Structural Vocal pathologies

Vocal Fold Nodules Histology

Thick BMZ

Cause of Vocal Fold Nodules

phonotrauma

Vocal Fold Nodules Features

Bilateral lesions which causes an hourglass glottis

Vocal Fold Nodules Complaints

Breathy voice quality, vocal fatigue, and issues with upper pitch range

Vocal Fold Nodules Demographics

In children: onset preschool years (common in boys), young adults: onset teen years (common in girls), Adults: onset 20-40 (common in women)

Vocal Fold Nodules Treatment

Vocal rest, vocal hygiene, voice exercises

Fibrous Mass Types

Subepithelial or Ligament

Fibrous Mass Histology

Thick BMZ

Cause of Fibrous Mass

phonotrauma

Fibrous Mass Features

Unilateral OR bilateral lesions with reactive lesion, Subepithelial causes hourglass glottis, Ligament not usually

Fibrous Mass Complaints

Breathy voice quality, vocal fatigue, issues with upper pitch range AND painful

Fibrous Mass Demographics

non-significant

Fibrous Mass Treatment

Voice therapy and vocal rest (may need surgery)

Vocal Fold Polyps Histology

Focal (midline) collection of gelatinous material in SLLP (may hemorrhagic)

Cause of Vocal Fold Polyps

phonotrauma

Vocal Fold Polyps Feature

Unilateral OR Bilateral lesions (may have reactive lesion)

Vocal Folds Polyps Complaints

Breathy voice, vocal fatique, loss voice quality and range

Vocal Fold Polyps Demographics

Non-significant

Vocal Fold Polyps treatment

SLP therapy or surgery

Vocal Fold Cysts Histology

Mass in SLLP (epidermoid or mucous-retention)

Cause of Vocal Fold Cysts

Epidermoid: phonotrauma or congenital, Mucous-retention: blocked duct

Vocal Fold Cysts Features

Unilateral, may have reactive lesion (not always in medial edge)

Vocal Fold Cysts Complaints

Depends on location (edge vs surface)

Vocal Fold Cysts Demographics

Non-significant

Vocal Fold Cysts Treatment

Tend not to respond to SLP treatment, may need surgery

Reinke’s Edema (smoker’s polyps) histology

Increased gelatinous material in SLLP (very inflamed)

Cause of Reinke’s Edema

Smoking tobacco

Reinke’s Edema Features

Bilateral broad lesions (length of vocal folds)

Reinke’s Edema Complaints

Significantly lower pitch, increased vocal effort and fatigue

Reinke’s Edema Demographics

Chronic smokers

Reinke’s Edema Treatment

SLP therapy and surgery

Laryngeal Cancer Histology

Squamous cell carcinoma

Cause of Laryngeal Cancer

Smoking, alcohol

Laryngeal Cancer Features

Roughness, breathiness

Laryngeal Cancer Complaints

Vocal quality, globus sensation, pain

Laryngeal Cancer Demographics

More common in men (older)

Laryngeal Cancer Treatment

Laryngectomy

Laryngectomy effects

Breathing through a tracheostoma and direct access of airway to outside world

Laryngectomy Alaryngeal speech (voice source is lost)

Tracheo-esophageal puncture (TEP), electrolarynx, esophageal speech

Pre-surgery SLP role in laryngeal cancer

Obtain baseline voice use, functions, needs as well as patient and family education

Post-surgery SLP role in laryngeal cancer

Training in trach management, interim communication methods, and alaryngeal speech