Chapter 3: Approaches to Intervention Flashcards
The Physician’s Role
- develop professional relationships
- order tests and consult to ascertain associated or underlying etiologic factors
- differential diagnosis
True vocal fold nodules
- postpubertal females and prepubertal males
- benign, bilateral
Cysts
- fluid-filled lesions that result from trauma
- usually unilateral
- surgery
Polyps
- unilateral
- surgery
- middle aged people
- cigarette smoking, vocal abuse, trauma, vocal fold hemmorage (exact cause unknown)
Vascular lesions
- in the larynx involve dilation of blood vessel (reddening network of blood cells
- meds, rest, caution, possibly hormones)
Papillomas
- multiple wartlike growths caused by virus
- can be life-threatening
- laser removal
- often reoccur
Cancer of the larynx
-surgical removal of malignancy
Movement Disorders of the Larynx
Adductor Spasmodic Dysphonia (AD-SD):strained
Abductor Spasmodic Dysphonia (AB-SD): breathy
Paralysis of the vocal folds
Unilateral recurrent laryngeal nerve (RLN) paralysis
Unilateral superior laryngeal nerve (SLN) paralysis
Movement disorders
Vocal fold weakness (paresis)
Reinke’s Edema
- middle aged patients
- atypical low pitch level
- rough, hoarse vocal quality
- heavy smoking, phonotrauma, reflux, env irritants
Contact Ulcers and Granulomas
- hyperadduction with vocal process
- forceful phonation
Trauma
Arytenoid dislocation from trauma Laryngeal injury (ETI- intubation)
Laryngeal Webs
- congenital or acquired
- surgical removal
Sulcus Vocalis
- congenital or acquired
- vocal scar
Benign Lesions
nodules
cysts
polyps
reactive lesions
Resonant Voice Therapy
LMRVT physiological approach motor skill learning -hygiene -deactivation (stretch, warm up) -activation (practice w/ resonant voice) -self therapy planning -recovery training (self-monitor, adjust to lapses) -support hierarchy
Vocal Function Exercises
- warm up
- stretching
- contraction
- adductory power exercises
Laryngeal massage
digital manipulation
-for hyperfunction compensatory strategies
Manual Circumlaryngeal Techniques
- focal palpitation
- manual laryngeal reposturing techniques
- circumlaryngeal massage
Stretch and Flow Phonation
physiological technique
- biomechanics of phonaton “Focus on the flow”
- thematics of language
Adjunct Techniques
from other fields
- Alexander
- Feldenkrais
Estill Voice Model
series of practical, hierarchal techniques for professional voice users
Lifestyle adjustments and behavioral changes
- Hydration therapy (increase water intake, use humifier, medications)
- dietary and lifestyle modifications (raise head of bed, decrease spicy, fatty, caffeinated foods and alcohol, lose weight, avoid eating before lying down)
Accent Method of Voice Therapy
counseling
vocal procedures
Lee Silverman Voice Treatment (LSVT)
reduced loudness, hoarse voice, monotone, imprecise artic
- Voice Focus
- Rationale
Cognitive Cuing
careful selection of word images in utterance to create meaningful context
Cognitive Behavioral Therapy
most effective for clients with functional dysphonia
-new thought patterns, behaviors
Biofeedback
tactile
auditory
visual
