Functional Voice Disorders Flashcards
Functional Voice Disorders are Characterized by (4):
- muscle tension
- hyperfunction
- larynx “riding high”
- anxiety accompanies the disorder (type A ppl)
Functional Voice Disorders make up ___% of dysphonia cases:
at least 10% (all voice disorders)
Are men or women more likely to get a functional voice disorder?
Predominantly women (worriers, tend to be more emotional)–>a little sexist but ok…
Causes of Functional Voice Disorders:
- URI (upper respiratory infection)
- Compensating for an organic problem (VFs get forced together)
- Stressful/traumatic event
- Psychosocial (mood, anxiety, adjustment)
- Organic
- Idiopathic (don’t know)
Is there a structural pathology for functional disorders?
With the exception of organic causes,
NO STRUCTURAL PATHOLOGY IS PRESENT UNLESS AN ORGANIC DISORDER DEVELOPS
What does a “functional” disorder mean?
We create it. Not due to an organic or neurological problem. Sometimes it’s a psychogenic cause. E.g. ppl hold tension places and it causes problems. If you hold your stress in your larynx, stress becomes a functional voice disorder
Anatomy and Physiology for functional disorders:
Anatomy = ok, no paralysis, no legions everything looks good (unless the cause is organic)
Physiology = not ok
Classifications of Etiologies (4):
- Psychogenic – caused by underlying psychological factors
- Misuse/Abuse – caused by hyperfunction
- ->Excessive throat clearing or habitual coughing (no longer necessary, post illness)
- ->Excessive/inappropriate singing/performing (e.g. Adell or always singing in falsetto)
- Idiopathic (we don’t know)
- Organic – compensatory hyperfunction as a result of organic pathology
(e. g. nodules or VF hemorrhage)
Functional Disorders types:
- Puberphonia
- Functional aphonia
- Functional dysphonia
- Paradoxical VF Movement (PVFM)/ PVCD (paradoxical vocal cord disorder)/VCD (vocal cord disorder)
What is Puberphonia?
- disorder typically affecting males when they are supposed to drop their voice during puberty. Instead, they hold on to the higher pitch voice and hold tension there. Can happens with women during menopause
- Aka “mutational falsetto”
- Pitch control disorder (pitch too high, pitch breaks)
- 1 octave lower is normal development
- Typically male puberty
- Not due to anatomic immaturity of larynx
- Emotional stress
- Larynx “rides high”
What is Functional aphonia?
- No voice
- Voice may come and go
- Might only be able to get out a whisper or shrill-sounding voice
- Used to be termed “hysterical” syndrome and “conversion” symptom or “conversion hysteria”
- May be temporary or intermittent
- 80% of cases coexist w/ psychiatric disorders
What is Functional dysphonia?
- Another name: MTD (muscles tension dysphonia)
- ↑ m. tension, ventricular compression/phonation, A-P press, hyptertension
- Excessive tension of laryngeal/ extralaryngeal muscles (neck, shoulder)
- “Clavicular breathing”/“Chest breathing”
- ↑ vocal effort
- Vocal fatigue
- Hyperfunction
- Ventricular compression
- Ventricular phonation
- A-P press
Organic causes of Functional dysphonia:
- Nodules
- Polyps
- Laryngitis
- Reflux
What is Paradoxical VF Movement (PVFM)
(also called PVCD (paradoxical vocal cord disorder)/VCD (vocal cord disorder)?:
- when breathing in, vocal fold adduct instead of stay abduct
- get “ inspiratory strider” due to adducted vocal folds
- 3 different names: PVFM, PVCD, VCD
- Frequently misdiagnosed as asthma
Etiologies of Paradoxical VF Movement (3):
- Psychogenic
- LPR
- Neurological
