Sydney Voice Clinic

Who are we?

The Sydney Voice Clinic is a multidisciplinary Clinic established in 1988 for the diagnosis of voice and swallowing disorders. The Clinic is run by Associate Professor Thomas E Havas and is the first integrated Voice Clinic established in Australia where conjoint assessment by an Otolaryngologist and a Speech pathologist takes place utilising the latest Video Endoscopic, Electrophysiologic Diagnostic Techniques.

Conjoint consultation takes place in our state of the art Voice Laboratory. Each patient is given a comprehensive questionnaire concerning various aspects of their medical history, including general medical history, specific voice history and vocal requirements.

What happens at the consultation?

After taking a comprehensive history, a simple standardised questionnaire is completed.

Following this, the doctor will perform a comprehensive general physical examination. Then, local anaesthesia is applied to the patient's nostrils.

High resolution flexible digital endoscopy is undertaken on every patient and the images are projected on to a large screen for the patient to see first hand what their larynx and surrounding hypo pharynx looks like. If any pathology is present this can be highlighted for the patient’s better understanding of the condition.

A digital recording of the examination is made in every case. The option exists for either digital recording and/or appropriate video prints to be given to the patient or subsequent therapists.

If appropriate, acoustic analysis is undertaken. Acoustic analysis is undertaken using the latest computerised “Kay” voice analysis package. This provides a visual representation of the dynamics of voice in terms of any abnormal features their probable aetiology and serves as a guide for appropriate treatment.

In addition to the above, stroboscopic evaluation is undertaken if necessary.

Types of Examinations

Stroboscopic examination involves a rapidly flashing light which slows down the movement of the larynx so that any subtle problems – particularly those associated with prolonged professional voice use – can be demonstrated, diagnosed and appropriately treated.

In particularly complex cases electrophysiological diagnosis can take place. This involves inserting a small needle through the skin into the small muscles of the larynx so that electrical activity can be monitored. This is very useful in the diagnosis of various nerve and muscle disorders such as paralysis of the vocal fold or vocal polyps as illustrated on the right.

Vocal Polyps

Vocal Nodules are small areas of thickening or mini calluses on the vocal folds. They occur due to banging the vocal folds together with excessive tension. Vocal nodules are a common cause of hoarseness in children and adults often being associated with excessive shouting or screaming or excessive strained use of the voice. (This condition is benign. It nearly always responds to speech therapy.)

Vocal Nodules

In cases where the nodules are large or mature or speech therapy has failed vocal nodules are appropriately treated by microsurgical dissection and removal. If vocal habits are appropriately altered the nodules will not recur.

The Sydney Voice Clinic was established for the diagnosis and treatment of voice and swallowing disorders. It was the first of its kind to introduce flexible endoscopic evaluation of swallowing.

Early Laryngeal Cancer

Why visit the Voice Clinic?

    • Hoarseness
    • Loss of voice
    • Difficulty Swallowing
    • Chronic sore throat
    • Diagnosis and treatment of early laryngeal cancers (as illustrated on the right) by expeditious laser excision