10 - Organic Voice Disorders Flashcards
What are Organic Voice Disorders?
When there’s something wrong with the anatomy and/or structure of larynx
What are Functional Voice Disorders?
The anatomy is fine but, there something wrong with the physiology
What are Neurogenic Voice Disorders?
When there is neurological damage and/or brain injury
What are Vocal Nodules?
2
Bilateral VF masses
Sort of like callouses
What causes Vocal Nodules?
Phonotrauma
What are symptoms of Vocal Nodules?
3
Hoarseness
Reduced pitch
Reduced loudness.
How do we treat Vocal Nodules?
3
Voice rest
Voice Hygiene
Sometimes surgery.
Where are Vocal Nodules usually located on the VFs?
Between anterior 1/3rd and posterior 2/3rd
What is GERD?
Gastro-Esophageal Reflux Disorder
stays in esophagus
What is LPR?
Laryngo-Pharyngeal Reflux
acids enter airway
How will vocal nodules affect Maximum Phonation Duration?
It will be reduced
How will vocal nodules affect respiration?
2
Intake will remain the same
Outtake will be shortened due to laryngeal valving
What do Acute Nodules look like?
How severe are they?
Gelatinous
Less severe - nodules in initial stage
What do Chronic Nodules look like? (2)
How severe are they?
Callous-like or fibrosis
Rest of glottis will probably be inflammed
More severe - long-time nodules
What are Vocal Polyps?
2
Unilateral masses
Have a blood supply
What causes Vocal Polyps?
Phonotrauma
What are the symptoms of Vocal Polyps?
3
Hoarseness
Reduced pitch
Reduced loudness
How to we treat Vocal Polyps?
Surgery
What are Sessile Vocal Polyps?
2
Fully attached to vocal fold edge
Blister-like
What are Pedunculate Vocal Polyps?
Attached by small stalk or stem
What is Laryngitis?
Inflammation of the larynx.
What causes Laryngitis?
4
Sometimes infections (colds, flu, etc.)
Acid reflux (GERD or LPR)
Phonotrauma
Irritation, such as from allergies or smoke.
What are the symptoms of Laryngitis?
3
Fever
Hoarseness
Cough.
How to we treat Laryngitis?
3
Treatment of primary cause (infection, reflux, irritant, etc.)
Vocal rest and hygeine
Self-resolves in a week
What is Reinke’s Edema?
2
Edematous (edema of) Reinke’s space
Thick, gelatinous material accumulates in the superficial layer of the lamina propria (Reinke’s Space)
What area of the vocal folds is affected by Reinke’s Edema?
Superficial layer of the lamina propria
What causes Reinke’s Edema?
2
Smoking - usually
Phonotrauma - less common
What are the symptoms of Reinke’s Edema?
5
Hoarseness
Poor mucosal wave
Reduced pitch
Dyspnea (breathlessness)
Corresponding acoustic measures impaired (vibrations asymmetric and aperiodic)
How do we treat Reinke’s Edema?
3
Quit (or reduce) smoking
Vocal hygiene
Surgery (can reoccur if causal factors not eliminated)
What is a Laryngeal Cyst?
3
VF Mass surrounded by a membrane
Membrane holds a collection of material - usually mucus
No blood supply
What are the symptoms of Laryngeal Cyst?
3
Hoarseness
Reduced pitch
Impaired mucosal wave.
On what part of the VFs are Laryngeal Cysts located?
2
Underneath the mucosa
Within the superficial lamina propria.
What differentiates a cyst from a polyp?
Polyps have a blood supply
How do we treat cysts?
3
Surgery
Vocal hygiene
Vocal rest
What are Granuloma (Intubation Granuloma)?
2
Growth covering contact ulcer area
Incubation = Growth over irritations due to intubation tubes
What are the symptoms of Granuloma?
3
Breathiness
Hoarseness
Reduced pitch
(Sometimes, phonation not affected)
Where are Granuloma located?
2
Posterior sides of the vocal processes
Mucosa of the vocal processes.
How do we treat Granuloma?
2
Treating the root cause (acid reflux, phonotrauma, etc.)
Surgery if it does not go away
What are Contact Ulcers?
2
Reflux related lesions in the posterior parts of the VF.
Raw sores
What causes Contact Ulcers?
Laryngo-pharyngeal reflux.
