Disorders and specific tx. Flashcards
What are the voice features associated with hyperfunction or musculolskeletal tension disorder (MTD)?
No single voice feature associated with this: can be aphonic, breathy, hoarse, high pitch, etc.
What treatment should be used for MTD or hyperfunction?
• Need to release tension: Aronson technique
• Need to release anxiety
• Need to create improved aerodynamic balance
Also,
o relaxation techniques, including digital manipulation of larynx
o holistic approaches (breathing, relaxation, phonation, e.g. accent reduction, RVT)
o breathing
o direct voice work
What treatment should be used for conversion disorders?
- Need ENT clearance to r/o pathology
- Patient Education
- Symptom removal via voice therapy
- Counseling
- Referral if needed: at the right time!
- Prognosis is good if patient ready
o often unaware of relationship between vegetative functions and voice, so often can cough, laugh normally.
o Can be responsive to laryngeal manipulation
o Counseling as part of treatment
o Show client that they can produce voice. Start from a cough, etc. build connection. (motor tx).
What tx should be used for Contact Ulcers/ Granuloma?
• Steps in therapy: Patient education: what is different anatomically; causes and anatomical predisposition; behavioral changes needed
o Auditory Discrimination
o Voice Use Training
o * May need surgery
What are vocal features of contact ulcers/granuloma
ADD.
What tx should be used for vocal nodules (children)?
o Information/education
o Reduce or eliminate abuse/misuse
o Establish new voice habits with parent support and conistency
o Auditory discrimination
o Establish new phonatory patterns
o Trend is therapy first! Even if need surgery (hard, fibrotic nodules)
o May need psychology referral
What tx should be used for vocal nodules (adults)?
o Consider precipitating organic event: URI, LPR
o Or emotional event
o Better response to surgery (if needed) if voice therapy first
o Same sequence:
o Information, eliminate abuse, involve family, ear training, new approach to voicing
What are the symptoms of Hypofunction/ Myasthenia Laryngis/ Vocal Fatigue?
• Symptoms: o Voice gives out over course of day o Need increased vocal effort to speak o Change in voice quality o Reduced vocal range o Throat sensations o Tight chest, difficulty breathing o Increased cough and throat clearing
What are the 5 contributing factors to vocal fatigue?
want better closure but hyperfunction caused problem in the first place
o Fatigue of laryngeal muscles that provide tension and stability
o Fatigue of respiratory muscles
o Relaxation of passive tension
o Increased tissue viscosity from dehydration or chemical changes
o Changes in blood circulation
What tx should be used for Hypofunction/ Myasthenia Laryngis/ Vocal Fatigue?
o increased hydration o Periods of vocal rest o Exercises to build endurance o Amplification o *Research with teachers: good results with amplification and direct voice work
The goal of Ventricular Phonation and the Tx that should be used?
• Goal is to have true cords producing tone- IF non-organic etiology • Intervention: 1. lower carriage of larynx, 2. reduce laryngeal tension, 3. resonant voice approaches, 4. ear training, 5. increased breath support • Contrast to organic problems where use of ventricular cords is compensatory
What are the vocal features of Puberphonia/Mutational Falsetto?
high or intermediate pitch, weak, thin, breathy, hoarse
What tx should be used for Puberphonia/Mutational Falsetto?
Most have success in first session; 70% improve in 3-6 months
Most difficult aspect is carryover
Treatment:
1. lower carriage of larynx,
2. improve breath support;
3. break voice down into lower register via forceful adduction
Use pushing techniques , lifting, to get forceful adduction and phonate while you do it.
What are vocal features of Reflux?
hoarseness, globus, dysphagia, cough, chronic throat clearing, vocal fatigue and sore throat
What Tx should be used for reflux?
Life style changes (diet) elimination of spicy foods etc.
and medicine.
