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Otolaryngology – Head and Neck Surgery
Division of Communication Sciences and Disorders

Otolaryngology – Head and Neck Surgery
Division of Communication Sciences and Disorders

The Division of Communication Sciences and Disorders, within the Department of Otolaryngology, consists of both audiologists and speech-language pathologists (SLPs) who work in a variety of specialized settings across the Penn State Health system.

Audiologists

Our team of board-certified audiologists has completed advanced training in audiology and hearing instrument services. 

Services:

  • Vestibular evaluations
  • Electrophysiologic evaluations
  • Hearing loss and associated treatments, such as cochlear implants, osseointegrated devices and hearing aids

Our audiologists practice at the following sites:

University Physician Center 
Otolaryngology – Head and Neck Surgery and Audiology
200 Campus Drive, Suite 400, Entrance 2
Hershey, PA 17033 
Phone: 717-531-6822
Fax: 717-531-4907
Hours: Monday – Thursday, 7 a.m.-8 p.m., Friday 7 a.m.-5 p.m.

Clinicians:
•    Frank Baur, AuD
•    Roxanne Hagenbuch, MS, FAAA
•    Jessica Jordan, AuD, CCC-A
•    Maura Kelly, AuD, CCC-A
•    Jill McClelland, AuD, CCC-A
•    Stephanie Milks, AuD, CCC-A, FAAA
•    Jackie Price, AuD
•    Ashley Wampler, PhD, CCC-A
•    Kathryn Brindamour, Hearing Instrument Specialist
 

Penn State Health Lime Spring Outpatient Center
Specialty and Ancillary Health Services – First Floor, Suite E

2221 Noll Drive
Lancaster, PA 17603
Phone: 717-715-1001
Hours: Monday – Friday, 8 a.m.-5 p.m.

Clinicians:
•    Jackie Price, AuD
•    Maura Kelly, AuD, CCC-A

Speech Language Pathologists

Speech-language pathologists (SLPs) treat patients of all ages for a variety of diagnoses, including disorders of articulation, phonology, language, cognition, swallowing, voice, pragmatics, hearing and fluency, as well as instruction on augmentative and alternative communication (AAC). Depending on their disorder or needs, your patients may be best served at a particular clinic within Penn State Health Milton S. Hershey Medical Center. This helps schedule patients with an SLP most thoroughly trained in their disorder area, ensuring more efficient diagnosis and improved patient care.

ALS Clinic (Neurology)
30 Hope Drive, Suite 1500, Entrance B
Hershey, PA 17033
Phone: 717-531-8070

Disorders treated: 

  • Amyotrophic lateral sclerosis (ALS)
  • Primary lateral sclerosis (PLS)

Services: 

  • Dysphagia evaluations and management
  • Dysarthria evaluations
  • Functional communication needs
  • Cognitive dysfunction evaluations 
  • AAC evaluation and programming
  • Telemedicine

SLP:

  • Carrie Reichwein, MS, CCC-SLP


Developmental Clinic
905 W. Governor Road, Suite 300
Hershey, PA 17033
Phone: 717-531-6807
Fax: 717-531-0276

Disorders treated: 

  • Suspected autism/pragmatics
  • Speech/language delay
  • Phonological disorders
  • Language disorders
  • Global developmental delay

Services: 

  • Autism evaluations
  • Speech/language evaluations
  • AAC informational counseling
  • Communication strategy instruction (Hanen Centre More Than Words Program)

SLP:

  • Brandon Henken, MS, CF-SLP

ENT Clinic (University Physician Center) 
Otolaryngology ― Head and Neck Surgery and Audiology
200 Campus Drive, Suite 400, Entrance 2
Hershey, PA 17033
Phone: 717-531-6822
Fax: 717-531-4907

Disorders treated: 

  • Dysphonia
  • Vocal fold polyp
  • Vocal fold granuloma
  • Vocal fold nodules
  • Vocal fold paresis/paralysis
  • Vocal fold hemorrhage
  • Vocal fold dysfunction (VCD) paradoxical vocal fold motion (PVFM) disorder and laryngospasm
  • Presbylarynx
  • Muscle tension dysphonia
  • Velopharyngeal dysfunction (VPI)
  • Laryngectomy/aphonia
  • Dysphagia (during head and neck cancer treatment)
  • Hearing loss with cochlear implantation

