Voice disorders affect millions of people, and Mr Nick Hamilton sees a wide range of conditions at his practices at The London Clinic and One Welbeck. His PhD research into voice box scarring, combined with his fellowship training at the MGH Voice Center in Boston, has given him particular expertise in diagnosing complex voice disorders.
Understanding the most common voice conditions and how they’re diagnosed can help you recognise when you might need specialist help.
What are vocal cord nodules and how are they diagnosed?
Vocal cord nodules are small, benign growths that develop on the vocal cords due to vocal trauma or overuse. They’re often called “singer’s nodules” though they can affect anyone who uses their voice extensively.
Mr Hamilton diagnoses nodules using flexible laryngoscopy, a procedure that allows direct visualisation of the vocal cords. The nodules appear as small, callus-like bumps that prevent the vocal cords from closing properly.
Symptoms typically include hoarseness, vocal fatigue, and a rough or breathy voice quality. Professional voice users often notice decreased vocal range or difficulty hitting certain notes.
How does Mr Hamilton identify vocal cord polyps?
Vocal cord polyps are fluid-filled swellings that can develop on one or both vocal cords. Unlike nodules, polyps can occur from a single episode of vocal trauma, such as shouting at a sporting event.
During examination at The London Clinic or One Welbeck, Mr Hamilton uses advanced video laryngoscopy to identify polyps, which appear as soft, grape-like growths on the vocal cord surface.
Polyps often cause more dramatic voice changes than nodules, sometimes resulting in significant hoarseness or a “double voice” effect where two different pitches are heard simultaneously.
What is vocal cord paralysis and how is it diagnosed?
Vocal cord paralysis occurs when one or both vocal cords cannot move properly due to nerve damage. This can result from surgery, viral infections, or neurological conditions.
Mr Hamilton’s expertise in complex voice disorders enables him to diagnose paralysis through careful examination of vocal cord movement during breathing and speaking. He uses dynamic laryngoscopy to assess how well the vocal cords move.
Research indicates that approximately 1 in 1000 people develop vocal cord paralysis, with symptoms including breathy voice, difficulty speaking loudly, and sometimes swallowing problems.
How does Mr Hamilton diagnose laryngopharyngeal reflux?
Laryngopharyngeal reflux (LPR) occurs when stomach acid reaches the throat and voice box, causing irritation and inflammation. Unlike heartburn, LPR often doesn’t cause obvious symptoms.
Mr Hamilton looks for specific signs during examination, including redness and swelling around the vocal cords, particularly at the back of the voice box. His published research on this condition helps him identify subtle signs that other practitioners might miss.
Common symptoms include chronic throat clearing, persistent cough, sensation of a lump in the throat, and voice changes, particularly in the morning.
What are vocal cord cysts and how are they identified?
Vocal cord cysts are fluid-filled sacs that develop within the vocal cord tissue. They can be congenital or develop due to blocked mucus glands on the vocal cord surface.
During consultation, Mr Hamilton uses high-definition laryngoscopy to identify cysts, which appear as smooth, rounded swellings that can significantly affect voice quality.
Cysts often cause persistent hoarseness and may require surgical removal, particularly if they’re large or significantly impacting voice function.
How does Mr Hamilton approach voice disorder diagnosis?
Mr Hamilton’s diagnostic approach combines his clinical expertise with advanced technology. He uses flexible video laryngoscopy as a primary diagnostic tool, allowing real-time visualisation of vocal cord function.
Voice analysis may include acoustic measurements and perceptual assessment of voice quality. His research background enables him to interpret complex findings and identify conditions that might be missed by less specialised practitioners.
The diagnostic process typically involves a detailed history, physical examination, and laryngoscopy, with additional tests ordered if needed based on initial findings.
What makes Mr Hamilton’s diagnostic approach unique?
His PhD research into voice box scarring and tissue damage provides additional insight into complex cases. This research background, combined with his fellowship training in Boston, enables him to diagnose rare or complex conditions.
Mr Hamilton’s experience with professional voice users means he understands the subtle voice changes that can significantly impact careers, even when they might seem minor to other practitioners.
His collaborative approach with speech therapists and other specialists ensures comprehensive assessment and treatment planning for complex cases.
When should you seek specialist diagnosis?
Any voice change lasting more than two weeks warrants professional evaluation. Mr Hamilton particularly recommends early consultation for professional voice users or anyone whose voice is essential to their livelihood.
Sudden voice changes, particularly if accompanied by swallowing difficulties or breathing problems, require urgent specialist assessment.
His expertise in complex voice disorders makes him particularly qualified to evaluate persistent or recurring voice problems that haven’t responded to initial treatment.
You can book a comprehensive voice assessment with Mr Hamilton at The London Clinic or One Welbeck by calling 020 7034 6053 to discuss any concerns about your voice.
