Speech Problems

In these conditions the vocal cords and larynx are working normally, but there are articulation or rhythm problems mainly with the tongue and/or soft palate which result in an indistinct voice. These medical problems vary from a simple tongue tie, to neurological disorders of the tongue and pharynx such as cerebrovascular disease and motor neurone disease, or a stammer. Some genetic females are born with certain male characteristics and vice versa. In some of these individuals there may be desire to higher or lower their basic voice pitch therefore as part of a gender re-assignment programme.


Rigid and Flexible Endoscopy


The mouth can be examined directly using a bright halogen headlight. The introduction of a sterile rigid endoscope with an angled lens into the mouth, or a sterile flexible endoscope whose tip can be manually rotated in various directions, allows a very detailed inspection of the whole of the tongue base, lower pharynx and vocal cords.


Flexible laryngoscopy is carried out with the patient seated in an upright position and requires initial preparation of the nasal lining with a topical spray. Cophenylcaine, a surface local anaesthetic and decongestant, is sprayed into each nostril held open by a dilator speculum. This drug is absorbed very quickly and numbs and shrinks the nasal lining. Although the introduction of a flexible endoscope into the nasal cavity is an unusual feeling it is not unpleasant. The subsequent examination will take less than 5 minutes. Rigid laryngoscopy requires a seated patient with their head extended forwards. It involves gently placing a metal tube with an angled lens and attached camera into the back of the throat to examine the vocal cords in detail. Active movements on phonation can be recorded to provide an accurate clinical record and to document changes after treatment.

Computerised Voice Analysis


This test is used to measure your voice quality and the time the vocal cords are vibrating together during the phonatory cycle. It is completely painless will show any improvement or change in your voice with treatment.


The test is undertaken in a soundproof booth to improve the accuracy of the recordings and a soft collar is placed around the neck. It involves recording the voice through a microphone whilst you sing various vowels and/or read a specific written passage.

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