Hard to swallow

Patients with swallowing and voice disorders have a unique outpatient service at Children's dedicated to treating their conditions. The Flexible Endoscopic Evaluation of Swallowing (FEES) and Voice outpatient service is the only one of its kind in Dallas-Fort Worth.

The FEES service supplements video swallowing assessments. Patients with swallowing disorders are fed a variety of foods and liquids before an evaluation is performed to determine whether the patient is safe to swallow. A majority of patients treated at Children's have aerodigestive disorders with multiple airway, pulmonary and digestive problems. The most common condition treated is dysphasia — an impairment in communication — related to prematurity.

Dr. Romaine Johnson, an otolaryngologist at Children's and assistant professor of Otolaryngology at UT Southwestern Medical Center, evaluates the patients and performs the procedures to determine treatment plans.

"The disorders treated at Children's are very common," Dr. Johnson said. "The services provide patients with a doctor as well as a speech therapist to help care for their complex condition."

The specialists at Children's primarily treat voice disorders that arise from laryngeal pathology such as vocal nodules and cysts. Vocal cord nodules are among the most common conditions treated. Ashley Brown, MS, CCC-SLP, and Christy Plummer, MS, CCC-SLP, speech-language pathologists in the outpatient service, evaluate the patients' voice quality, pitch, resonance and intensity. Brown and Plummer also educate parents on appropriate vocal hygiene.

Tags: voice disorders, ENT, swallowing, vocal, laryngeal pathology, nasoendoscopy