Job Description:
Collaborate in patient care with our Voice and Swallowing Center laryngologists and other physician referrals. Perform rigid and/or flexible video laryngostroboscopy to assess laryngeal function and biomechanics. Evaluate patients via use of acoustic, phonatory aerodynamic, and/or perceptual measurements for differential diagnosis and to formulate recommendations/plan of care. Offer individualized voice therapy treatment programs through a variety of approaches. Educate patients on issues regarding vocal health and hygiene, potentially abusive vocal behaviors, irritable larynx syndrome, chronic cough/throat clearing, and management of reflux through dietary and behavioral modifications. Provide therapy pre- and post- laryngeal surgery to optimize vocal outcome and reduce the risk of re-injury. Educate patients how to independently resolve episodic dyspnea related to inducible laryngeal obstruction through laryngeal control/respiratory retraining exercises, postural adjustment and optimization of typical respiratory patterns during speech and at rest. Perform differential diagnosis of swallowing disorders via clinical and instrumental assessment using Modified Barium Swallow Studies (MBS) and/or Flexible Endoscopic Examination of Swallowing (FEES). Identify treatment options for dysphagia, including alternative means of nutrition (PEG or NG), diet modifications (thin/nectar/honey-thickened liquid), postural techniques, and exercise-based swallowing therapy. Provide evidence-based dysphagia rehabilitation utilizing sEMG, lingual manometry, respiratory muscle training, and pharyngeal strengthening exercises. Perform pre and post swallowing evaluations via FEES or MBS before patients begin radiation and/or undergo surgical resection of the head and neck. Assess and train patients on optimal adaptive feeding techniques such as lavage feeding, modified syringe feeding, glossectomy techniques, and all other compensatory strategies for oral and pharyngeal deficits post-surgery. Provide therapeutic intervention for intelligibility in the post-operative patient when indicated, utilizing compensatory strategies for intelligibility and/or compensatory techniques and exercises for lingual/labial/facial strength, range of motion, and articulatory competence. Manage total laryngectomy patients. Includes thorough pre-operative education on upcoming changes regarding anatomy and communication between inpatient and outpatient providers. Train patients on use of electrolarynx, HME systems, stoma support, and other stoma care products. Maintain a working knowledge of pertinent insurance coverage and assist patients and family members with ordering/obtaining necessary stoma care/cover supplies. Manage tracheoesophageal voice prosthesis (TEP) program. Provide pre-op education regarding purpose, use, cleaning, and maintenance of the TEP. Troubleshoot both chronic and urgent TEP issues, such as leaking, changes in voicing, dislodgement, loss of the prosthesis, or tissue changes. Fit patients for hands-free devices and provide all education and training.
