Voice Tx Flashcards
(25 cards)
Puberphonia/FD
Voice therapy- holding larynx-should be at mid 100’s
Laryngeal manipulation Circumlaryngeal massage Laryngeal relaxation-laryngeal sigh Neck stretches Pitch control- Visipitch (videogames for loudness pitch) & vocal function exercises.
symptoms?
Functional Aphonia/FD
Voice therapy
Breathing Laryngeal manipulation Circumlaryngeal massage Laryngeal relaxation/yawn-sigh voice = laryngeal sigh Neck stretches
symptoms?
Functional Dysphonia-Muscle tension dysphonia/FD
Voice therapy- same as functional aphonia
Breathing Laryngeal manipulation Circumlaryngeal massage Laryngeal relaxation/yawn-sigh voice (this is especially useful for MTD) Neck stretches
symptoms?
Paradoxical VF/FD
Paradoxical VF- the vf adduct on inspiration-
Respiratory training- “rescue breathing
Inhale/exhale through a straw
Deep nasal sniff with /f/ on exhalation
Laryngopharyngeal reflux management
Voice therapy: breathing patterning, laryngeal relaxation/yawn-sigh voice
symptoms?
Vocal fold nodules/OD
Voice tx is the same for Vocal fold nodules/Polyp & Cyst
Modified voice rest
Low impact voice
Voice therapy:
Laryngeal relaxation/laryngeal sigh
Resonant voice therapy
Vocal function exercises
symptoms: hourglass closure, strong personality & hearing loss
Polyp/OD
Modified voice rest
Low impact voice
Voice therapy: Laryngeal relaxation/laryngeal sigh Resonant voice therapy Vocal function exercises SURGICAL REMOVAL- SOMETIMES THEY DONT RESPOND TO VOICE THERAPY
symptoms: edema, voice variability, breathing problems depending on size.
Cyst/OD
Modified voice rest
Low impact voice
Voice therapy: Laryngeal relaxation/laryngeal sigh Resonant voice therapy Vocal function exercises SURGICAL REMOVAL- TRY VOICE THERAPY FIRST
Symptoms: increase vocal effort, vocal fatigue, edema.
Papilloma/OD
Laser surgery w/Mitomycin C (if at anterior commissure)
symptoms: globus sensation, breathing problems & scarring (recurrent)-caused by HPV.
Granuloma/ contact ulcer OD
Benign polyp on vocal process- don’t forget to add vocal process!
symptoms: heartburn/indigestion (reflux type), breathing problems, excessive throat clearing.
Proton pump inhibitor 6+ months Reflux diet: soda, tomatoes, citrus, spicy food Hydration Modified voice rest Low impact voice
Sulcus Vocalis OD
No behavior therapy because not misuse abuse
Higher pitch voice or may have no voice problems
Congenital- Surgery
Laryngomalacia- cartilage fails to stiffen
Subglottal stenosis- narrow sub glottal space
Esophageal atresia- occlusion of the esophagus
Tracheoesophageal fistula- openings b/t trachea and esophagus.
Web/OD
99% of webs are anterior commissure webs
Surgery w/Mitomycin C
May have no voice or breathing problems
Hemorrhage/OD
erythema(VF redness), VF edema & Varix (Varices)
MODIFIED VOICE REST
HYDRATION
Reflux diet- no caffeine, no alcohol or smoking
Steroids
Voice therapy: laryngeal relaxation/ yawn sign & Resonant voice therapy.
Laryngitis/OD
Soar throat, cough & fever
MODIFIED VOICE REST- just shut up!
HYDRATION
Medications- Proton pump inhibitor, antibiotics, allergy, steroids.
Reinke’s edema/OD
low pitch, vocal fold edema, impaired breathing
Surgery ( if occluding airway) Smoking cessation HYDRATION REFLUX DIET same as hemorrhage Proton pump inhibitor
Leukoplakia/OD
decreased vocal fold vibration, edema & low pitch
Biopsy
Smoking cessation
HYDRATION
REFLUX DIET
Candida/Fungus-OD
Anti-fungal meds & Hydration
Candida might look like leukoplakia if the anti-fungal meds do not work then you need to send the client for a biopsy.
Cancer/OD
Pain, strain & difficulty and painful swallowing
Surgery- laser , partial/complete laryngectomy
Voice therapy post laryngectomy: Compensatory for partials/ cordectomy- Alaryngeal voice: electrolarynx, Esophageal Speech, TEP
Smoking cessation
HYDRATION
Radiation/ chemotherapy- radiation is localized and chemotherapy is systemic.
Laryngeal trauma
Modified voice rest
HYDRATION
Medications: Steroids or antibiotics
LPR/Laryngopharyngeal reflux
Proton pump inhibitor 6+ months
Reflux diet- usually when I see PPI I think of LPR
HYDRATION
Neurogenic disorders
LMN: VF paralysis, Myasthenia Gravis, Guillan-Barre, Flaccid dysarthria
UMN: Spastic dysarthria, hypokinetic dysarthria, hyperkinetic dysarthria (SD, essential tremor), Ataxic Dysarthria.
Mixed: ALS, TBI, MS
LMN involvement
Paralysis- voice therapy: compensatory techniques (hard glottal attack, isometric push)- Swallowing precautions
Surgery- VF augmentation, VF medialization thyroplasty
Flaccidity- hypernasality- Voice therapy- Compensatory & strengthening techniques, swallowing precautions, palatal lift
UMN involvement
Spastic- voice therapy: laryngeal relaxation, neck stretches, resonant voice therapy
Hyperkinetic- botox
Hypokinetic- respiratory training & voice therapy LSVT and vocal function exercises
Ataxic- speech therapy/overarticulation
Mixed dysarthria
Mix of dysarthria types ( usually spastic & flaccid)
ALS- no voice exercises
Compensatory, maintain
MS- max out strengthening during remission
TBI- respiratory training
