lee akst, md
Published on June 26, 2020
Pleased to introduce Dr. Lee Akst, laryngeal surgeon and the Director of Johns Hopkins Voice Center. Also, please check out the broadcast where Dr. Akst answers questions about voice disorders, when it is time to see a voice specialist and what to expect when you do. http://onc.broadcastmed.com/5225/videos/diagnosing-and-treating-voice-disorders-johns-hopkins-voice-center-qanda #fellowshipofthelarynx
1) Where do you currently practice?
I currently practice at the Johns Hopkins Voice Center, in Baltimore Maryland
2) Where did you complete your medical training? Laryngology?
I completed medical school at Yale, Otolaryngology residency at the Cleveland Clinic, and Laryngology fellowship at the Massachusetts General Hospital Center for Laryngeal Surgery and Voice Rehabilitation.
3) How/why did you come to choose laryngology?
I know that many laryngologists came to the field because of a personal joy in singing. My own attraction to the field was more related to the medical/surgical aspects of it – as I was going through my residency and dealing with all aspects of ear, nose, and throat disease, I found that the laryngology patients were the most interesting to me and that laryngeal surgery was the most fascinating to me.
4) What comes to your mind as one of the most pressing issues in contemporary voice disorders?
There are 2 pressing issues, I’d say. One is relative to the big-picture concern of making sure that all patients with voice or swallowing disorders have the appropriate ability to see a laryngologist when indicated – many patients with dysphonia and dysphagia, unfortunately, are told to “live with it” if nothing dangerous is identified on initial work-up, and this approach does not recognize the tremendous quality-of-life impact that laryngology care can have on patients with dysphonia and dysphagia. We need to keep educating primary care physicians, otolaryngologists, and the patients themselves that specialty care is available, and that it can substantially improve patient day-to-day quality-of-life. The second issue, more medically oriented, remains scar – even though we’re getting better and better at treating vocal folds surgically in a function-preserving fashion, we still don’t have any great treatment options when a patient with vocal fold scar presents to us in the office. We need clinical science to catch up the promising scar therapies that basic science is investigating now!
5) What is/are your research interest(s)? Would you tell us in layman’s term, what your research is about? In what ways can your research be applied in the clinical field?
My research is clinically focused and wide-ranging, looking at a variety of issues involved in laryngology – treatment of laryngeal dysplasia, for instance, but also impact that stenosis treatment has on voice, role of botulinum toxin on muscle tension dysphonia, and patterns in care of laryngopharyngeal reflux disease.
6) In your opinion, what poses the greatest challenge in care of voice disorders?
See the anwer to #4 – one great challenge in care of voice disorders is helping to make sure that every patient who might benefit from seeing a laryngologist is able to see a laryngologist.
7) What is your vocal pet peeve?
I don’t know that I have one.
8) Which vocal myth would you like to dispel?
Again, I don’t know that I have one.
9) Your most memorable voice case?
One of my memorable patients is a lovely gentleman with recurrent dysplasia. He continually presents with thick, keratotic lesions of the bilateral anterior vocal folds – I remove them in microflap fashion, he does well for a while, and then his disease comes back. Though one might think that he would be getting frustrated by the need for multiple procedures over the years, he’s always happy that we’ve been able to maintain good vibration and restore normal voice after each procedure – he’s my reminder to always focus on the patient experience of disease, and to emphasize patient function when considering the quality of an outcome.
10) As a laryngologist/surgeon, what keeps you on your toes?
My patients keep me on my toes – every week or two, at least one case comes in where laryngeal findings on exam are not what I would have expected based on history and perceptual voice analysis. Always trying to predict what I might see on stroboscopy prior to exam and then comparing actual findings to predicted findings is always a good way to make sure I’m evaluating patients with ‘fresh eyes’.
11) What do you think the next steps are in growing the field of laryngology?
As per #4 and #6, I think we need to continue focusing on education of our medical colleagues about the quality-of-life impact that laryngologists can have on patients with voice and swallowing disorders.
12) What advice would you like to give to the general populace about voice care? How about to the professional voice users?
For both general voice users and also vocal performers and professional voice users – if something doesn’t feel right, don’t just ignore it or push past it. Seek specialty care – there’s a laryngologist and speech pathologist out there that can help you!
13) Who are your favorite singers?
In the car, I tend to listen to whatever is on the radio, or whomever my kids have on – so current favorites are Taylor Swift, DNCE, and Adele. Otherwise, if I want something on in the background while working, I generally choose U2, Jack Johnson, and Dave Matthews Band.
14) What sparks “joy” for you as a person?
Joy for me comes from time spent with my family and my friends.