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Finding Her Voice Again

October 2015

Surgical procedure improves quality of life for patient

When Judy and Ronald Poe would have a conversation, he often told his wife that he couldn’t hear or understand what she was saying. Judy Poe thought he might be hard of hearing, but she soon realized it was actually her changing voice that was causing the difficulty.

“I hate having to repeat myself, but I kept having to do that because people like my husband couldn’t understand me. It just wears you out,” Poe says. “My voice was going up and down, and it was very frustrating.”

When Poe discussed the problem with her physician, she was referred to Joseph P. Bradley, MD, Washington University otolaryngologist (ear, nose and throat specialist) at Barnes-Jewish West County Hospital and the Washington University Voice and Airway Center, located just a few miles from the hospital in Creve Coeur.

Poe shared her concerns with Dr. Bradley, who examined her larynx, or voice box, by videostroboscopy, a technique used to evaluate the function of the vocal cords using a strobe light to illuminate the larynx.

“He knew right away what was wrong and said my voice box wasn’t closing like it should,” Poe says. “I didn’t have any pain, and there wasn’t anything life threatening, but I really wanted to fix what was wrong.”

Dr. Bradley explained that she was experiencing a common problem many older adults face when they begin losing muscle mass. Her vocal folds were not closing completely, leading to air escaping when she tried to talk.

“She was experiencing an age-related change to her voice, which makes communication more difficult with others,” says Dr. Bradley, who explains that it’s not uncommon for men to experience a higher pitch in their voice, while women may have either a lower or higher pitch. “I told her there were several treatment options and that this was not something my patients have to live with, and that we could improve her quality of life.”

Poe first chose an awake vocal fold injection under local anesthesia, which involved Dr. Bradley injecting a filler material into her vocal folds that offered great results, but was a temporary fix.

“I decided I wanted something more permanent, so I wouldn’t have to go back and forth for injections,” says Poe, whose travel from her home in Cape Girardeau, Mo., to the Washington University Voice and Airway Center was about 200 miles round trip. “Dr. Bradley was so professional and concerned about me. He is the reason I went ahead and did the procedure.”

In mid-May of this year, Poe returned to Barnes-Jewish West County Hospital, where Dr. Bradley performed a bilateral medialization thyroplasty. While the patient is under sedation, he drills small holes into the cartilage of the voice box and places strips of GoreTex™ into the sides of the vocal folds in order to push them closer together.

“Mrs. Poe did very well during the procedure, and her recovery has been very successful,” Dr. Bradley says. “She had an overnight stay so that I could observe for airway swelling.”

Poe said she was very impressed with the hospital and everyone who cared for her. “It’s such a pleasant, clean hospital and isn’t too big,” she says. “Everyone was very nice and made sure I was taken care of before and after the surgery.”

Since her procedure, Poe has followed up with Dr. Bradley, who referred her to his colleague, speech pathologist Archie Harmon, PhD, CCC-SLP, another member of the Washington University Voice and Airway Center.

“Although the core voice problem was fixed through surgical intervention, post-operative voice therapy is helpful to maximize her loudness, clarity, vocal endurance and vocal effort,” Dr. Harmon says. “Usually, most patients only need one to two post-operative voice therapy sessions to optimize their voice quality to meet their needs.”

Following her voice therapy, Poe should not require any additional treatments, Dr. Bradley says. “Whether you have an issue like Mrs. Poe had or other voice-related problems, we are here to help our patients,” he says. “You don’t have to accept this in your life. It can happen to all of us.”

Voice and Airway Center Provides Help for Patients with Voice-related Concerns

The Washington University Voice and Airway Center in West St. Louis County opened in January 2015. The comprehensive center offers a range of in-office treatments in a convenient location near Barnes-Jewish West County Hospital.

The Voice and Airway team is led by otolaryngologists Joseph Bradley, MD, and Randal Paniello, MD, PhD. The team also includes speech pathologists Archie Harmon, PhD, CCC-SLP, and Megan Radder, MM, MA, CFY-SLP.

“All of us who provide patient care are trained specifically for voice-related issues,” Dr. Bradley says. “We treat patients ranging from pediatric to the elderly with any kind of voice and airway complaint, focusing on sound production.”

The physicians and speech pathologists treat a wide-range of issues, including hoarseness, aging voice problems, spasmodic dysphonia, vocal cord paralysis, pre-cancer and early cancer of the larynx, and swallowing problems to name a few.

A variety of treatments are available to treat different disorders, including voice therapy services, injection therapies and surgical procedures. It is the only regional center to offer awake KTP laser therapy to treat vocal cord lesions and facilitate voice preservation.

To schedule an appointment with Dr. Joseph P. Bradley, or another specialist, call 314.542.WEST (9378) or toll-free 844.542.9378 or request a call for an appointment.

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