Oral-facial clefts are birth defects in which the tissues of the mouth or lip don’t form properly during a baby’s development.
The WVU Medicine Multi-Specialty Cleft Palate Clinic is committed to caring for and treating those with clefts of the lip and/or palate and other craniofacial problems. Our team includes the following specialists:
- facial plastic surgeons
- otolaryngologists (ENT)
- speech pathologists
Babies are typically referred very soon following birth, so the team makes recommendations about early care, such as making sure he or she is eating without difficulty, is gaining weight, and when the best time for surgery will be.
As the baby grows and develops, we evaluate speech and language skills and discuss any necessary referrals for intervention with the parents.
Primary care physicians, parents, teachers, and any other professionals from the tri-state area can make referrals to the Cleft Palate Clinic by calling 304-598-4825.
Twenty-five percent of people are habitual snorers. Problem snoring is more frequent in males and overweight people, and it usually grows worse with age.
If you snore, you may have at least one of the following problems:
- poor muscle tone (lack of tightness) in the muscles of the tongue and throat
- excessive bulkiness of tissues of the throat
- problems with the size and shape of the palate
- obstructed nasal airways
Is snoring serious?
Since snoring disturbs sleeping patterns, a person who snores may not sleep restfully. Furthermore, heavy snorers tend to develop high blood pressure at a younger age than non-snorers.
Obstructive sleep apnea is an exaggerated form of snoring. Loud snoring is interrupted by frequent periods of totally obstructed breathing. This is serious if the episodes last more than 10 seconds each and occur more than seven times in an hour.
Apnea (obstructed breathing) sufferers may experience 50 to 500 episodes per night, and many spend as much as half their sleep time with blood oxygen levels below normal. During the obstructive episodes, the heart muscle may not receive sufficient oxygen, resulting in irregular heartbeats that may be life threatening.
Since snorers with severe sleep apnea are often unaware of it, a laboratory sleep study may be the only way to discover the condition.
Snoring and sleep apnea can be more than a bother to your sleep partner. Dr. Steven Coutras, a WVU Medicine otolaryngologist, discusses the unexpected health effects that can come about with untreated sleep apnea.
Can snoring be cured?
Snoring means obstructed breathing, and obstruction can be serious. A child who snores should be thoroughly examined by a physician. Medical evidence suggests that a tonsillectomy and adenoidectomy will probably make an important difference in the health and well-being of the child.
If you snore, you should be examined to find out if you have a serious problem. Treatment will depend on the diagnosis, and it may be as simple as managing nasal allergies or infection. In other cases, surgery may be required to correct a nasal deformity or to remove large tonsils or an enlarged uvula.
Dr. Coutras provides comprehensive surgical care for patients with obstructive sleep apnea or snoring, specifically those who have not had successful medical treatment or are interested in exploring other treatment options.
Our multi-disciplinary team of surgical and sleep providers collaborate to develop individualized treatment plans for patients with sleep apnea or snoring problems, which may include:
- A comprehensive history and physical examination including an airway evaluation
- Nasal surgeries – septoplasty, nasal turbine reduction, nasal valve reconstruction, or nasal tumor or polyp removal
- Palatal surgeries- uvulopalatopharyngoplasty (UPPP), tonsillectomy, palate radiofrequency, palatal implementation
- Base of tongue surgeries – lingual tonsillectomy, partial midline glossectomy, radiofrequency to the base of the tongue, genioglossal advancement, hyoid myotomy and suspension, tongue suspension suture
- Other surgical procedures – maxillomandibular advancement, tracheostomy, limited uvulopalatopharyngoplasty, custom oral appliances
Through our ongoing clinical research, our team continually collaborates to refine and improve surgical treatment of OSA.
DOC Health Report: INSPIRE for Sleep Apnea
Swallowing Difficulty (Dysphagia)
Difficulty in swallowing (dysphagia) for adults is primarily the result of mechanical, muscle, or nerve disorders. Mechanical disorders are most often associated with surgery for cancer. Muscle and nerve disorders may include:
- myasthenia gravis
- muscular dystrophy
- multiple sclerosis
- amyotrophic lateral sclerosis
- Parkinson’s disease
- head injury
Dysphagia also occurs in children and infants.
Infections and swelling of the adenoids and tonsils are common in children, and adults occasionally have problems as well. A doctor’s examination is usually needed to find out if there is a bacterial infection.
Enlarged tonsils and adenoids can cause problems even if they don’t get infected. Sometimes tonsils and adenoids are so large that children have problems breathing or, less commonly, eating.
