functional voice disorders Flashcards
(28 cards)
what is muscle tension dysphonia? what is it often related to? therapy (2)?
- observable tension of neck, shoulders, jaw, throat
- psychosocial stress
- voice therapy, relaxation
what is generalized tension phonation? (2)
- All laryngeal muscles are engaged during phonation, including the abductor muscles
- Activity of the posterior cricoarytenoid muscle leads to a posterior glottic gap leading to nodules, polypod degen, chronic inflammation
what is lateral hyperadduction?
VFs coming together too forcefully; can lead to a strained voice quality.
what can cause anterior-posterior hyperadduction?
speaking in a lower than natural pitch
what is hyperadduction of the ventricular folds? tx (2)?
- false folds closing over true folds
- tx: relaxing, voice therapy
what is vocal fatigue? symptoms (5)?
- effortful, inconsistent, ineffective phonation
- deteriorating voice quality, resp support, xerostomia, pain at base of tongue/throat, laryngeal globus
what is progressive laryngeal muscle fatigue (myasthenia laryngis)?
- medical condition
- more severe vocal fatigue; normal, disappears, comes back after break
how might vocal fatigue appear during ax (4)? tx?
- ax: stroboscopic exam – normal at rest but -amplitude, phase symmetry and anterior gap may be present
- tx: physiological voice tx
what is phonotrauma? causes (4)?
- trauma from phonation
- prolonged mal behaviours such as loud/aggressive phonation, hard voice onset, poor shouting/singing tech, aggressive/repetitive vegetative maneuvers (coughing, grunting)
phonotrauma tx (2)?
- voice tx + counselling
- phonosurgery + voice tx
what is mixed glottal-ventricular phonation vs ventricular phonation?
- mixed: can change pitch
- ventricular: no pitch modulation
ventricular phonation tx (2)?
- voice tx
- vocal re-education
what is puberphonia in males vs females?
- males: post-mutational falsetto
- females: juvenile voice
post-mutational falsetto: possible causes (3), perceptual signs (3), and physiology (1)?
- causes: feminine self-ID, resistance to adulthood, muscle incoordination
- signs: elevated larynx, high pitch, soft breathy voice
- habitual cricothyroid hyperfunction
T or F: because of this habitual lengthening of the vocal folds in post-mutational falsetto, the compression that is necessary for loudness cannot be achieved and patients may find it difficult to raise their voices.
true
juvenile voice: possible causes (2)? perceptual signs (4)? physiology (1)?
- causes: resistance to adulthood, muscle incoordination
- signs: child-like pitch, elevated larynx, high pitch, soft breathy voice
- habitual cricothyroid hyperfunction
therapy for post-mutational falsetto and juvenile voice?
voice therapy!
how does male-to-female transgender voice tx work? (3)
- cricothyroid approximation (stitching the 2 cartilages tg)
- anterior web instalment
- voice tx
how does female-to-male transgender voice tx work? (2)
- prolonged testosterone tx
- voice tx
what is psychogenic conversion dysphonia and aphonia? what does it often follow? more common in males or females? induced by?
- severe aphonia/dysphonia despite intact anatomy/physiology
- often follows cold/sore throat
- females
- stress/tension
psychogenic voice disorder tx? (2)
- voice tx
- psychotherapy
irritable larynx syndrome criteria? (3)
- tension: dysphonia and/or laryngospasm with/without globus, chronic cough
- palpable/visible tension in cricothyroid, thyrohyoid, supralaryngeal muscles
- sensory trigger: airborne or esophageal irritant
describe the irritable larynx syndrome severity spectrum (4)
- chronic throat clearing
- chronic cough
- paradoxical VF motion (closing during inhalation)
- laryngospasms
how do larynges become irritable? (3)
- altered neuronal control
- changed sensitivity threshold
- laryngopharyngeal reflux
