Chapter 7: Voice Management (Team Management of Neurogenic Voice Disorders)

Question 1

What are 3 characteristics of unilateral VF paralysis?

Answer 1

1) breathiness
2) low intensity
3) diplophonia

Question 2

What are possible elements of a team approach for unilateral VF paralysis? (5)

Answer 2

1) voice therapy
2) phonosurgical management (especially if permanent)
3) reinnervation
4) temporary VF medialization if (idiopathic)
5) combination

Question 3

How might patients compensate for unilateral VF paralysis? (2)

Answer 3

1) hyperfunction

2) falsetto voice

Question 4

What are 6 treatment methods for unilateral VF paralysis?

Answer 4

1) hard glottal attack exercises
2) pushing exercises
3) lateral digital pressure
4) head tilt method
5) half-swallow “boom” technique
6) VFEs

Question 5

How is spasmodic dysphonia treated?

Answer 5

Botox injections that are LEMG guided, during phonation of /i/

Question 6

For ADSD, where is botox injected and what does it result in?

Answer 6

into the vocalis muscle, resulting in decreased spasm activity for the 3-6 months

Question 7

For ABSD, where is botox injected and what happened?

Answer 7

into the PCA, decreases the ability of the vocal folds to spasm in the abducted position

Question 8

What 2 things follow a botox injection temporarily?

Answer 8

1) swallowing problems

2) breathiness

Question 9

What are the 2 techniques for Botox injection?

Answer 9

1) intraoral technique using a long curved syringe

2) percutaneous with or without LEMG