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Voice and Swallowing Therapy

It's not unusual to develop a voice problem at some point in your life; swallowing and other communication disorders aren't as common. Voice and swallowing therapy is an effective way to treat many different conditions that can affect your communication and ability to swallow. 

Therapy with a speech pathologist is an effective way to treat many conditions that can result from voice abuse or overuse, neurological trauma or disease, surgery, cancer treatment, physical changes due to acid reflux or narrowing of the wind pipe, and even aging.

We frequently treat patients struggling with:

  • Dysphagia — difficulty swallowing

  • Dysphonia — abnormal voice quality

  • Dysarthria — abnormal articulation (distorted speech)

  • Aphasia — difficulty expressing or understanding language

  • Cognitive impairment — impaired thinking or recall

  • Airway dysfunction — such as chronic cough or a vocal cord dysfunction

Diagnostic Procedures

Our experienced clinicians perform a comprehensive office examination, and may also perform one of several diagnostic tests, such as FEES/FEESST, videofluoroscopic evaluation of swallowing, flexible endoscopy and stroboscopy, laryngoscopy, language and cognitive assessments, and testing with our computerized speech lab.


Videostroboscopy is a diagnostic test that is used to examine the form and function of the larynx (voice box), including the vocal folds, as well as the health of the surrounding muscles and tissues. It is similar to laryngoscopy. This test can pinpoint the underlying causes of a range of vocal symptoms, including hoarseness.

Videostroboscopy may be performed by inserting a flexible telescope in the nose or a rigid telescope into the back of the mouth. The patient is then asked to follow simple vocal instructions that help to assess the health of the larynx and vocal folds.

Fiberoptic Endoscopic Evaluation of Swallowing (FEES) with Sensory Testing (FEESST)

Fiberoptic Endoscopic Evaluation of Swallowing (FEES) with Sensory Testing (FEESST) is a relatively new method of evaluating swallowing function and diagnosing swallowing disorders. Both FEES and FEESST complement the commonly known barium swallowing test, in which patients used to drink an opaque substance to enhance X-rays of the throat.

During FEES, a clinician passes a small scope with a camera through the patient's nose and down into the throat. The first part of the test measures the ability of the voice box to perform certain basic motor functions. The second part of FEESST measures the patient's ability to swallow. With the camera in place, the patient swallows various foods mixed with food coloring. From the camera's vantage point, the physician can observe the intricacies of the process as the patient attempts to swallow food. When FEESST is performed, additional testing is performed to test reflexes that are protective of the airway.

FEES and FEESST are performed in the office. It provides immediate results and completely avoids the need for X-rays.

Transnasal Esophagoscopy

Transnasal esophagoscopy is a diagnostic procedure physicians use to examine the esophagus or food pipe. This is performed in a physician's office and takes only about 5-10 minutes to complete. While traditional esophagoscopy requires patients to be sedated, Temple physicians are now able to perform the procedure without sedation, allowing for faster recovery and greater safety. 

After applying a numbing spray, the physician inserts the endoscope (a small tube) through the patient's nose and into the esophagus. While the tube is in place, small amounts of air will be puffed into the esophagus. The patient will then be asked to burp or swallow in order to gauge the health of throat anatomy. Depending on the findings, the physician may also take photos with the camera, or a small tissue sample for testing.


For some patients suspected of having a problem in their windpipe, office-based bronchoscopy (endoscopy of the windpipe and lungs) offers a safe and comfortable screening method without the downtime associated with sedation or general anesthesia. Medications are used to numb a person’s throat and voice box, and a flexible endoscope is inserted through the voice box and into the lungs. This allows for accurate diagnosis and treatment planning for many patients with lesions of the airway. Office-based bronchoscopy is a novel technique that is offered only at advanced voice, airway, and swallowing centers.


Laryngoscopy is a diagnostic test that is used to evaluate the basic anatomy and function of the throat and voice box. It is performed by inserting a flexible endoscope in the nose or a rigid one in the mouth. The patient may be asked to breathe a certain way or make certain sounds in order to carefully examine the throat.

Treatment Options

Temple's licensed and certified speech-language pathologists perform a comprehensive evaluation and choose from a wide range of tests to diagnose and develop a personalized treatment plan based on your condition and needs. Therapy can include: 

  • Swallowing therapy — Focuses on strengthening muscles of the throat and tongue to improve your ability to swallow.

  • Speech/language/cognitive therapy — After a comprehensive evaluation, therapy focuses on exercises to improve the aspects of communication that aren’t functioning normally.

  • Voice therapy — Voice therapy concentrates on improving vocal technique, including breath support and resonance (what happens to sound as it moves up the voice box). It can also involve exercises to stretch and soften vocal folds, and improve vocal health.

For many conditions, voice or swallowing therapy is often the only treatment needed. The most effective treatment for some conditions, such as laryngitis, may be lifestyle changes — quitting smoking, avoiding exposure to irritants — or reducing reflux by avoiding fatty food and lying down after eating. Medication injections with BOTOX® can prevent the muscle spasms caused by spasmodic dysphonia. If a condition requires surgery or injections, therapy is usually required after the procedure, too. 

Why Temple Health?

Temple's team offers expertise and experience in diagnosing and treating voice, airway and swallowing conditions. Our board-certified otolaryngologists and certified speech-language pathologists collaborate to develop and provide the communication and swallowing treatment that's right for you.

Ready for an Appointment?

Find a doctor near you, request an appointment, or call 800-TEMPLE-MED (800-836-7536) today.