11 Voice Disorders

The flashcards cover essential terminology and definitions related to voice disorders, their classification, prevalence, and treatment methods.

Laryngectomy

The surgical removal of all or part of the larynx, most commonly due to laryngeal cancer, impacting an individual's ability to speak and breathe naturally.

Alaryngeal Communication

• Some individuals must produce voice without the benefit of a larynx. This is alaryngeal communication.

  • Tracheostomy: Methods include esophageal speech, tracheoesophageal puncture, and electronic speech devices.

Velopharyngeal Dysfunction (VPD)

A condition where the soft palate and pharyngeal walls do not adequately separate the oral and nasal cavities during speech, leading to hypernasality and sometimes nasal air emission.

Diplophonia

A voice quality characterized by the perception of two distinct pitches produced simultaneously during phonation, often caused by irregular vocal fold vibration or mass lesions.

Prevalence and Incidence of Voice Disorders

Relatively high compared to other disorders (25-30%) and is higher for woman than men. Prevalence refers to the proportion of a population with a voice disorder at a specific time, while incidence is the rate at which new cases occur over a period.Common causes are vocal nodules and edema/swelling. 

Vocal Abusive Behaviors and Warning Signs

talking in noisy environments, Coughing or clearing the throat frequently, Using caffeine products, Yelling, screaming, cheering, Giving speeches or lectures, Spending time in smoky environment

Voice Disorder Treatment (General)

The primary goals are to restore the best possible voice for communication, reduce vocal symptoms (e.g., hoarseness, pain, fatigue), eliminate abusive vocal behaviors, and improve the patient's quality of life.

Vocal Nodules

Benign, bilateral, callus-like growths on the free edges of the vocal folds, typically caused by chronic vocal abuse or misuse, leading to hoarseness or breathiness.

Vocal Granuloma

Mass of tissue created by the body at the site of an ulcer to help the healing process.

Contact Ulcers

Inflamed, open lesions that develop on the medial surface of the arytenoid cartilages, often caused by chronic irritation from forceful voice use, LPR, or intubation trauma.

Neurogenic Voice Disorders

Voice disorders that result from illness, damage, or disease to neurological systems associated with vocal production.

• vagus nerve

Types of Neurogenic Disorders

• Vagus Nerve Lesions

• Spasmodic Dysphonia

• ALS

• Parkinson’s Disease

• Iatrogenic Etiology

• Vocal Tics and Tourette Syndrome

• Paradoxical Vocal Fold Movement

Mutational Falsetto (Puberphonia)

Describes a male child or adolescent who exhibits an inappropriately high voice

• despite having a physiologically mature larynx

Juvenile Voice Disorder

A disorder in which women maintain a juvenile voice into adulthood

Goals for Evidence-Based Practice (EBP) Treatment of Voice Disorders

• To teach a vocal behavior that is absent

• To substitute an appropriate vocal behavior for an inappropriate one

• To strengthen vocal behaviors that are weak or inconsistent

Voice Treatment Components (Holmberg et al., 2001)

• Vocal hygiene

• Respiration exercises

• Loudness reduction

• Relaxation training

• Carryover activities

Voice

The complex, dynamic product of vocal fold vibration that allows us to vocalize and verbalize.

Adduction

The state in which the vocal folds are closed (active)

Abduction

The state in which the vocal folds are open (at rest)

Resonance 

Actual vibration of the air within the pharyngeal column, which affects the quality of voice

Fluency

Rate of vocal fold vibration, expressed as cycles per second, or hertz (Hz)

Pitch

Psychological or perceptual equivalent of frequency

Intensity

Physical measure of sound pressure, reported in decibels (dB)

Loudness

Perceptual correlate of intensity

Phonatory quality

How well the two vocal folds work during vibratory cycle

A Voice Disorder 

Individuals whose pitch, loudness, or phonatory quality differs significantly from that of persons of a similar age, gender, cultural background, and racial or ethnic group.

Dysphonia

The umbrella term used to refer to a voice that is disordered in some way.

Asphonia 

Refers to the total loss or lack of voice

Breathy, hoarse, rough, jitter, diplophonic, pressed, ringing, flutter, creak

are descriptors of voice quality that indicate various types of dysphonia.

Hypofunction

Describes vocal folds that are underfunctioning and have inadequate tension

Hyperfunction

When vocal folds are overly tense and compress together too tightly

Diplophonia

Means “double pitch” and describes a vocal quality in which the vocal folds produce two different pitches simultaneously

Adults and children with voice disorders do not receive treatment for the following reasons

• Treatment access

• Lack of knowledge

• Social perceptions about vocal quality

Defining Characteristics of VD

A voice disorder affects one or more of the following perceptual characteristics of voice:

• Resonance

• Pitch and Loudness

• Phonatory Quality

GERD

More commonly called heartburn, indigestion, and acid reflux disease; a condition in which acid from the stomach backs up into the esophagus