02:10am Tuesday 02 June 2020

On World Voice Day, Patient Celebrates His Voice and the Doctor Who Restored It


Now 31, Glevenyak is thrilled to be able to talk about how his voice, and his life, were restored at the Miller School’s Miami Voice program on any day, but especially on April 16, which happens to be World Voice Day. He owes his recovery to David E. Rosow, M.D., assistant professor of otolaryngology, who with four speech pathologists and the Frost School of Music behind him, is building Miami Voice into a premier medical center for singers, performers, and others who, like Glevenyak, rely on their voices for their livelihoods.


“We have the team and the resources to provide the most comprehensive approach to any voice problem for anyone in the state,” said Fred F. Telischi, M.D., professor and Chair of Otolaryngology. “There is, unfortunately, a wide disparity of care and limited awareness in the general public about the importance of good care of the larynx and voice.”


Glevenyak, who was referred to UM after his vocal cords were badly scarred by an operation to remove recurring growths, learned the hard way that, “if you have a voice problem, you need to see a doctor who specializes in voices” – a laryngologist. How he found Rosow would be a stroke of good timing.


A violinist with the Boston Philharmonic Orchestra for nine years, Rosow is among the few laryngologists with a background in music. He realized he could combine his love of music with his love of medicine while on his ENT – ear, nose and throat – rotation at Harvard Medical School.


There in the office of one of the world’s leading voice specialists and innovators, Steven E. Zeitels, M.D., Director of the Center for Laryngeal Surgery and Voice Rehabilitation at Massachusetts General Hospital, was a piano. Zeitels doesn’t play, but speech pathologists used the piano to warm up his singing patients, who have included Adele, Julie Andrews, and Roger Daltrey. “When I saw that, a light bulb went off,” Rosow recalled. “I knew I wanted to do specifically what he did.”


After completing a residency in otolaryngology/head and neck surgery at New York Presbyterian Hospital, Rosow returned to Harvard as Zeitels’ 2010-2011 Clinical Fellow in Laryngeal Surgery and Voice Disorders. There he learned the delicate techniques of repairing the voice damaged by nodules, cysts, polyps, cancer or other vocal cord disorders from the master who invented many of them.


At about the same time, Roy Casiano, M.D., professor and vice chair of otolaryngology, who with speech pathologist Donna Lundy, Ph.D., CCCSLP, associate professor of otolaryngology, had launched the Department of Otolaryngology’s comprehensive voice and swallowing clinic in the 1980s, began focusing exclusively on his world-renowned area of expertise – sinus and skull-based surgery. He recruited Rosow to take over the voice program with Lundy, who is revered at the Frost School, and by singers across South Florida, for her skill at teaching people who overuse or misuse their voices how to protect them. Soon, an opera singer with a doctorate of musical arts will join the voice therapy team.


Fortunately for Glevenyak, Rosow arrived at the Miller School in August 2011, just weeks after he saw a local doctor for the second time about the lingering hoarseness he had developed during a bout of walking pneumonia. For the second time, the doctor removed wart-like growths from his larynx, but this time Glevenyak’s hoarseness devolved into a raspy, barely audible whisper. He couldn’t even talk on the phone. Unable to explain why, the surgeon referred Glevenyak to UM.


Rosow took one look and had the answer: The doctor had correctly diagnosed Glevenyak with recurrent respiratory papillomatosis, a rare respiratory infection, which caused by the common human papilloma virus (HPV), promotes the growth of benign lesions on the larynx. The doctor also prescribed the correct treatment – laser removal of the warts – but he used the wrong tool, leaving Glevenyak with a thick web of scars at the intersection of his V-shaped vocal cords.


“Scarring has a real impact on the voice,” Rosow said. “If you use a laser on both sides of the vocal cords too close to where they come together they can fuse, leaving less of the vocal cord available to vibrate. Joe had terrible scarring. That’s why he had such a terrible voice. He sounded like an 85-year-old man.”


Over the next eight months, Rosow performed a number of surgeries on Glevenyak to mitigate the scarring and promote healing. That included the insertion of a plastic stent into his vocal cords, where it remained for weeks.


When Rosow finally removed the stent, Glevenyak drove back to Jupiter, nervously waiting for the anesthesia to wear off so he could try out a few sentences. “Hi, my name is Joe.” “Good afternoon.” “I just saw Dr. Rosow.”


He was elated. His voice wasn’t as strong as it is now, but it was his voice, not the croaky whisper that scared children away, and was about to cost him his job. “I was overjoyed,” he said. “I knew that 85-year-old voice, that one I thought I’d have to live with, was gone. Holy cow, I had my life back.”


What hasn’t come back in nearly a year are the recurring warts. After regaining his voice, Glevenyak had to return to Rosow periodically to have new growths removed. Initially, there would be six or seven, but they soon dwindled to one or two, then disappeared altogether. Glevenyak credits that welcome turn to a skilled voice surgeon who knows exactly the right tools and techniques to use.


“Without Dr. Rosow and the University of Miami I would be doing manual labor,” Glevenyak said. “It’s not just his hands of gold. He’s got a totally different laser to control the disease, and he knows how to use it. Two years ago, my life as I knew it was over and now it’s like nothing happened.”

University of Miami

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