Voice Clinic
A voice that sounds different, breathing that feels effortful, or food that doesn't go down easily can be unsettling, and often points to something that deserves proper attention. The Voice, Airway & Swallowing Clinic at Bharati Hospital's ENT Department brings together advanced diagnostic technology and specialist clinical care to get to the root of these problems — and address them properly, under one roof.
OVERVIEW
Voice, airway, and swallowing problems are more connected than they might seem — they all involve the same region of the body, the larynx and upper airway, and they all require the kind of detailed, real-time examination that standard imaging simply cannot provide.
The clinic is led by senior ENT surgeons working alongside specialised voice and swallowing therapists. What sets it apart is the technology underpinning every assessment — particularly the Pentax Flexible Laryngostroboscopy system, one of the most advanced tools available for evaluating the voice box and upper airway. Equipped with a chip-on-the-tip camera, it passes gently through the nose and delivers high-definition images of the larynx while the patient sits comfortably, speaks, and swallows naturally — no discomfort, no general anaesthesia, no guesswork.
Our Technology - Pentax Flexible Laryngostroboscopy System
The clinic's flagship diagnostic tool — and one of the best available anywhere in the field. The system uses an ultra-slim, flexible camera with the imaging chip built directly into the tip, which allows it to capture exceptional detail even in the narrow, curved anatomy of the throat and larynx.
What makes it genuinely different from a standard endoscope is the stroboscopy function. Vocal cords vibrate hundreds of times per second — far too fast for the eye or a standard camera to capture meaningfully. The stroboscopy system uses a precisely synchronised flashing light to create what is effectively a slow-motion video of the vocal cords in motion. This slow-motion view reveals micro-level problems — small lesions, subtle asymmetries, stiffness, or abnormal vibration patterns — that would be completely invisible on a regular examination. For voice disorders in particular, it is not just useful; it is essential.
The system also supports full airway evaluation and swallowing studies, making it the central tool across all four of the clinic's core services.
Scope of Services
Advanced voice diagnostics — Fiberoptic Laryngoscopy (FOL)
For patients experiencing: hoarseness, voice fatigue, cracking, pitch changes, or loss of voice
Whether you use your voice professionally — as a teacher, singer, lecturer, or public speaker — or simply find that your everyday voice has changed and isn't recovering, a Fiberoptic Laryngoscopy gives a precise, high-definition picture of exactly what is happening at the level of the vocal cords.
The examination is quick, comfortable, and immediately informative. It can accurately identify vocal nodules, polyps, cysts, muscle tension dysphonia, vocal cord paralysis, and other structural or functional causes of voice change — without the patient needing to do anything more than sit, breathe, and speak normally.
Comprehensive airway evaluation — Stridor, Laryngomalacia & Stenosis
For patients experiencing: noisy breathing, stridor, shortness of breath, or breathing difficulties in infants and adults
Noisy or laboured breathing is never something to wait out. Stridor — a high-pitched sound during breathing — signals that the airway is narrowed or partially obstructed, and the cause needs to be identified.
- In infants (laryngomalacia): The most common cause of noisy breathing in newborns, where soft tissue above the vocal cords collapses inward during inhalation. Using a specialised neonatal flexible scope, the airway can be assessed gently and in real-time while the baby breathes — giving parents clear answers quickly and without distress to the child.
- In children and adults (airway stenosis): Narrowing of the windpipe — from prolonged intubation, trauma, or medical conditions — can be precisely mapped using the clinic's high-definition flexible scope. The extent and location of the narrowing is documented clearly, and a corrective plan is formed from there.
Airway evaluation for sleep apnoea
For patients experiencing: heavy snoring, waking gasping for air, or diagnosed or suspected Obstructive Sleep Apnoea (OSA)
Obstructive Sleep Apnoea occurs when the muscles and soft tissues of the throat relax during sleep, partially or fully blocking the airway. The difficulty has always been identifying exactly where that blockage happens — because it happens at night, during sleep, and varies from person to person.
A dynamic airway evaluation using the flexible endoscope maps the specific site of obstruction — whether it is behind the tongue, at the level of the palate, or lower in the throat. This precise mapping is what allows treatment — whether medical, device-based, or surgical — to be genuinely targeted rather than generic.
