Bastian Voice Institute

08/09/2026

Take a journey down memory lane with a photo of Dr. Robert Bastian 40 years ago, explaining a videoendoscopy to the patient. Even with the advances in technology and innovation, the basics of laryngology evaluation and patient care at Bastian Voice Institute remain the same today:

1. what the patient tells us;
2. what the voice (phenomenology) tells us; and
3. what the larynx, seen at close range, tells us.

And overall, to provide the highest quality medical, surgical, and behavioral care and consideration for persons with voice, swallowing, and airway disorders.

07/26/2026

At three months since onset and subsequent treatment with the macrolide antibiotic azithromycin, the patient says even her singing voice is recovered to baseline. The shocking and deep ulceration seen at her initial examination has completely healed, with only faint residual pinkness: https://laryngopedia.com/ulcerative-laryngitis/ -treatment

07/19/2026

R-CPD has become widely recognized by otolaryngologists (ENT physicians) around the world, leading to successful diagnosis and treatment of thousands of patients.

Since Dr. Bastian's original description of R-CPD in 2019, adoption within gastroenterology has been slower. One reason may be that R-CPD is diagnosed primarily by recognition of a highly characteristic clinical syndrome rather than by conventional diagnostic testing—and this is a different diagnostic paradigm than what is applied to many other gastrointestinal disorders.

Dr. Jerome Lechien (Belgium) and Dr. Bastian have now published a comprehensive review article in the gastroenterology literature. The article reviews the current understanding of R-CPD, including its etiology, pathophysiology, clinical presentation, diagnosis, and management. Its title includes the phrase:
"...What the Gastroenterologist Should Know."

The hope is that this review will increase awareness among the specialists who may encounter patients with R-CPD first, leading to earlier diagnosis, fewer unnecessary tests, and more timely, effective treatment: https://doi.org/10.1097/MOG.0000000000001177

07/17/2026

When a burp is needed, the average person can, at least for a time, say either “no” or “yes” to release it.

Unfortunately, for people with R-CPD, the problem is that they do not yet have access to that “yes.” Botox temporarily provides that "yes" on their behalf by relaxing the muscle that has been blocking the release. In that sense, Botox acts like training wheels for burping.

But the Botox effect does not last forever. Before the botox-provided training wheels fade, the individual must participate in, and eventually master, the process:

1) Noticing the tiny inner "throat" movement that gives the burp that final moment of "permission" to come out;

2) Practicing it;

3) Gradually learning to reproduce it even when Botox is completely gone.

In a new video, Dr. Bastian explores how to recognize, find, and master your own burping “YES.”

07/09/2026

Dr. Bastian is deeply honored to have been invited to speak at the 25th Otorhinolaryngology Foundation Congress in São Paulo, Brazil on August 20-22, 2026. His talks will focus on R-CPD (inability to burp, no-burp), and dysphagia with special focus on the videoendoscopic swallow study (VESS). He will also participate in two panel discussions.

06/14/2026

Beginning with the first 51 cases of R-CPD reported in 2019 with colleague Smithson, Dr. Bastian has raised global awareness of the disorder through peer-reviewed open-access publications, his public service website Laryngopedia (search "RCPD" on www.laryngopedia.com), YouTube educational content (), Zoom lectures worldwide, and in-person teaching. He has taught the diagnosis and treatment of R-CPD to a host of physicians on every continent except Antarctica.

06/09/2026

The terms Paradoxical Vocal Cord Motion (PVCM) and Vocal Cord Dysfunction (VCD) have long been used to describe episodic difficulty breathing. Yet both terms, though entrenched among laryngologists and speech pathologists, may obscure more than they clarify, suggesting that they be retired.

Drawing on extensive clinical experience, the author proposes that the phenomenon labeled PVCM/VCD is, in many cases, better understood as a nonorganic, behavioral disorder of laryngeal use—whether conscious or subconscious: https://laryngopedia.com/paradoxical-vocal-cord-motion-and-vocal-cord-dysfunction-should-these-terms-be-retired/

06/07/2026

Is a person's wheezing due to Asthma, "Asthma-MAXXING," or Nonorganic Wheezing?

The answer lies in understanding large-airway wheezing.

Some patients can voluntarily narrow their trachea and mainstem bronchi, amplifying the apparent severity of asthma ("asthma-maxxing").

Others can even convincingly simulate asthma and receive that diagnosis despite not having the condition:

If you would like to have an educational / informational Zoom call ...

06/04/2026

How do you distinguish between Essential Voice Tremor or Laryngeal Dystonia (Spasmodic Dysphonia) with an overwhelming Dystonic Voice Tremor component using vocal phenomenology alone?

Listening carefully to this patient audio sample reveals two key points of potential distinction: https://laryngopedia.com/understanding-the-distinction-between-essential-voice-tremor-and-dystonic-voice-tremor/

06/03/2026

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