organic voice disorders Flashcards
(20 cards)
What are vocal nodules?
Inflammatory degeneration of the SLP, most common benign lesion, usually bilateral, pin sized-pea sized
Can be acute (traumatic/hyperfunctional use) which is gelatinous and floppy, with overlying epithelium unchanged
Can be chronic (harder, less flexible, thickened epithelium aka VF cover during vibration)
Tx: Voice therapy, phonosurgery if reqd, followed by voice therapy
What is a VF polyp?
Fluid filled lesion in SLP, bigger than nodules, usually in median 1/3 of fold, mostly unilateral!
Cause= acute vocal trauma/misuse
Types= sessile and pedunculated (one w a sac)
Tx= voice conservation, if this has no improvement then phonosurgery + voice therapy, smaller ones usually okay w therapy
What is Reinke’s Edema?
When Reinke’s space is filled with thick fluid, uniform swelling, caused by longstaning trauma (e.g. vocal misuse + smoking)
glottal closure= usually complete
Polypoid degeneration= most severe form of RE, entire membranous portion of VF has viscous fluid; VF swollen and enlarged
Characteristics= increased mass/stiffness + preserved closyre, consistent changes in low pitch and hoarseness!!
Tx= Phonosurgery, where fluid is drained, voice therapy post op
What are vascular lesions?
Four types= hemorrhage, hematoma, telangietasias and varix
Hemorrhage and the hematoma that follows can cause ACUTE and POSTACUTE DYSPHONIA ):
Telangiectasias and varix may affect the amplitude, periodicity and symmetry of the mucosal wave
What is a VF hemorrhage?
When blood flow from the ruptured vessels in the VF happens, usually SLP; imp later for vibration
Unilateral= bleeding in one fold, most common, from acute phonotrauma e.g. shouting
symptoms= sudden hoarseness, loss of vocal range, fatigue
Bilteral= less common,bc of severe trauma, e.g blunt neck injury
Tx= voice conservation and rest!
What is a VF hematoma?
When there is an cumulation of blood leaked from vessel
Tx= voice therapy and rest
What is Telangiectasias?
Visible dilated capillaries, can impact voice quality and increase bleeding risk, can happen bc phonotrauma
Tx= if needed laser surgery otherwise voice rest
What is a varix?
A mass of blood vessels, red striations, an abnormally dilated vein on the surface of VF
often bc of phonotrauma
seen in singers
Tx= laser if needed if not voice rest
What is acute laryngitis?
Inflammation of the VF mucosa, usually bc of viral infections, red larynx
Tx= external and internal hydration, rest and antibiotics and cough suppressants
What is Croup
laryngotracheobronchitis - more serious response that kids have
narrowing of subglottic airway with hoarseness, cough and inspiratory stridor
attacks last 30-60 min
What is chronic laryngitis?
It is a longstanding mucosal inflammation, viscous mucus, epithelial thickening, NOT linked with a viral infection
Mild to severe dysphonia, laryngeal fatugue, throat clearing, usually painless, some swelling
Causes= repeasted acute laryngitis, vocal misuse, smoking, poor hydration
Tx= elimiate causing factors, voice therapy can help reduce misuse behaviours
What is a VF granuloma?
A benign lesion forming on posterior part of VF because of chronic irritation/trauma to laryngeal tissues
Usually on vocal process of arytenoid cartilages
NOT polyps, not on VF, on cartilage
Why? = GERD, laryngeal intubation, persistent vocal misuse
Tx= voice therapy
What is a congenital/acquired cyst?
Cysts are fluid filled sessile growths, can be on the VF, ventricular folds or laryngeal ventricle
Cause= blocked mucosal gland duct, or bc of vocal misuse; usually unilateral
Characteristics= stiff, large ones can inhibit glottal closure
Tx= NO behavioural tx, needs phonosurgery + post op voice therapy
What is a papilloma?
A wart like tumor that develops in epithelium, can invade LP and vocalis muscle
Caused by HPV
Effects= severe dysphonia, lesions affect mass/stiffness of body and cover in many locations
can spread throughout airway
Tx= aggresiive treatment, interferon mediciaiton which supressess reduplcaition, laser surgery that is repeated as necessary, tracheostomy needed if compromised airway
What is papillomatosis?
Several papilloma’s
What is a congenital laryngeal web?
When the tissue bridge bw the VF at the ant commisure is NOT sperated during 10th week of gestation
laryngeal stridor or resp. distress may happen
depending on size and thickness voice quality would be impacted
Tx= phonosurgical removal of web, inserting keel for several weeks to prevent reformation, voice rehab, no voice therapy for this
What is acquired laryngeal web?
fibrous membrane forming bw VF after birth, bc of trauma, inflammation, medical interventions
Tx= phonosurgery if needed
What is sulcus vocalis?
A ridge along the whole membranous portion of VF, in SLP, increases VF cover stiffness
Bowing/spindle shaped gap between folds during phonation
variable voice effect depending on gap
etiology unknown , acquired onset though from phonosurgery or aging or paralysis
Tx= may not be needed, surgery not possible, vioce therapy
What is presbylarynx?
Age related changes in the laryngeal structure and function
Lowered resp effieicny and elasticity of VF mucosa
characteristcs
- lowered loudness
- pitch and loudness instability
- decreased voice quality
- 65+ age
- VF obwing because of decreased VF bulk and cover
