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Voice > Childhood Voice Disorders > Flashcards

Childhood Voice Disorders Flashcards

1
Q

Laryngeal papillomatosis

A
  • Laryngeal warts (similar to HPV)
  • Most common laryngeal growth in children
  • Benign, wart-like growths
  • Viral: agressive & diffuse
  • Hoarseness
  • Poor vibration
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2
Q

Medicosurgical management of laryngeal papillomatosis

A
  • Surgical removal
  • Cryotherapy
  • Antiviral agents
  • Carbon dioxide laser
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3
Q

Voice therapy for laryngeal papillomatosis

A

Little role in treatment (assist with communication strategies to compensate for hoarseness)

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4
Q
A

Laryngeal papillomatosis

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5
Q

Laryngeal web

A

Extends across glottis, obstructing airway

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6
Q

Medicosurgical management of laryngeal web

A

Tracheotomy (above the vocal folds (as opposed to tracheostomy - under the vocal folds)) required to divide the web (above the vocal folds)

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7
Q

Voice therapy for laryngeal web

A
  • Residual voice function usually adequate
  • Optimise:
    • Loudness
    • Pitch
    • Quality
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8
Q
A

Laryngeal web

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9
Q

Laryngomalacia

A
  • Most common congenital laryngeal disorder
  • Immature cartilaginous development
  • Inspiratory stridor: Supraglottic structures collapse during inspiration
    • Noticeable when running around, crawling etc.
    • Soft larynx (moves in and out when breathing creating stridor)
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10
Q

Medical management of laryngomalacia

A
  • 90%: wait and it will resolve itself
  • 10%: surgery required
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11
Q

Subglottic stenosis

A
  • Narrowing of the airway
  • Requires surgery
  • The type of surgical procedure may affect vocal function
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12
Q

Subglottic haemangioma

A
  • Requires surgery
  • The type of surgical procedure may affect vocal function
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13
Q

Vocal fold paralysis

A
  • 2nd most common congenital disorder
  • Associated with spina bifida, meningomyelocele
  • Vagus nerve (CNX) - recurrent laryngeal branch
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14
Q

Disorders associated with vocal abuse & misuse

A
  • Most common voice disorder
  • 50% of children with voice disorders have vocal nodules
  • Main approach is voice therapy (some, just wait and see)
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15
Q

Psychogenic voice disorders

A
  • Hysterical conversion dysphonia (an event happens, causes conversion)
  • Puberphonia
  • Incomplete & delayed maturation
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16
Q

Hearing impairment

A
  • No exposure to sound
  • Difficulty with control of pitch, loudness, nasality, intonation
  • Associated features:
    • Abnormal breathing
    • Increased laryngeal tension
    • Excessive effort
  • Acquired laryngeal pathologies:
    • Vocal nodules
    • Vocal polyps
    • Oedema (swelling)
17
Q

Voice therapy for hearing impairment

A
  • Vocal quality
  • Pitch & loudness control
  • Tongue position
  • Need visual feedback
18
Q

Prematurity

A
  • Prolonged ventilation & intubation (endotracheal tube - through the mouth & vocal cords)
  • Tissue oedema, leading to ulceration at the subglottic level, leading to stenosis
  • Corrective surgery can cause:
    • Vocal fold damage
    • Potential recurrent laryngeal nerve palsy
    • Arytenoid dislocation
19
Q

Tracheotomised child

A
  • Facilitation of oral communication
  • Development of expressive speech depends on the ability to vocalise
  • Temporary occlusion of the tube with a finger, flexion of neck, externally applied devices (e.g. Passy-Muir speaking valve, electrolarynx), oesophageal speech (burping)
  • AAC devices (includes iPad etc.)
20
Q

Disorders of nasal resonance (2)

A
  • Hypernasality
  • Hyponasality
21
Q

Causes of hypernasality

A
  • Cleft palate/submucous cleft (most common)
  • Congenitally short palate
  • Velar paralysis
  • Adenoidectomy (hypernasality 1 in 500)
  • Tonsillectomy (hypernasality self corrects between 3-6 months)
22
Q

Voice therapy for hypernasality

A
  • Mild:
    • Increase oral to nasal resonance
    • Increase palate strength
  • Severe:
    • Pharyngoplasty
23
Q

Causes of hyponasality

A

Structural changes lead to anterior & posterior nasal flow obstruction:

  • Adenoidal hypertrophy
  • Septal deviation
  • Stenosis
  • Bone/cartilage
24
Q

Treatment of hyponasality

A

Medical/surgical

Voice (5 decks)

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