The Comprehensive Voice Program: From Advanced Office-Based Procedures to Community Outreach
New technology is allowing Ronda E. Alexander, M.D., a fellowship-trained laryngologist at Memorial Hermann-Texas Medical Center and the new UT-Houston Texas Voice Performance Institute (TVPI), to perform many minimally invasive procedures safely in the office, improving patient satisfaction, and reducing the overall cost of treatment.
“We can now perform biopsies and remove very selected lesions in the office, saving certain patients a trip to the OR,” says Dr. Alexander, who is an assistant professor in the Department of Otorhinolaryngology-Head and Neck Surgery at The University of Texas Medical School at Houston. “For instance, we can do office-based biopsies for leukoplakia to determine whether we need to go forward with surgery since this may involve a complicated medical clearance evaluation. If we can determine that the lesion is likely to be malignant, it’s worth it for the patient to proceed with the evaluation. Other conditions can be monitored over time. Office-based procedures are particularly helpful for patients who are apprehensive about surgery and those who are poor candidates for general anesthesia due to their physical condition.”
State-of-the-art videostroboscopy in the Department of Otorhinolaryngology’s new clinical space provides a close look at the vibration of the vocal cords and is essential for diagnosing vocal pathology. Through real-time projection of the exam on a 32-inch flat-panel screen, patients can actually see the source of their problem. “Having this capability gives our patients a greater understanding of their particular condition and encourages them to be more involved in their own care,” Dr. Alexander says.
A collaborative effort between Memorial Hermann-TMC and the Texas Voice Performance Institute at the UT Medical School, the Comprehensive Voice Program offers patients immediate access to multidisciplinary management expertise, including neurology, gastroenterology, pulmonology, speech pathology, medical oncology, and radiation oncology. As a fellowship-trained laryngologist, Dr. Alexander is available to consult on cases involving complex speech and swallowing disorders and neuro-laryngology issues, or to assume permanent management of difficult cases.
“Our voice service collaborates closely with neurologists,” she says. “We work with the Mischer Neuroscience Institute to provide comprehensive diagnosis and treatment of movement disorders of the head and neck. Our relationship with the Department of Neurology allows us to consult with the full range of neurology specialists and subspecialists on medical issues that involve both disciplines and offers our patients access to care in one location, provided by physicians in close communication.”
Dr. Alexander is also available to speak with teachers at schools, voice coaches, chorale directors, and others who use their voices in their work, at no charge. She makes presentations to groups on effective voice use, recognizing overuse, common problems that affect the voice, special care issues, the voice and aging, and tips for keeping the voice healthy. “As a singer who made my debut at the age of four, I understand the importance of being physically prepared to use your voice and knowing how to protect it,” she says. “As a subspecialist in laryngology, I’ve helped many patients manage and rehabilitate an injured voice as well as diagnosing and treating a broad range of other complex disorders.”
To refer a patient to Dr. Alexander, please call 713-486-5000 or visit www.ut-ent.org.