Voice and Swallowing Disorders

Hoarseness without an obvious explanation that lasts longer than two to four weeks should always be evaluated by an ENT specialist. Many people assume a raspy voice will resolve on their own. Persistent changes warrant investigation. Any voice change that follows surgery on the thyroid, spine, heart or major blood vessels also needs prompt attention. The nerves to the vocal cords can be affected during these procedures.

The warning signs are more urgent, for swallowing. Difficulty swallowing liquids or solids that worsen over time needs to be checked. Coughing or choking during meals, a sensation of food getting stuck in the chest or unexplained weight loss all merit an immediate consultation. The first clue that a person is silently aspirating food or liquid into their lungs while swallowing manifests as recurrent chest infections or pneumonia. A baseline swallowing assessment is advised for anyone who has suffered a stroke or been diagnosed with Parkinson's disease, multiple sclerosis, or amyotrophic lateral sclerosis (ALS), even before obvious symptoms appear.

Detailed history covering voice use patterns, the timing and character of symptoms, medical conditions, medications and lifestyle factors such as smoking and vocal demands is assessed. A physical examination follows. This is typically using a flexible laryngoscope passed gently through the nose to visualise the throat and voice box without gagging or discomfort.

Videostroboscopy is the gold standard for voice disorders. This special camera uses strobe light which captures slow-motion images of the vocal cords vibrating during sound production. It reveals subtle abnormalities in vibration that would be invisible to the naked eye alongside closure patterns and symmetry. Laryngeal electromyography (LEMG) measures the electrical activity of the laryngeal muscles in some cases. This helps predict recovery in vocal cord paralysis.

For swallowing disorders, a fibre-optic endoscopic evaluation of swallowing (FEES) is conducted. This uses a small camera that passes through the nose to watch the throat during actual swallows of coloured food or liquid. A modified barium swallow study is performed with a radiologist and captures X-ray video of a patient swallowing different consistencies mixed with barium. This shows whether food is entering the airway or moving properly into the oesophagus.

• Vocal cord nodules, polyps, and cysts
• Reinke's oedema and chronic laryngitis
• Functional voice disorders and muscle tension dysphonia
• Spasmodic dysphonia
• Unilateral and bilateral vocal cord paralysis
• Laryngopharyngeal reflux (LPR)
• Laryngeal papillomatosis (HPV-related lesions)
• Vocal cord haemorrhage and scarring
• Presbyphonia (age-related voice changes)
• Oropharyngeal dysphagia
• Esophageal dysphagia
• Aspiration and recurrent pneumonia
• Laryngeal stenosis and airway narrowing

Treatment always begins with the least invasive approach at NMC, providing expert care to patients across Abu Dhabi, Dubai, Sharjah, Ajman, Ras Al Khaimah and Al Ain. Voice therapy with a specially trained speech-language pathologist is the cornerstone of care for many functional voice disorders and mild vocal cord lesions. Therapy teaches efficient vocal production. It reduces compensatory strain and addresses behavioural patterns that contribute to injury as well. For singers, teachers, salespeople, performers or voice therapy techniques are tailored.

We manage laryngopharyngeal reflux with dietary modifications and targeted acid suppression when medication is appropriate. For patients with spasmodic dysphonia, Botox injections into the laryngeal muscles provide remarkable relief. They often restore near-normal voice quality for several months before repeat injection is needed.

Surgical intervention is reserved for conditions where conservative measures fail. It is also an option when structural abnormalities clearly require physical removal. Microlaryngoscopy under general anaesthesia allows precise removal of polyps, nodules, cysts or papillomas. It does so with minimal trauma to surrounding healthy tissue. We offer injection laryngoplasty for vocal cord paralysis. This is where filler material is injected into a paralysed cord to improve closure. Medialisation thyroplasty is also offered, which is a permanent procedure to reposition the cord.

Our approach is highly multidisciplinary for swallowing disorders. Close collaboration between gastroenterologists, neurologists and rehabilitation physicians is a cornerstone of treatment. Swallowing rehabilitation techniques help patients strengthen muscles and learn compensatory strategies. We work with dietitians to modify food textures and ensure adequate nutrition without aspiration risk, when swallowing safety cannot be restored.

Consultant ENT surgeons with dedicated fellowship training in laryngology from leading international centres lead our teams. Alongside them are experienced speech-language pathologists who hold advanced certifications in voice therapy and swallowing rehabilitation. Every patient receives a cohesive treatment plan rather than fragmented care with our integrated model, with both physician and therapist collaborating closely.

Our specialists have particular expertise in caring for professional voice users. This ranges from opera singers and broadcasters to school teachers and call centre staff. They understand that a voice disorder is not merely a medical problem. It can be a threat to livelihood and identity. The same thoughtful approach applies to patients with swallowing disorders. The fear of choking during meals creates profound anxiety that our team addresses with patience and practical support.