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Voice Clinic

The Voice Clinic at McMaster Children’s Hospital is made up of experts in diagnosing and treating all types of voice conditions, and we believe in educating our patients so they can maintain good vocal health. We take your vocal health seriously.

Most voice disorders are easily treatable when diagnosed properly. It is important to address your vocal needs quickly before they get worse. A voice problem can indicate something as simple as viral laryngitis or as serious as vocal fold (cord) cancer.

Care We Provide

Conditions We Treat

  • The voice conditions seen at this clinic include, but are not limited to the following:
  • Functional Dysphonia: primary or adaptive muscle tension dyphonia or stress, trauma, or psychogenic related voice quality changes.
  • Spasmodic Dysphonia: spasm affecting the closing or opening of the vocal fold muscles.
  • Laryngopharyngeal Reflux: Lax upper esophageal sphincter leading to acid related changes of laryngeal mucosa.
  • Laryngitis: Inflammation of the vocal folds.
  • Respiratory Papilloma: Human papillomavirus affecting specifically vocal folds and pharyngeal space.
  • Vocal Fold Dysplasia: Leukoplakia, Erythroplakia, Keratosis- cell level changes in the vocal folds.
  • Benign Vocal Fold Lesions: nodules, polyps, cysts, granuloma.
  • Vocal Fold Paralysis/ Paresis: Immobilityor reduced mobility of one or both vocal folds.
  • Irritable Larynx Syndrome: Chronic cough or throat clearing, paradoxical vocal fold motion, laryngeal spasms, aerophagia.
  • Hemorrhage: collection of blood within the vocal fold due to the rupture of a blood vessel.
  • Reinke’s Edema: inflammation of the mucosa tissues typically due to smoking.
  • Presbyphonia: Age related vocal fold changes such as thinning and possible bowing.

Therapy follows a direct model in a one-on-one context. Group therapy may be offered in the near future.

What to Bring

  • Your Ontario Health Card or other health insurance information. The Ministry of Health and Long Term Care requires us to validate your health card at every clinic visit.
  • Complete questionnaire and forms received prior to your scheduled visit
  • Any notes or questions that you may have
  • List of current medications for you or your child

When you arrive, please check-in at the reception desk. The Business Clerk will register you in the electronic system so that your team will know that you have arrived.

Please wear a mask or have your child wear a mask in the case of a cough or runny nose. We also ask that you do not cancel an appointment in relation to throat soreness or cold symptoms.

What to Expect

You will meet with the clinic Speech Language Pathologist (S-LP) for a period of 45 minutes. During this time, you will participate in a medical and voice intake, perceputal, acoustical, and aerodynamic measurements related to the voice.

Fifteen minutes are reserved for the visualisation of the vocal folds with the approach of an interdisciplinary team. An Ear, Nose, and Throat specialist and an S-LP participate in this examination. Visualisation of the vocal folds is ideally performed with laryngovideoendostroboscopy examination.

No special preparation is needed for your assessment visit.

Team Members

The services offered by the voice clinic are possible due to the close collaborations of key players with diverse professional backgrounds. All professionals here at the clinic have a special interest in voice and voice disorders in children and adults.

The voice clinic team includes:

  • Ear, Nose & Throat Physician
  • Speech Language Pathologist (S-LP): A S-LP can also be called a Speech Therapist or a Speech Pathologist. The S-LP is an accredited professional who has an in-depth knowledge of the anatomy of the throat as well as the functional aspects of phonation. The S-LP therapeutically assists patients in rehabilitation and/or optimisation of the voice function in relation to both speech and singing voice production.
  • Communication Disorder Assistant
  • Business Clerks

Referral Process

Pediatrics (0-18 years): A family physician’s signature and referral is mandatory and may be faxed directly to the clinic at: 905-521-8552. Please note that HIN # are mandatory for each referral as well as clear patient demographics.

Adults: Due to current waitlists (8-12) months, an ENT referral is required for all adult patients.

Who visits the voice clinic?

Individuals who experience a variety of symptoms visit the voice clinic. These symptoms include:

  • Recurrent or persistent hoarseness
  • Loss of vocal range
  • Periodic voice loss
  • Voice fatigue
  • Muscle and neck pain in association to voice use
  • Decreased vocal power or projection
  • Patients with neurological or autoimmune conditions or syndromes that affect the voice
  • Patients with a tracheostomy learning to use a speech valve
  • Transgender patients
  • Patients are seen at the clinic for pre- and post-phonosurgical follow-up and scar reduction rehabilitation

Urgent Referrals: Referrals are reviewed on an individual case basis.

Please note: the clinics are not for emergencies. If you or your child need to be seen on an emergency basis please call your family doctor or go to your local emergency department.

Resources

RESOURCES

Download our flyer on voice care

Helpful Links

Canadian Association of Speech-Language Pathologists and Audiologists

College of Audiologists and Speech Language Pathologists of Ontario

Ontario Association of Speech Language Pathologists and Audiologists

World Voice Day

Voice Care Tips

  • Keep well hydrated; avoid consuming caffeine and alcohol- both will dehydrate your vocal cords.
  • Allow time for silent breaks throughout the day, especially after times when voice use is increased.
  • Avoid smoking, and avoid exposure to second hand smoke.
  • Take throat pain and/or hoarseness as a sign to rest. If the symptoms persist, see your doctor. Keep well hydrated and sip water throughout your day. Boost your water intake when you drink caffeine and alcohol because they dehydrate your vocal cords.
  • Aim to do as little yelling as possible.
  • If you feel any throat pain or hoarseness, take this as a sign to rest. If it persists, act on it and see a doctor.
  • If there is a microphone available, grab it! If not, ask for one. There is no such thing as being tough and doing without.
  • Have a sip of water or swallow with effort the next time you need to clear your throat.