Swallowing evaluations — FEES (Flexible Endoscopic Evaluation of Swallowing)
For patients experiencing: difficulty swallowing, coughing while eating or drinking, choking, or a sensation of food getting stuck
Swallowing problems — collectively called dysphagia — carry real risks beyond discomfort. Food or liquid entering the airway instead of the oesophagus can cause aspiration pneumonia, weight loss, and nutritional decline, particularly in older patients or those recovering from stroke or neurological illness.
FEES is the gold standard assessment for swallowing disorders. The flexible endoscope is passed into position, and the patient eats and drinks small amounts of food and liquid — dyed for visibility — while the entire swallowing mechanism is observed in real-time. It captures whether the airway is being protected during swallowing, where the breakdown in the swallowing sequence is occurring, and what textures or positions are safest for the patient. From there, a targeted swallowing therapy plan is built.
When to Visit the Clinic
A consultation is strongly recommended if any of the following have persisted for more than two to three weeks:
- Hoarseness, roughness, or an unexplained change in voice quality
- Increased effort, discomfort, or fatigue when speaking
- Noisy or laboured breathing — in an infant or an adult
- Heavy snoring combined with daytime tiredness or waking gasping
- Coughing, choking, or a sensation of food sticking when eating or drinking
These symptoms don't always indicate something serious — but they always deserve a proper look.
Voice Clinic Team
Dr Prasun Mishra
MS ENT & Laryngologist
Head of Voice clinicDr Chethana R
MS ENT &
Fellowship in Laryngology
Dr Shivani Dixit
MS ENT
(Fellowship in Laryngology)Mr Appas Saha
Speech Language Specialist
(Voice and swallowing therapy )
FAQs
Is the laryngoscopy procedure painful?
No. The flexible scope is ultra-slim and passes gently through the nose after a light topical spray. Most patients find it far less uncomfortable than they expect. There is no sedation required, and patients can drive themselves home afterwards.
Who should see a voice specialist — is it only for singers or professional speakers?
Not at all. Anyone whose voice has changed, become hoarse, weakened, or started giving out — whether they use it professionally or not — deserves an assessment. Voice changes that persist for more than two to three weeks should always be investigated, as they can occasionally be the first sign of something that responds very well to early treatment.
My baby has noisy breathing — should I be worried?
Noisy breathing in a newborn is common and is most often caused by laryngomalacia — a soft, floppy airway that usually resolves as the baby grows. However, it should always be assessed properly to confirm the diagnosis and rule out other causes. The clinic uses a specialist neonatal scope that is gentle enough for infants, and the examination gives parents clear answers quickly.
What is dysphagia and how serious is it?
Dysphagia means difficulty swallowing — food or liquid either doesn't go down easily, or goes the wrong way into the airway rather than the oesophagus. In the short term it is uncomfortable and distressing; in the longer term, repeated aspiration can cause serious chest infections. It is particularly common after stroke, neurological illness, head and neck cancer treatment, or simply with age.
Can swallowing problems be treated without surgery?
In many cases, yes. Swallowing therapy — working with a specialist therapist on posture, technique, food texture modification, and targeted exercises — can significantly improve or resolve dysphagia. Surgery is considered when there is a structural cause that therapy alone cannot address. The FEES assessment guides which approach is appropriate.
What is the difference between a standard laryngoscopy and laryngostroboscopy?
A standard laryngoscopy shows what the vocal cords look like — their structure, colour, and any obvious lesions. Stroboscopy goes further, creating a slow-motion view of the cords vibrating in real-time. This reveals how they are actually moving — whether they vibrate symmetrically, whether there is stiffness or a subtle lesion affecting their motion — information that is critical for diagnosing voice disorders accurately and choosing the right treatment.
What happens at a sleep apnoea airway evaluation?
The flexible endoscope is used to map the upper airway while the patient is awake and breathing normally, sometimes with certain manoeuvres to simulate the relaxation that occurs during sleep. This identifies exactly where the airway collapses or narrows — information that is essential for recommending the right treatment, whether that is a CPAP device, a dental appliance, or a surgical correction targeted to the right level.