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CSD9615 > 07 - Phonation Disorders > Flashcards

07 - Phonation Disorders Flashcards

1
Q

What are some neurological disorders associated with abnormal vocal acoustics (e.g. vocal frequency, amplitude, and cycle-to-cycle variation)?

A

Parkinson’s Disease
Unilateral Vocal Fold Paralysis (Flaccid Dysphonia)
Spasmodic Dysphonia (Laryngeal Dystonia)

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2
Q

What is Parkinson’s Disease (PD)?

A

A degenerative neurological disease involving damage to the basal ganglia
-involves the loss of dopamine producing neurons

Characterized by:

  • Rest tremor
  • Reduced speed of movement
  • Reduced range of movement
  • Muscle rigidity
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3
Q

How does PD affect speech (how it’s perceived and the vocal fold movement)?

A

Speech is perceived to be:

  • reduced in loudness
  • monotone
  • breathy/harsh
  • imprecise

Reduced force and range of adductory vocal fold movements (bowing of the folds)

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4
Q

Name 3 aspects of vocal frequency and amplitude that may be different from normal in a PD patient

A
  • higher than normal average F0 (high pitch)
  • lower than normal average amplitude (reduced speech intensity; usually a major concern)
  • lower SDF0 (monopitch; important to some patients)
  • lower SD of amplitude (monoloudness; important to some patients)
  • decreased phonational range
  • decreased dynamic range
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5
Q

How might the average amplitude in a PD patient change?

A

Lower than normal average amplitude (reduced speech intensity) and lower SD of amplitude (monoloudness)

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6
Q

How might the F0 of a PD patient change?

A

Higher than normal average F0 (high pitch) with a lower than normal SDF0 (monoloudness)

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7
Q

How might the phonational range of a PD patient change?

A

Decreased phonational range

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8
Q

How might the dynamic range of a PD patient change?

A

Decreased dynamic range

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9
Q

The cycle-to-cycle variations in phonation (jitter and shimmer) for a PD patient will be _____ (lower/higher) than normal. What does the resulting voice sound like?

A

Higher than normal jitter and shimmer

Voice sounds breathy/harsh

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10
Q

Name one Voice Intensity Treatment Program for PD patients

A

Lee Silverman Voice Therapy (LSVT)

Speech-in-Noise (SIN)

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11
Q

What are two types of vocal acoustic treatments for PD patients?

A 
Voice Intensity Treatment Programs (e.g. LSVT, SIN)
Levodopa Medication (dopamine replacement)
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12
Q

Name 1 outcome measure of Voice Intensity Treatment Programs for PD patients

A

Increased vocal amplitude (intensity)
Increased F0 and amplitude variability
Increased phonational & dynamic range

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13
Q

Name 1 outcome measure of Levodopa medication in PD patients

A

Increased vocal amplitude (intensity)
Reduced jitter and shimmer
Increased Harmonics - to - Noise Ratio (HNR)

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14
Q

What is another name for Unilateral Vocal Fold Paralysis?

A

Flaccid Dysphonia

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15
Q

What is Flaccid Dysphonia?

A

Complete or partial paralysis of the vocal fold on one side (unilateral)
-often the result of damage to the recurrent laryngeal nerve during chest or neck surgery

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16
Q

Describe the voice of someone with Flaccid Dysphonia

A

Breathy
Harsh
Diplophonic (perceived as producing two different pitches at once)
Reduced in loudness

17
Q

Name 2 ways Unilateral Vocal Fold Paralysis (Flaccid Dysphonia) affects vocal frequency and amplitude

A

Lower than normal average F0 (low pitch)
Diplophonia (double pitch; can be a major concern when present)
Lower than normal average amplitude (reduced speech intensity; usually a major concern)
Lower SDF0 (monopitch)
Lower SD of amplitude (monoloudess)
Decreased phonational & dynamic range

18
Q

How might Flaccid Dysphonia affect someone’s F0?

A 
Lower than normal average F0 (low pitch)
Lower SDF0 (monopitch)
19
Q

How might Flaccid Dysphonia affect someone’s vocal amplitude?

A

Lower than normal average amplitude (reduced speech intensity)
Lower SD of amplitude (monoloudness)

20
Q

Which disorder causes “double pitch” (diplophonia)?

A

Unilateral Vocal Fold Paralysis (Flaccid Dysphonia)

21
Q

How might Unilateral Vocal Fold Paralysis affect cycle-to-cycle variations in phonation?

A

Higher than normal jitter and shimmer (related to breathy and harsh voice quality)

22
Q

Which disorder is treated with thyroplasty?

A

Unilateral Vocal Fold Paralysis (Flaccid Dysphonia)

A small piece of silastic material is surgically inserted into the paralyzed vocal fold, pushing it towards the midline

23
Q

Describe how thyroplasty helps treat Unilateral Vocal Fold Paralysis (Flaccid Dysphonia)

A

A small piece of silastic material is surgically inserted into the lateral side of the paralyzed vocal fold, acting to push the vocal fold towards the midline and thereby helping to bring the folds together for phonation

24
Q

What are the outcome measures of thyroplasty on Flaccid Dysphonia?

A
  • increased vocal amplitude (intensity)
  • reduced diplophonia
  • increased F0 variability and amplitude variability
  • reduced jitter and shimmer
25
Q

Which neurological voice disorder causes the voice to be perceived as strained and contain frequent irregular vocal spasms and voice arrests?

A

Spasmodic Dysphonia (Laryngeal Dystonia)

26
Q

Spasmodic Dysphonia is characterized by irregular involuntary contractions of the laryngeal _______ (abductor/adductor) muscle(s)

A

Adductor muscles

27
Q

Spasmodic Dysphonia (Laryngeal Dystonia) is believed to be a dystonic type of movement disorder involving damage to the _______

A

Basal ganglia (located in the base of the brain; involved in coordination of movement; recall, this is the same part of the brain affected by PD)

28
Q

How does Spasmodic Dysphonia affect vocal frequency and amplitude?

A
  • Average F0 can be higher than normal (high pitch)
  • Higher than normal SDF0 and SD of amplitude (largely due to rapid pitch and intensity shifts associated with vocal spasms)
  • Frequent voice breaks
29
Q

Spasmodic Dysphonia is also known as what?

A

Laryngeal Dystonia

30
Q

In Laryngeal Dystonia, SDF0 and SD of Amplitude are ______ (lower/higher) than normal. Explain why

A

Higher

-largely due to rapid pitch and intensity shifts associated with vocal spasms

31
Q

How does Spasmodic Dysphonia affect jitter and shimmer?

A

Higher than normal jitter and shimmer (strained voice and vocal spasms)

32
Q

How are the vocal acoustics of Spasmodic Dysphonia treated?

A

Botulinum toxin (Botox) injection

  • either unilateral or bilateral injection into the vocalis muscle
  • causes a mild partial paralysis of the vocal fold which significantly reduces the vocal spasms
  • a temporary reversible paralysis lasting about 4-6 months
33
Q

Botox is used to treat Laryngeal Dystonia. What are some of the outcome measures?

A

Reduced SDF0 (variability)
Reduced voice breaks (reduced spasms)
Reduced shimmer and jitter
Reduced laryngeal resistance

CSD9615 (22 decks)

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