Chapter 72 - Voice disorders, voice therapy

Question 1

optimal therapy for spasmodic dysphonia

Answer 1

botox plus voice therapy

voice therapy alone is insufficient…adding therapy to botox improves outcomes

Question 2

How to dissipate PVFM attack

Answer 2

rapid shallow breathing (panting)
yawning
pursed lip breathing (relax upper body tension, diaphragm breathe, 1 second gentle sniff then gently exhale via pursed lips 2-3 seconds)…this generates back pressure to open/relax airway
“s” and “f” breathing to direct emphasis away from respiratory system, relax larynx

Question 3

VPD vs VPI

Answer 3

VPD (dysfxn) is impaired mition, VPI is tissue insufficiency…both can lead to hypernasality

Question 4

hyponasality

Answer 4

detected on m, n, ing sounds (they replace them with b, d, g)
usually due to anatomic obstruction

Question 5

Assimilated nasality

Answer 5

voiced consonants/vowels present as nasal when adjacent to nasal consonants
Due to velopharynx opening too soon/remaining open too long

Question 6

Diagnosis of hyponasality/hypernasality

Answer 6

Hypo: “my name means money” and “Mary made lemon jam” with nares plugged and unplugged…if unplugged doesn’t sound much different, then hyponasal

If significant difference between the two sentences, may have hypernasality

May also use nasometer (relative oral to nasal coustic energy…result is nasalance)’
Spectography, radography, endoscopy

Question 7

Tx of hypernasality

Answer 7

If organic/functional: voice therapy (alter tongue position, change loudness, auditory feedback, counseling, etc)
surgery/prosthodontist if physical inadequacy…palatal lift, oburator, prosthesis