Disorders of voice

Question 1

What is a voice disorder?

Answer 1

Range of conditions that affect the larynx

Question 2

What is dysphonia?

Answer 2

Impairment causing poor quality voice
Hoarseness

Question 3

What is the prevalence of a voice disorder?

Answer 3

29.9% of the general population at some point in our lives
Slightly more prevalent in adult women than adult men

Question 4

What can cause someone to develop a voice disorder?

Answer 4

Exposure to laryngeal irritants

Question 5

How do irritants impact the larynx?

Answer 5

Provokes allergic reactions
Inflames laryngeal tissue
Increases mucous levels
Provokes unhelpful laryngeal behaviours e.g. throat clearing

Question 6

What are the different ways to classify a voice disorder? x3

Answer 6

Organic
Functional
Psychogenic

Question 7

What are organic voice disorders?

Answer 7

Physiological
Results from changes in vocal tract, larynx or respiratory system

Question 8

How can organic voice disorders be classified further? x2

Answer 8

Structural
Neurogenic/neuromuscular - affected by disordered CNS or PNS

Question 9

What are vocal nodules?

Answer 9

Always appear bilaterally
Typical place is the middle of the vocal folds
A contact lesion (like a callous)
Affects how well the vocal folds can close

Question 10

How can polyps affect the vocal folds?

Answer 10

Usually unilateral
Variable size and shape
Mostly benign, extra tissue (soft)

Question 11

How can cysts affect the vocal folds?

Answer 11

Usually unilateral - may lead to nodules
Firm mass of tissue within a membrane (hard)

Question 12

What are some organic/structural voice disorders?

Answer 12

Polyps
Cysts
Tumour
Reinke’s oedema

Question 13

What is Reinke’s oedema?

Answer 13

Structural classification
Fluid within Reinke’s space
Puffy and swollen presentation
Usually smoking related
Can sometimes be drained

Question 14

What is spasmodic dysphonia?

Answer 14

Neurogenic classification
Rapid pitch changes - wobbly and strangled
Often onsets gradually

Question 15

What are the two types of spasmodic dysphonia?

Answer 15

Neurogenic classification
Adductor spasmodic dysphonia - spasms trigger vocal folds to close
Abductor spasmodic dysphonia - spasms trigger vocal cords to open

Question 16

How can functional disorders be further split?

Answer 16

Hyperfunctional - overuse of laryngeal muscles
Hypofunctional - incomplete vocal cord closure

Question 17

What is vocal cord palsy?

Answer 17

Hypofunctional classification
Paralysis of one or both vocal cords
Paralysis may occur in adducted or abducted position

Question 18

What can cause vocal cord palsy?

Answer 18

Disturbance to superior laryngeal nerve (SLN) or recurrent laryngeal nerve (RLN)
Pressure on SLN/RLN nerve
Strokes or TBI
Viral causes

Question 19

What is muscle tension dysphonia? (MDT)

Answer 19

Hyperfunctional classification
Excessive recruitment of inappropriate laryngeal structures to produce voice
Tension in neck, shoulders, face etc.

Question 20

What is laryngopharyngeal reflux?

Answer 20

Acid reflux that affects your voice and throat
Features include hoarseness, laryngitis and chronic throat clearing

Happens when both the lower and upper esophageal sphincters relaxes inappropriately

Question 21

What is meant by psychogenic voice classification?

Answer 21

Many symptoms similar to functional
Potential for normal phonation
Voice varies according to social context, mood etc.

Question 22

How can an SLT support trans voice?

Answer 22

Transgender Centres of Excellence is used
Exploration of authentic voice may be a potential goal
Help to alleviate gender dysphoria

Question 23

What are the two types of reflux?

Answer 23

Laryngeal Reflux (LPR) (silent reflux)
Gastro-oesophageal reflux disease (GORD) (heartburn)