jefferson Center for Voice and Swallowing (JCVS) is a center of excellence at Thomas Jefferson University at the Center City Philadelphia Campus. It is dedicated not only to the voice but also to care of complex swallowing and airway problems.

Hoarseness is a common symptom of swelling of the tissues of the larynx associated with the common cold, influenza and seasonal allergies. It will usually go away with the other symptoms of nasal congestion and cough. More long-standing voice change can result from chronic irritation.

Overuse and abuse of the voice, speaking too loud and/or too much can lead to swelling and development of benign growths(vocal nodules, singer’s nodules) that prevent normal vocal cord function. Mucosal irritation can be caused by tobacco smoke, reflux stomach acid and post-nasal drainage. All of these conditions are treatable with medications, therapy, and occasionally, minimally invasive surgery.

Less commonly, hoarseness is caused by problems with vocal cord motion. Paralysis can lead to weak, breathy voice and sometimes difficulty with breathing. Other types of problems with vocal motion are caused by spasms of the muscles that move the vocal cords causing a wide variety of voice complaints. Accurate diagnosis involves comprehensive evaluation by a voice team, neuromuscular testing, and often radiological tests. The JCVS employs many innovative treatments for these conditions. Vocal weakness can be corrected with temporary or permanent vocal cord augmentation. Spasmodic conditions are often controlled with oral medications or Botox injections. In all cases, treatment is dependent on integrated voice therapy.

An additional major concern is laryngeal cancer with about 30,000 new cases reported in the US each year. While this number has remained fairly stable, the percentage of women affected has steadily increased due to the increase of cigarette smoking among women in the last century. Hoarseness is the earliest and most common symptom. Some patients with early laryngeal cancer also note throat irritation, sore throat and pain in one ear. When laryngeal cancer is detected at an early stage, it is successfully treated with preservation of voice. The leading risk factor is cigarette smoking. The risk is reduced substantially five years after a patient stops smoking and the risk continues to decrease for ten years more. We are active in promoting and encouraging smoking cessation for all of our patients and employ many resources to help patients quit. The JCVS is a leader in clinical research to develop a program of medical treatment and support for smoking cessation throughout large medical practices.

The medical staff of the JCVS includes: Joseph Spiegel, MD and Maurits Boon, MD and Speech Pathologists, Adeline Schultz, MEd, CCC-SLP, and Rosemary Ostrowski, MM, MS, CCC-SLP. We bring decades of experience and dedication to care of patients with voice and swallowing disorders. The Center is located in the Department of Otolaryngology Head & Neck Surgery at 925 Chestnut St, Philadelphia, PA 19107. State-of-the-art technology is employed to diagnose and treat patients, and voice therapy is provided on site. We have developed a team approach to treatment based on each individual patient’s concerns and goals.

A problem with your voice may be a minor impairment, a significant limitation in your work, or a sign of a life-threatening condition. No matter how serious, the JCVS will provide the most modern, accurate diagnostics and will work with you to preserve, protect and improve your voice.