CSDS 115 - UNIT 5 - Functional Vocal Pathology + idiopathic and autoimmune diseases

Mutational Falsetto (Puberphonia)

Etiology:

• psychological, physical

Description:

• Maintenance of high-pitched voice past the time of puberty

Perceptual symptoms:

• High-pitched, May be breathy or low in volume

Management:

• Voice therapy

Ventricular Phonation

Etiology:

• Severe generalized laryngeal muscle tension, Severe true vocal fold dysfunction

Description:

• Use of false vocal folds (ventricular folds) for voice production

Perceptual symptoms:

• Low-pitched, Rough/Hoarse vocal quality

Management:

• IF VF cannot open = ventricular phonation compensatory strategy, Voice therapy

Muscle Tension Dysphonia (MTD)

Etiology:

• Reflux, Excessive voice use with occupation, High stress levels

Description:

• Visual signs of increased muscle activity in head/neck; Excessive glottic compression

Perceptual symptoms:

• Strained vocal quality, Possible higher pitch

Management:

• Voice therapy techniques

Transgender Voice Transition

Etiology:

• Voice masculinization/Feminization

Description:

• Transitioning from female to male, pitch will be too high and vice versa; Resonance, intonation, rate and vocal intensity

Perceptual symptoms:

• Within normal limits for gender assigned at birth

Management:

• Voice therapy techniques

Conversion Aphonia

Etiology:

• Psychogenic, Manifestation of stress, depression, or anxiety, No evidence of physical or neurogenic cause

Description:

• Psychogenic voice disorder

Perceptual symptoms:

• Significant functional and social impact on patient, family, spouse, partner etc.

Management:

• none

list autoimmune and idiopathic diseases

• idiopathic

  • paradoxic vocal movement (AKA vocal cord dysfunction)

• autoimmune

  • amyloidosis

  • systematic lupus erythematosus

  • rheumatoid arthritis

  • sjogren’s syndrome

  • fibromyalgia

  • scleroderma

  • wegner’s granulomatosis

list the functional vocal pathology

• mutational falsetto (puberphonia)

• ventricular phonation

• muscle tension dysphonia (MTD)

• transgender voice transition

• conversion aphonia

Paradoxic Vocal Fold Movement (PVFM)

• IDIOPATHIC

• Also known = Vocal Cord Dysfunction

• Appear in asthma, vocal fold paralysis, laryngeal edema, voice disorder

• Diminished phonatory intensity during sudden attach + anatomic airway obstruction

• Signs and symptoms

  • Audible airway obstruction/limitation causing inspiratory and/or expiratory stridor/wheezing

  • Episodic dyspnea

  • Chocking episodes

  • Muscle tightness (neck, chest, generalized)

  • Intermittent or chronic cough

  • Aphonia, dysphonia, hoarseness, strained-strangled voice, breathy voice, weak voice, and or diplophonia

  • Dysphagia, heartburn, or globus sensation

Amyloidosis

• AUTOIMMUNE

• Vocal Characteristics:

  • Changes in vocal quality, associated w/ airway obstruction, stridor, and shortness of breath

Systematic Lupus Erythematosus

• AUTOIMMUNE

• Vocal Characteristics:

  • Hoarseness, throat pain, and/or dysphasia

Rheumatoid Arthritis

• AUTOIMMUNE

• Vocal Characteristics:

  • Globus sensation, hoarseness, dyspnea, stridor or dysphagia

Sjogren’s Syndrome

• AUTOIMMUNE

• Vocal Characteristics:

  • Hoarseness, cough secondary to thickened mucous

Fibromyalgia

• AUTOIMMUNE

• Vocal Characteristics:

  • Hoarseness, pain on swallowing, and pain with voice

Scleroderma

• AUTOIMMUNE

• Vocal Characteristics:

  • Dysphonia and the possibility of submucosal vocal fold lesions

Wegner’s Granulomatosis

• AUTOIMMUNE

• Vocal Characteristics:

  • stridor

Sarcoidosis

• AUTOIMMUNE

• Vocal Characteristics:

  • Dysphonia, dry cough with/without hoarseness