Questions about Vocal Fold Microsurgery

Here is a list of common vocal fold microsurgery questions. Why is vocal fold microsurgery done? The commonest reason is that there is a visible lesion such as nodules, polyps, capillary ectasia (dilated capillaries), epidermoid or mucus retention cyst, glottic sulcus, papilloma, or a known vocal fold cancer. The point is to remove the lesion […]

Questions about Cricopharyngeus Myotomy

Questions about Cricopharyngeus Myotomy (CPM) for Cricopharyngeus Muscle Dysfunction with or without Zenker’s Diverticulum   What is Cricopharyngeus Myotomy (CPM) and why is it done? This procedure refers to division of a circular sphincter muscle that serves as a one-way valve or ‘gate’ at the top of the esophagus. This muscular ‘gate’ must open briefly […]

Granulomatosis with Polyangiitis (GPA)

A newer term for the auto-immune disorder previously called Wegener’s Granulomatosis. Airway Stenosis Caused By Wegener’s Granulomatosis, Before and After Dilations Tags

Idiopathic Subglottic Stenosis

Idiopathic (unknown cause) inflammatory subglottic stenosis is a frustrating breathing problem seen mostly in women. It appears to be an autoimmune disorder that we have thought for many years to be an incomplete expression (forme fruste) of Wegener’s Granulomatosis, aka granulomatosis with polyangiitis (GPA). In a caseload of perhaps 125 patients, it appears that standard […]

Subglottic Stenosis

Subglottic stenosis is narrowing just below the vocal cords, in the lowest part of the larynx and immediately above the first tracheal ring. Examples of causes include scarring from a breathing tube used during a long ICU stay, Wegener’s Granulomatosis (aka Granulomatosis with polyangiitis), and idiopathic subglottic stenosis (aka limited Wegener’s Granulomatosis). Subglottic Stenosis, after […]

Open Epidermoid Cyst

An open epidermoid cyst occurs when it spontaneously ruptures, but yet not empty all of its contents (keratin). The outline of the partially-emptied cyst may still be very evident, but it usually assumes an oval shape with the long axis oriented anteriorly and posteriorly. If the cyst empties nearly completely, the white oval is no […]

Positive and Negative Practice

Positive/negative practice is a behavioral treatment prescribed primarily for patients with nonorganic voice disorders. A patient with a nonorganic voice disorder has been diagnosed with aberrant voice production due to the abnormal use of a normal mechanism, often due to stress or some sort of secondary gain. She or he may have been ‘stuck’ with […]


Ever wonder how we laugh? can’t be loaded because JavaScript is disabled: Laughing ( VESS of the laryngopharynx during laughter VESS Recorded at Bastian Voice Institute can’t be loaded because JavaScript is disabled: Laugh ( Laughing that can be seen and heard! In this video, Dr. Bastian looks into the esophagus via VESS. […]

Diet Modification for Dysphagia

Diet modification for dysphagia are suggested dietary changes, particularly regarding food consistencies, directed at improving a patient’s ability to swallow and at avoiding aspiration. For example, an individual who is struggling with aspiration might be advised to avoid thin liquids and use thicker or carbonated liquids instead. Or this individual might be advised to avoid […]