Signs that adenoid and tonsil enlargement is causing problems include:
- mouth breathing
- excessive snoring
- struggling to breathe or gasping to breathe, especially while sleeping
Surgery is the only effective treatment for enlarged tonsils and adenoids that are causing problems.
Viral upper respiratory tract infections (URIs), better known as the common cold, affect most people occasionally. Adults tend to get two to four colds a year, and children can get eight to 10 colds per year. While the symptoms make you feel bad, the infections are not serious and normally end within a few days.
Bacterial URIs (either sinusitis or bronchitis) can also develop. It can be difficult, even for doctors, to tell the difference between a viral and bacterial URI.
Many factors, including the duration and severity of symptoms and any underlying respiratory problems, need to be considered before antibiotics are prescribed. A viral infection can also weaken a person’s defenses, setting the stage for a secondary bacterial infection. Antibiotics provide relief for a bacterial infection, whereas viral URIs do not respond to antibiotics.
People normally swallow hundreds of times each day. It’s an action we perform without thinking, unless there is a problem. Likewise, our voices also are used continuously. We speak and don’t notice how our own voice sounds except when it hurts or is a strain to talk.
Jason McChesney, MD, an expert in WVU Medicine’s Otolaryngology Department explains voice and swallowing conditions and their treatment.
What is a laryngologist?
A laryngologist has special expertise and training in the diagnostic and therapeutic approach to voice and swallowing disorders. These disorders include hoarseness, laryngitis, vocal cord polyps and lesions, gastroesophageal reflux disease (GERD), and laryngopharyngeal reflux disease (LPRD).
What is the most common voice problem?
Hoarseness is the most common voice problem. There are a number of possible causes for this condition, including upper respiratory infections, improper voice use, and recent surgery requiring a breathing tube. If hoarseness lasts longer than a few days, it may be due to more significant problems that should be evaluated by examining the vocal cords.
What are the symptoms of swallowing disorders?
Swallowing disorders can include the feeling of food or liquid sticking in the throat, frequent choking or coughing when eating or drinking, or sensing a lump in the throat. Some swallowing difficulties can be due to reflux. Swallowing disorders also occasionally can result from hypertension, diabetes, thyroid disease, stroke, a tumor in the throat, or other conditions.
Some medications, such as nitrates, antidepressants, calcium tablets, iron tablets, vitamin C, antipsychotics, and tetracycline, can also cause swallowing difficulties.
How is reflux treated?
Mild reflux can be controlled by changing some habits and behaviors such as eating smaller, more frequent meals and less spicy foods; eliminating tobacco, alcohol, and caffeine; losing weight and reducing stress; avoiding food before bedtime; and elevating the head of the bed a few inches. Patients experiencing symptoms of chronic reflux, such as swallowing problems, the sensation of having a lump in your throat, or throat pain, should be evaluated by a laryngologist for more extensive treatment options.
How are voice and swallowing disorders diagnosed and treated?
You will be asked detailed questions about your voice problems and a visual examination of your esophagus will be performed. In some cases a thin, flexible instrument (endoscope) may be passed down your throat allowing your doctor to see what is going one when you swallow. Depending on the severity of the problem, a solution can be achieved through behavioral therapy, diet, medication, or surgery.
We use our voices every day and take them for granted as our means of communicating. However, voicing is a highly coordinated activity. Typical complaints about voices include a hoarse or raspy voice or a change in vocal quality.
Common problems that may affect your voice include:
- vocal cord nodules
- contact ulcers
- vocal cord paralysis
- cancer of the larynx
Voice tremors and hoarseness arise from muscle, mechanical, and nerve disorders. Dr. Jason McChesney explains.
A thorough evaluation is important to learn what the problem is and what to do about it.
If you have voice problems, you will be evaluated using a technique that allows us to see detail and subtle movements of the vocal cords that cannot be seen with the naked eye.
The examination is videotaped and reviewed later by you and your physician. This video provides visual feedback, helping you to understand your vocal cord problem, plus it can help you stick with your treatment plan.
Together, you, your doctor, and your speech/language pathologist work to obtain your best possible voice quality
Spasmodic dysphonia is a voice disorder characterized by a strained and strangled-sounding voice.
Along with speech therapy, the treatment for spasmodic dysphonia used today is botulinum toxin injected into the vocal cords. This therapy provides temporary relief and lessens the strained voice quality. Most people require repeat injections every 3 to 6 months.