pathologies pt 1

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46 Terms

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most common laryngeal pathologies for young adults vs middle age vs older adults

young adults:

  • male: edema

  • female: edema, polyps, nodules

middle age:

  • male: polyps

  • female: edema, polyps, nodules

older adults:

  • male: VF paralysis

  • female: VF paralysis

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chronic dysphonia is more common in …

  • women

  • Those w/ reflux or frequent URI

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voice disorders have a higher prevalence with who?

Occupations with heavy vocal demands

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structural pathologies of TVF are identified via:

  • Visual examination

  • History of voice use

  • Disorder onset/course/remission

  • Audioperceputal quality of voice

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audioperceputal quality of voice is identified by changes in…

mucosal layers / T VF muscle body impact mass, size, stiffness, flexibility and tension, glottal closure

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audioperceputal quality of voice varies with

  • Lesion severity

  • Habitual voice usage

  • Compensatory strategies- both productive or maladaptive

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Malignant Epithelial Dysplasia – AKA

laryngeal cancer

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Malignant Epithelial Dysplasia common symptoms

  • Hoarseness

  • Difficulty breathing

  • Laryngeal pain

  • Referred ear pain

  • Dysphagia

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Malignant Epithelial Dysplasia typical cause

Chronic irritation to laryngeal epithelium/mucosa

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Malignant Epithelial Dysplasia treatment options

  • Radiation

  • Surgical excision

  • Chemotherapy

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Malignant Epithelial Dysplasia SLP role

  • Education

  • Laryngeal or alaryngeal voice rehabilitation

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TVF nodules- AKA

Midmembranous Phonotraumatic Lesions

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midmembranous phonotraumatic lesions

  • Most common of benign lesions

  • Bilateral and symmetric

  • Medial edge near junction of anterior ⅓ posterior ⅔

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Midmembranous Phonotraumatic Lesions typical cause

Inappropriate vocal techniques, talkative, socially aggressive or Tense

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Midmembranous Phonotraumatic Lesions population

Most common in children and adult females

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Midmembranous Phonotraumatic Lesions symptoms

Roughness, breathiness and strain

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Midmembranous Phonotraumatic Lesions treatment

  1. Voice Therapy

  2. Surgical excision + postsurgical Voice Tx

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polyps

  • Fluid filled

  • Develops in superficial layer, usually mid ⅓ cord

  • Sessile vs. pedunculated

  • Usually w/ active blood supply

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TVF polyps typical causes

Voice misuse, acute vocal trauma

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TVF polyps population

Most common in adults

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TVF polyps symptoms

Varies- based on location, type and impact on glottic closure

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TVF polyps treatment

  1. Strict voice rest

  2. Surgery

  3. Surgery + voice rehab.

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cysts

  • Fluid filled, sessile

  • Typically embedded in superficial layer of LP, sometimes extend to intermediate and deep layers

  • Sometimes associated w/ reactive lesion on contralateral cord

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vocal folds cysts typical causes

Congenital or acquired w/o clear etiology

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vocal folds cysts symptoms

Varies- based on location, size

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vocal folds cysts treatment

  • surgery

  • NOT responsive to voice therapy

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reinke’s edema AKA

polypoid degeneration

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  • Superficial layer of LP becomes filled w/ fluid

  • Fluid filled bags / balloons

reinke’s edema

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reinke’s edema typical causes

Chronic vocal abuse and smoking

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reinke’s edema symptoms

  • Lower pitch, husky voice 2’ increased stiffness/mass

  • Reduced amplitude and mucosal wave during vibration

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reinke’s edema treatment

  • Surgery

  • Post-op voice rehab

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Permanent tissue changes to lamina propria

vocal fold scarring

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vocal fold scarring typical causes

Chronic vocal abuse, lesion, post-surgery

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vocal folds scarring symptoms

  • Increased stiffness and reduced mucosal wave

  • Roughness, strain, reduced vocal range, loudness and endurance

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vocal fold scarring treatment

  • Voice therapy for compensation

  • Phonosurgical tx

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Special TVF scar- furrow along the superficial layer of LP - causes concave appearance

sulcus vocalis

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vascular, exophytic and inflammatory lesion

granuloma

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ulcerated lesion

Contact ulcer

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vocal fold granuloma/contact ulcer typical causes

  • Intubation

  • LPR (laryngopharyngeal reflux)

  • Persistent voice misuse (pressed, low pitch)

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vocal fold granuloma/contact ulcer symptoms

  • Can be painful, sore throat or ear pain

  • Doesn’t typically impact voice

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vocal fold granuloma/contact ulcer treatment

  1. Medical

  2. Surgical

  3. Voice Therapy

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leukoplakia

white plaque

1. Benign or malignant

2. Bilateral or unilateral

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keratosis, leukoplakia, erthroplasia typical causes

  • Chemical irritants (alcohol. tobacco)

  • Hyperfunctional voice

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keratosis, leukoplakia, erthroplasia symptoms

Increase mass /stiffness of VF cover

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keratosis, leukoplakia, erthroplasia treatment

  1. Surgery / biopsy

  2. Voice Therapy

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abnormal mucosal change

epithelial hyperplasia