Lakeshore Professional Voice & Swallowing Center

Lakeshore Ear, Nose and Throat Center


Welcome to the Lakeshore Professional Voice Center, a part of Lakeshore Ear Nose and Throat Center. We are dedicated to the prevention, diagnosis, treatment, and research of voice disorders.

The voice is an expression of the soul. Our ability to speak and sing is a precious possession which should be valued and protected. Unfortunately, voice problems are all too common and often taken for granted.

Maintaining vocal health is essential for effective communication. While some professions (singers, actors, teachers, public speakers, clergy, politicians, and others) depend on their voices for their livelihood, almost everybody depends on his or her voice for daily living. Voice injuries can have dramatic physical and emotional consequences which may impair a person's quality of life. Moreover, although hoarseness is usually a sign of a problem with the larynx ("voicebox"), it may also be the first clue of other underlying medical issues. Early identification of voice problems usually improves one's chances for full recovery.

At Lakeshore Professional Voice Center we have a highly specialized voice team and a state-of-the-art voice laboratory to provide sophisticated medical and surgical care for patients with voice problems. We provide voice, speech, and performance therapy and training to the professional and non-professional voice user. Our center offers voice conservation seminars and workshops for choirs and other groups where rigorous voice use is required. Individual and group voice therapy is available. Please read below for more information about the care we provide.

The Voice Team

Lakeshore Professional Voice Center is codirected by Adam D. Rubin, MD and Cristina Jackson-Menaldi, PhD.

Laryngologist: Dr. Adam D. Rubin is board certified in Otolaryngology and sub-specializes in the evaluation and treatment of voice and swallowing disorders. He earned his B.A. at Yale University and his medical degree at Harvard University. Dr. Adam D. Rubin completed his residency at the University of Michigan and his fellowship in Laryngology and Care of the Professional Voice at the American Institute of Voice and Ear Research. He is an adjunct assistant professor at the University of Michigan.

Voice Pathologist: Cristina Jackson-Menaldi, PhD is our voice pathologist and created the Professional Voice Center 15 years ago with Lakeshore ENT president Dr. Daniel Megler.

Care for the Professional Voice

Over the past 30 years, our understanding of and ability to treat voice problems have increased dramatically largely due to the interdisciplinary collaboration of otolaryngologists, speech language and voice pathologists, singing and acting teachers, and performers. A new medical subspecialty emerged, laryngology, to raise the level of care for voice patients. The laryngologist and voice pathologist work together as a "voice team" to provide sophisticated voice care.

The voice team at Lakeshore Professional Voice Center has extensive experience working with professional voice users. Singers, speakers, lecturers, and others whose livelihoods depend on their voices can be assured of receiving the finest in clinical evaluation and treatment.

Services

The staff of the Lakeshore Professional Voice Center takes a multidisciplinary approach to your voice problems to provide you with the best opportunity for a healthy voice. Services offered include:

  • Comprehensive evaluation of voice disorders
  • Objective and perceptual analysis of the voice
  • Strobovideolaryngoscopy
  • Care for the Professional Voice
  • Voice, speech and performance therapy
  • Individual and group voice therapy
  • Seminars for choirs and larger groups of voice users
  • Laryngeal microsurgery for vocal fold masses
  • Surgery for vocal fold paralysis and paresis
  • Treatment of the aging voice
  • Evaluation and management of laryngopharyngeal reflux
  • Laryngeal BOTOX® injections for spasmodic dysphonia

We provide treatment for a comprehensive range of common voice problems, such as:

  • Voice Problems related to vocal misuse and abuse
  • Sudden Hoarseness Requiring Voice Rest
  • Vocal Fold Tear
  • Vocal Fold Hemorrhage
  • Vocal Fold Masses
  • Vocal fold Nodules
  • Vocal Fold Pseudocysts
  • Vocal Fold Polyps
  • Vocal Fold Cysts
  • Contact Masses
  • Reinke's polyposis (Reinke's edema)
  • Papillomas
  • Leukoplakia
  • Cancer
  • Impaired vocal fold closure
  • Vocal fold paresis
  • Vocal fold paralysis
  • Vocal fold bowing incl. type-I thyroplasty & injection laryngoplasty
  • Vocal fold scar and sulcus
  • Abnormal vocal fold movement
  • Spasmodic dysphonia
  • Muscle tension dysphonia
  • Paradoxical vocal fold movement
  • Masses resulting from Acid Reflux, incl. granuloma

The Voice Laboratory

At Lakeshore Professional Voice Center we have an expert voice team and the latest technology to obtain detailed objective and perceptual analysis of the voice. We use strobovideolaryngoscopy to image the vocal folds and evaluate their fine structure, as well as computerized voice analysis and aerodynamic studies to help us identify any factors contributing to your vocal problems.

Voice analysis procedures performed in our Voice Laboratory, which include:

  • Acoustic Analysis
  • Fundamental Frequency
  • Perturbations of frequency (jitter) and amplitude (shimmer)
  • Signal-to-noise ratio
  • Spectral analysis
  • Electroglottography (EGG)
  • Phonetogram (Voice Range)
  • Aerodynamics Studies
  • Strobovideolaryngoscopy
  • Laryngeal electromyography

What happens at the first visit?

You will be asked to fill out a detailed voice history and general medical history questionnaires.

Your initial evaluation takes place in 2 parts. You will meet individually with Dr. Menaldi and Dr. Rubin. We will try to arrange this for the same day if possible.

Dr. Menaldi will have you record your voice digitally and perform a computerized analysis of your voice. She may also perform pulmonary function tests (breathing tests) and do a trial of voice therapy.

Dr. Rubin will perform a full head and neck examination, and may perform flexible and rigid strobovideolaryngoscopy to visualize and assess the gross movement and vibration of your vocal folds.

By the end of your evaluation, you will understand the nature of your voice problem, and the potential roles of pharmacologic, voice therapy, and surgical intervention. Additional workup may be necessary.

Tips on Voice Care

  1. Avoid clearing your throat.
  2. Avoid coughing whenever possible.
  3. Speak in a clear tone.
  4. Avoid talking above loud noise.
  5. Keep volume level low on audio sets.
  6. Wear earplugs at music concerts.
  7. Keep airflow smooth during exercise (especially weight lifting)
  8. Drink plenty of water to avoid vocal cord dehydration (at least 8 glasses per day)
  9. Do not smoke and avoid smoky environments.
  10. If your voice quality changes suddenly, rest your voice and consult your physician or laryngologist.
  11. If your voice loss is gradual, but does not improve within 2 weeks, consult your physician or laryngologist.
  12. If you are speaking or singing in a way that makes you hoarse or causes discomfort, STOP!

Additional tips for the performer:

  1. Always warm-up before a performance.
  2. Rest the voice when you do not need to use it.
  3. Get formal voice training, if you have not already.
  4. Be careful with "character" voices and "emotional" releases. Always use good technique.
  5. Career longevity is dependent on maintaining a healthy voice. Make wise decisions and protect yourself.
  6. Come in early to be evaluated for any voice problems