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ENT Specialists is pleased to provide state-of-the-art services for voice and swallowing evaluation and intervention by way of functional video nasoendoscopy. Now, nasoendoscopy is performed with the cutting-edge video tip scope (“chip tip”), which provides a more detailed view of the throat, larynx (voice box), and vocal cords. In the past, nasoendoscopy has been performed using a Fiberoptic scope, which remains available as needed. Nasoendoscopy is essential to provide direct visualization of the nasal cavity, the throat, the larynx, the vocal cords, and surrounding structures. 

The ENT Specialists Voice Team uses nasoendoscopy for evaluation of swallowing and voice production. The Fiberoptic Endoscopic Evaluation of Swallowing (FEES) is now performed with the new video tip scope to provide a more detailed evaluation of swallowing function. The scope is also helpful to provide biofeedback during therapeutic swallowing intervention, allowing the patient to see how the therapist’s swallowing recommendations affect their own swallowing function. Furthermore, biofeedback sessions also help patients who experience voice difficulty. During voice therapy, nasoendoscopy can help patients see on-screen what they are really doing with their vocal tract and how therapist recommendations change maladaptive vocal behaviors.

The nasoendoscopy is a minimally invasive procedure which requires no preparation by the patient. The nasoendoscopy can be performed by either an ENT physician or a Speech-Language Pathologist (SLP) who specialized in voice function and care. Before the procedure, the SLP will obtain a case history of the patient and discuss the patient’s symptoms. The patient may also complete a questionnaire pertaining to their specific difficulty. During the procedure, a small tube (the scope) will be placed in the nose and through the nasal cavity towards the back of the throat. Once in place, the patient will complete a series of vocal or swallowing tasks related to the symptoms they exhibit. The SLP will also have the patient try a variety of functional tasks and monitor how the patient’s swallowing or voice behavior is affected and improved. Upon completion, the scope is gently removed and the SLP will review their findings with the patient. The SLP will also answer any questions pertaining to those findings. The findings will also be reviewed with an ENT physician, further helping to inform the patient’s plan of care. The entire procedure is video recorded and available to the patient at their request. 

 Myofascial Release therapy (MFR) is also available as an approach to use in tandem with biofeedback therapy. Use of MFR techniques are often key to mitigating voice and swallowing symptoms related to muscle pain and strain. MFR is an effective technique that involves gentle, hands-on manipulation of structures related to the voice and swallowing mechanisms. The power of MFR techniques is more readily recognizable when used during a biofeedback therapy session.

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