Services: 

  • Acoustic/aerodynamic voice evaluations (multidisciplinary with laryngologist)
  • Voice therapy
  • Lee Silverman voice treatment (LSVT LOUD)
  • Videostroboscopy (rigid, flexible)
  • Laryngoscopy
  • Cough reduction therapy
  • Laryngectomy counseling
  • Radiation dysphagia counseling
  • Voice prosthesis (TEP) replacement
  • Velopharyngeal dysfunction evaluations
  • Cochlear implant counseling
  • Aural rehabilitation 
  • Melissa Montano, MS, CCC-SLP
  • Erin Kelly, MS, CCC-SLP

 A female speech language pathologist or SLP performs laryngeal massage for patient with muscle tension dysphonia during voice therapy. The SLP has her hands just under the patient’s chin at the base of the neck. The patient is an older female.

A speech language pathologist performs laryngeal massage for a senior patient with muscle tension dysphonia during voice therapy.

Facial Nerve Disorders Clinic
845 Fishburn Road
Hershey, PA 17033
Phone: 717-531-1405

Disorders treated: 

  • Bell’s Palsy
  • Facial nerve palsy
  • Head and neck cancer
  • Lyme disease 
  • Cholesteatoma
  • Neurologic disorders
  • Ramsay Hunt syndrome
  • Intercranial tumors
  • Skull base or facial trauma
  • Stroke
  • Sarcoidosis
  • Sykinesis

Services:

  • Facial nerve rehabilitation

SLPs:

  • Nicole Fisher, MS, CCC-SLP


Feeding Clinic
905 W. Governor Road, Suite 350
Hershey, PA 17033
Phone: 717-531-7117
Fax: 717-531-0720

Disorders treated: 

  • Dysphagia
  • Chewing problems
  • Choking phobias
  • Food refusal
  • Food sensitivity
  • Transitioning to solid foods

Services: 

  • Pediatric dysphagia/feeding evaluations
  • Pediatric dysphagia/feeding therapy

SLPs:

  • Kristen Mauer, MS, CCC-SLP
  • Marie Kurtz, MS, CCC-SLP
  • Carrie Reichwein, MS, CCC-SLP

Therapy Services ― East Campus
30 Hope Drive, Suite 1500, Entrance B
Hershey, PA 17033
Phone: 717-531-8070

Disorders treated: 

  • Aphasia
  • Dysphagia
  • Dysarthria
  • Apraxia
  • Developmental speech/language delay
  • Articulation/phonological disorders
  • Expressive/receptive language disorders
  • Traumatic brain injury (TBI)/concussion
  • Autism/pragmatics

Services: 

  • Pediatric language evaluations/therapy
  • Adult cognition/language 
  • Evaluations/therapy
  • Adult/pediatric speech evaluations/therapy
  • Dysphagia evaluations, including modified barium swallow study (MBSS) performed in radiology
  • Dysphagia therapy
  • Neuromuscular electrical stimulation (NMES)/VitalStim
  • LSVT LOUD

SLPs: 

  • Marie Kurtz, MS, CCC-SLP
  • Nicole Fisher, MS, CCC-SLP
  • Kristen Mauer, MS, CCC-SLP
  • Carrie Reichwein, MS, CCC-SLP
  • Megan Clark, MS, CCC-SLP
  • Megan Klinger, MS, CCC-SLP
  • McKenzie Troutman, MA, CCC-SLP
  • Katherine O’Connor, MA, CCC-SLP

 Therapy session with a female speech language pathologist and a young girl learning to pronounce the letter “s.” Their hands are on their chins to learn the ”s” sound correctly during speech therapy.

