6 - ENT - Upper airway - Voice - Causes of voice change - Inflammatory + Muscle Tension Imbalance (MTI) Flashcards
Inflammatory laryngitis - infectious - causes
viral - part of URTI, recurrent respi papillomatosis due to HPV
bacterial (rare)
fungal - candida 2nd to steriod inhalers, immsuppression
Inflammatory laryngitis - infectious - S+S - acute viral
hoarse/croaky voice, aphonia
pain on voice use, coughing
erythematous/sloughy vocal folds, other URTI Sx
Inflammatory laryngitis - infectious - S+S - fungal and RRP
fungal - same as viral laryngitis, but w/o URTI Sx
RRP - severe dysphonia, airway problems may occur in children, multiple, raised erythematous lesions
Inflammatory laryngitis - infectious - management
VIRAL - self limiting - rest, analgesia, hydration, steam inhalation, cough suppressants
RRP - surgical excision
Inflammatory laryngitis - non-infectious - causes and mgmt
extra-oesophageal reflux, allergies
mgmt - vocal hygiene and dietary/lifestyle advice
–» PPI +/- alginates, H2 antagonists
Inflammatory laryngitis - non-infectious - Sx and Signs
Sx - huskiness, worsens with use, loss of high range
- throat clearing, cough, excessive mucus in throat, choking episodes
- GLOBUS sensation
- heartburn only in 40% (hence silent reflux)
Si - general erythema and oedema
Muscle tension imbalance - due to?
maybe - imbalanced contraction or excessive tension
Muscle tension imbalance - primary causes
stress, anxiety, depression
conversion disoders
neck/back problems, poor vocal hygiene/voice abuse, lifestyle/dietary
Muscle tension imbalance - seconday causes
excessive tension required to overcome deficiency elsewhere
- poor resp function
- structural defect of vocal folds
- nasal blockage affecting resonance
Muscle tension imbalance - S+S
sx - variable huskiness or aphonia, worsens with use, pitch changes, discomfort
si - excessive constriction of vocal folds, which themselves usually appear normal
Muscle tension imbalance - management
vocal hygiene and lifestyle advice
vocal therapy
address possible causes