What are the symptoms of Contact Ulcers?
4
Hoarseness
Breathiness
Reduced pitch
Occasionally reduced loudness.
How do we treat Contact Ulcers?
3
Steroid injections
Treat reflux (Medication, lifestyle management)
Can self-correct
What is Vocal Papilloma?
Where can it be located?
A viral infection that causes mass (benign tumor)
In supraglottal, glottal and subglottal regions.
What causes Vocal Papilloma?
Human papilloma virus (6 and 11)
What are the symptoms of Vocal Papilloma?
3
Hoarseness
Reduced pitch
Respiratory difficulties
How do we treat Vocal Papilloma?
Surgical excision is required.
What is Candida?
Yeast infection
this yeast is normally found in the body
What are the physical symptoms of Candida?
3
White, peppered spots
Edema
Erythema (reddening of skin)
What causes Candida?
1+3
Weakened immune system caused by…
- Medications/antibiotics
- General illness
- Chemotherapy
What are the voice symptoms of Candida? (3)
How sever are these symptoms?
Pressed Voice
Hoarseness
Breathiness
Minimal-Moderate voice changes
What are the laryngeal symptoms of Candida?
2
Irregular vocal edges
VF stiffness
How do we treat Candida?
Antifungal medicine
What is Laryngeal Webbing?
Webbing of the glottal region
What are the types of Laryngeal Webbing?
2
Congenital
Acquired (due to irritation of the mucosal surfaces)
What are the main physical symptoms of Laryngeal Webbing?
3
Respiratory difficulties
Shortness of breath.
Stridor (audible inhalation) may be apparant
What are the main vocal symptoms of Laryngeal Webbing?
Voice is harsh and high-pitched.
How do we treat Laryngeal Webbing?
What is the biggest potential danger with Laryngeal Webbing?
Surgery
Blockage of the airways
What percentage of Laryngeal Webbing is congenital?
How is it caused?
75% of all laryngeal we
Failure of the VF to separate during the 4-10th week in utereo
What percentage of Laryngeal Webbing is acquired?
How is it caused?
25%
Trauma usually from intubation or surgery complications
Where are Laryngeal Webs located?
Which is more common?
Can be either anterior or posterior
Anterior
What is Subglottal Stenosis?
A narrowing of the airway
What is the biggest danger in Subglottal Stenosis?
The inability to breath
What is Congenital Subglottal Stenosis?
How common is it?
Malformed cricoid cartilage (too small)
3rd most common congenital disorder
What is Acquired Subglottal Stenosis?
Caused by intubation or a tracheotomy
What is Idiopathic Subglottal Stenosis?
Who is it more common in?
Unknown cause
Middle aged women (25-50 yrs)
How do we treat Subglottal Stenosis?
How successful is it?
Surgery
It often reoccurs
What is Presbylarynges?
2
Voice disorder of the elderly
Characterized by sarcopenia (loss of muscle tissue due to aging)
What is Sarcopenia?
Thinning of muscles
What happens in Presbylarynges?
2
Superficial layer of the VF thins
Collagen in the VF becomes more dense
What is Sulcus Vocalis?
3
Groove or furrow in the VF
Usually bilaterally symmetrical.
Furrow may penetrate deep into the vocal ligament.
What causes Sulcus Vocalis?
2
Unknown.
Speculated to be LPR or vocal abuse.
What are the vocal symptoms of Sulcus Vocalis?
3
Hoarseness
Weakness
Increased effort
How do we treat Sulcus Vocalis?
Surgery
Sometimes injection of fluid
What is Varix?
Enlarged superficial, prominent vien in the VF
What is Ectasia?
Fused lesioning of a blood vessel in the VF
In what layer of the VF does Varix and/or Ectasia occur?
Superficial layer of lamina propria
What is Intubation Trauma?
3
Intubation = inserting a breathing tube into the trachea
Tube can irritate the oral and pharyngeal cavities
Granulomas can form over the site of irritation
What is Leukoplakia (Hyperkeratosis)?
Rough, hoarse voice from stiffness of the VF
What qualities are affected with Leukoplakia (Hyperkeratosis)?
(1+2)
All qualities
- Harshness
- Reduced pitch
What is seen physically in Leukoplakia (Hyperkeratosis)?
White masses
How do we diagnosis Leukoplakia (Hyperkeratosis)?
Biopsy