A speech language pathologist provides a visual cue to a young girl to help her pronounce the “s” sound correctly during speech therapy

Therapy Services (Inpatient ― Main Hospital)
500 University Drive
Hershey, PA 17033

Disorders treated: 

  • Dysphagia
  • Dysarthria
  • Apraxia
  • Aphasia
  • TBI
  • Cerebrovascular accident (CVA)/stroke
  • Tracheostomy/speaking valve

Services: 

  • Dysphagia evaluations/therapy
  • MBSS
  • Fiberoptic endoscopic evaluation of swallowing (FEES)
  • Cognition/language evaluations/therapy
  • Speaking valve evaluations

SLPs:

  • Sue Lynch, MS, CCC-SLP
  • Joan Schwanger, MS, CCC-SLP
  • Kelly Kauffman, MS , CCC-SLP
  • Laura Nairns, MS, CCC-SLP
  • Svetlana Bazhan, MS, CCC-SLP
  • Lauralee Pudup Hoffner, MA, CCC-SLP
  • Molly Polacco, MS, CCC-SLP
  • Katherine O’Connor, MA, CCC-SLP
  • Heather Noll, MA, SLP
  • Sarah Ames, MS, CCC-SLP

 A health care worker, wearing surgical gloves is checking man's throat as he drinks. She is a speech language pathologist specializing in dysphagia (swallowing) and she is checking the man's swallow as he drinks to determine if it is safe for him to eat or drink. Neutral tiled background could be in a hospital or could be a home.

A speech language pathologist performs a dysphagia (swallow) evaluation on a patient to determine if it is safe for him to eat and drink.

Cochlear Implant Board

The Cochlear Implant Board at Penn State Health Milton S. Hershey Medical Center consists of a team of otologists, audiologists, speech-language pathologists (SLPs), developmental pediatricians and geneticists. This team provides comprehensive and multidisciplinary care to our pediatric and adult patients undergoing cochlear implantation due to hearing loss.

Cochlear Implant Board members:

  • Huseyin Isildak, MD
  • Jessica Jordan, AuD, CCC-A
  • Maura Kelly, AuD, CCC-A
  • Jason May, MD
  • Jill McClelland, AuD, CCC-A
  • Stephanie Milks, AuD, CCC-A, FAAA
  • Melissa Montano, MS, CCC-SLP
  • Jackie Price, AuD
  • Cheryl Tierney, MD
  • Ashley Wampler, PhD, CCC-A

What is a cochlear implant?

A cochlear implant is a prosthesis that serves to bypass the areas of dysfunction within the cochlea and provide direct electrical stimulation patterns to the neural portion of the auditory system. Cochlear implantation allows for near restoration of auditory perception for the implanted ear(s), but does not restore normal hearing sensitivity. Cochlear implants can improve patients’ communication and quality of life. 

Success using a cochlear implant is rarely as simple as activating the implant. It depends on a variety of factors, including:

  • Severity of hearing loss
  • Duration of hearing loss
  • Prior expressive and receptive language skills (including sign language)
  • Age at implantation
  • Age at hearing loss
  • Age at identification of hearing loss
  • Vision status
  • Cognitive ability
  • Support system
  • Patient motivation

 Head and shoulders photo of a young boy showing one side of his head with a cochlear implant.

A boy with a Cochlear implant.

How does it work?

Cochlear implantation involves surgical placement of an electrode array to allow for electrical stimulation of the auditory nerve. Unlike hearing aids, which amplify sound, a cochlear implant bypasses damaged portions of the inner ear and electrically stimulates the auditory nerve. Each of the cochlear implant components works to collect sound from the external environment and transduce them into electrical signals that can be processed along the auditory pathway. 
The external sound processor serves to collect incoming auditory input and the external transmitting coil converts the signals into digital components. Internally, the receiving coil collects the digital signals and transduces them into electrical impulses, which are then transmitted to the electrode array. From there, the electrode array electrically stimulates the auditory nerve, and the encoded information is transferred to the brain. 

Who can get a cochlear implant?

Cochlear implantation is a surgical intervention intended for individuals who meet specific Food and Drug Administration (FDA) candidacy criteria. Adults and children as young as six to 12 months can be considered, but candidacy criteria differs across age groups and should be kept in mind when making referrals to audiology. Criteria includes:

  • Moderate to profound sensorineural hearing loss (adult); severe to profound sensorineural hearing loss (pediatric)
  • Minimum six months’ trial with amplification AND limited benefit from hearing aids as determined using evidence-based practice by the audiologist
  • No medical contraindications
  • High patient/family motivation and realistic expectations for outcomes

The FDA has also approved a cochlear implant system for individuals with single-sided deafness and asymmetric hearing loss. This configuration is intended for individuals who have profound sensorineural hearing loss in the ear to be implanted and normal hearing or mild to moderate sensorineural hearing loss in the other ear. Currently, the FDA has not approved unilateral implantation for children under the age of five. 

