SHS 511 (Module 5.1 (MTD-Polyps)

How do we classify voice disorders?

Functional

Organic

Neurologic

What classification do MTD, vocal nodules, and vocal polyps fall under?

Functional

Functional voice disorder defintion

Voice disorder primarily related to way that the voice is used

Phonotraumatic behaviors

Vocal misuse and abuse

Examples of phonotraumatic behaviors

Hard glottal attack

Laryngeal squeezing

Persistent vocal fry

Excessive talking

Talking too loud

Excessive coughing

Excessive throat-clearing

Yelling/screaming

Predisposing factors to functional voice disorder

Vocal demands

Allergies

GERD (LPR)

Structural changes are ____ to phonotraumatic behaviors

Secondary

MTD

Muscle Tension Dysphonia

MTF definition

excessive laryngeal musculoskeletal tension

What does MTD affect?

Extrinsic or intrinsic muscles

What type of functional disorder is MTD?

Hyperfunctional

Contributing factors of MTD

Anxiety

GERD

Infection

Edema

Primary MTD

Dysphonia in the absence of current organic pathology, without obvious psychogenic or neurologic etiology

Secondary MTD

Dysphonia in the presence of current organic pathology, or psychogenic or neurologic etiology

Auditory-perceptual characteristic of MTD

Strained voice

Acoustic characteristic of MTD

Decreased loudness level and range

Pitch variable but decreased range

Aerodynamic characteristic of MTD

Increased laryngeal resistance

Laryngeal imaging characteristics of MTD

Supraglottic hyperfunction

Increased medial compression of true and false VFs

Anterior-posterior compression

Management of MTD

Behavioral voice therapy

Voice hygiene

What are nodules and polyps?

BENIGN structural lesions

Vocal nodules definition

Callous-like swellings on inner margin of VFs

Inflammatory degeneration of superficial LP layer

How common are vocal nodules?

They are the MOST common benign VF lesion in adults and kids

Etiology of vocal nodules

Phonotraumatic behaviors

Auditory-perceptual characteristic of vocal nodules

Roughness and breathiness

Acoustic characteristics of vocal nodules

Difficulty producing high pitch sounds

Reduced pitch

Vocal fatigue

Laryngeal imaging characteristics of vocal nodules

Appearance (ranges)

Laryngeal and VF edema

HOURGLASS closure patterns

Decreased vibratory amplitude

Asymmetrical vibration

Early or acute nodules look:

Soft, pliable, reddish

Chronic nodules look:

Hard, white, thick, fibrotic

Aerodynamic characteristics of vocal nodules

Increased airflow

Decreased subglottal pressure

Management of vocal nodules

Behavioral voice therapy

Vocal hygiene

Surgery*

Vocal polyp definition

Small-to-large fluid filled sacks

Usually unilateral

May create contralateral reaction

Anterior 1/3 of VFs

Etiology of vocal polyps

Phonotrauma

-Gradual

-Single event (yelling)

-Associated with smoking

Auditory-perceptual characteristics of vocal polyps

Roughness and breathiness

Acoustic characteristics of vocal polyps

Decreased pitch and pitch range

Decreased loudness

Vocal fatigue

Aerodynamic characteristics of vocal polyps

Increased airflow

Decreased subglottal pressure

Management of vocal polyps

Behavioral voice therapy

Vocal hygiene

Surgery