When should children receive cochlear implants?

This decision is made on an individual basis by physician and audiologist recommendation per the candidacy criteria listed under “Who can get a cochlear implant?” However, from a speech and spoken language development perspective, this cannot be done too soon. Early identification of hearing loss and early auditory intervention is crucial for a child to develop spoken expressive language and comprehend spoken language receptively. There is a critical window for language and auditory neural development, with much of this development occurring before two to three years of age, when neuroplasticity is greatest. If the brain is not exposed to sound or spoken language during this time, these auditory neural pathways cannot develop, resulting in speech and spoken language delays. Therefore, children who receive their cochlear implants outside of this critical period will likely have speech delays and reduced potential for developing spoken language. 

How is audiology involved?

The Division of Communication Sciences and Disorders’ audiology department develops a relationship with each patient seeking cochlear implantation. Numerous audiology appointments are required to ensure that each patient meets eligibility criteria before pursuing implantation. These appointments can include hearing aid counseling, fittings and adjustments, as well as a comprehensive cochlear implant evaluation with follow-up discussions. We can also make referrals to speech-language pathology, genetics, child development and early intervention to maximize patient outcomes after implantation. 

How is speech-language pathology involved?

After initiating the cochlear implant candidacy process with audiology, patients are referred to an SLP to discuss expectations following surgery. This includes discussions regarding the goals of aural rehabilitation, information for online aural rehabilitation programs, sign language resources, communication strategies and environmental modifications to promote listening. For children, the importance of hearing on speech and spoken language development is heavily emphasized. Our clinicians also provide parents with language stimulation skills, local deaf/hard of hearing and early intervention resources and information on classroom accommodations. All cochlear implant patients are seen for a counseling session with an SLP before surgery, as well as following activation. If a patient is an appropriate candidate for aural rehabilitation, this will be recommended following activation.

What kind of follow-up appointments are required?

Patients attend audiology and speech-language pathology follow-ups.

Audiology follow-up

After implant surgery, the patient is seen by audiology for a cochlear implant activation. At that appointment, the audiologist will adjust, or map, the sound processor to allow for appropriate sound stimulation. Many mapping sessions are required over the first year after initial activation, and continued follow-ups are required over the patient’s lifetime to ensure success with the cochlear implant. During that time, the patient has repeated audiologic assessments to monitor progress and make appropriate adjustments to the implant programming. The goal of these appointments is to improve patient access to auditory information and maximize their hearing and speech-related outcomes.

It takes time and training for a patient to understand and recognize the signals received from a cochlear implant, which is why follow-up appointments with audiology and speech-language pathology are essential for patient success. Within a year of use, most people with cochlear implants make considerable gains with their speech comprehension.

Speech-language pathology follow-up

After receiving a cochlear implant, patients may benefit from additional services from an SLP trained in aural rehabilitation to gain the most benefit from this new device. While the brain may detect the presence of sound following cochlear implant activation, structured auditory training is recommended to learn to process and comprehend sound in this new way (electrically versus naturally). 

For adults who have lost their hearing and receive a cochlear implant, aural rehabilitation trains the implanted ear(s) to detect, differentiate and identify what sound it hears, as well as understand the meaning of those sounds in a different way. For children born without hearing, aural habilitation does the same, but helps train the implanted ear(s) to comprehend the meaning of sound for the first time. This is critical for developing spoken language. 

An SLP may target the following areas during aural rehabilitation/habilitation:

  • Pre-cochlear implant counseling (for adults and parents)
  • Auditory training
  • Functional communication skills training
  • Speechreading
  • Education on communication options
  • Environmental modifications to maximize listening (including in school settings)
  • Online auditory training resources for home practice
  • Sign language resources
  • Contact information for local academic and early intervention resources

It is very important for patients and parents of pediatric patients to be motivated to practice therapy exercises daily at home for maximum listening benefit. The amount of time and effort put into the aural rehabilitation process significantly impacts therapy outcomes. 

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