Handout 6: Voice Disorders

Question 1

3 Disorders involving Vocal Frequency, Amplitude, and Cycle-to-cycle Variation

Answer 1

parkinson’s
vocal fold paralysis
spasmodic dysphonia

Question 2

parkinsons

Answer 2

• a degenerative disease involving loss of dopamine producing neurons in the basal ganglia
• this movement disorder is characterized by rest tremor, reduced speed of movement, reduced range of movement, and muscle rigidity

Question 3

how does one perceive the speech of someone w parkinsons

Answer 3

reduced in loudness, monotone, breathy/harsh, and imprecise

Question 4

in parkinson’s there is a ____ range and force of adductory VF movement, aka ____ of the VFs

Answer 4

reduced, bowing

Question 5

parkinsons: ____ than normal average amplitude

Answer 5

lower … reduced speech intensity is a major concern

Question 6

parkinsons: _____ than normal averge F0

Answer 6

higher, high pitch

Question 7

parkinsons: ____ SDF0

Answer 7

lower, monopitch

Question 8

Parkinsons: ____ SD of amplitude

Answer 8

lower, monoloudness

Question 9

parkinsons: ____ max F0 phonational range

Answer 9

decreased

Question 10

parkinsons: ____ dynamic (intensity) range

Answer 10

decreased

Question 11

parkinsons: _____ jitter and shimmer

Answer 11

higher (breathy and harsh quality)

Question 12

what are the 2 treatments on vocal acoustics for those with parkinsons

Answer 12

voice intensity treatment programs

levodopa meds

Question 13

voice intensity treatment programs have what effects on those w parkinsons

Answer 13

• inc vocal amp
• inc F0 and amp variability
• inc phonational and dynamic range

Question 14

unilateral vocal fold paralysis- what is it? why does it occur? how is their voice perceived?

Answer 14

complete/partial paralysis of the VF on one side (unilateral)

often the result of damage to the recurrent laryngeal nerve during chest/neck surgery

perceived as breathy, harsh, diplophonic, and reduced in loudness

Question 15

describe the vocal freq and amplitude of someone with unilateral vocal fold paralysis

Answer 15

• lower than normal average F0 (low pitch)
• lower than normal average amp (reduced speech intensity)
• diplophonia = double pitch
• lower SDF0 (monopitch)
• lower SD amp (monoloudness)
• dec phonation and dynamic range

Question 16

diplophonia

Answer 16

double pitch

Question 17

describe the cycle to cycle variations in phonation for unilateral VF paralysis

Answer 17

higher than normal jitter/shimmer - breathy and harsh voice quality

Question 18

how is unilateral VF paralysis treated? outcomes?

Answer 18

thyroplasty - surgery where they insert a piece of silastic material into the paralyzed VF - acts to push the VF towards midline to help for phonation

outcomes: inc amp, reduced diplophonia, inc F0 and amp variability, reduced shimmer and jitter

Question 19

what is spasmodic dysphonia? how are those w the condition perceived?

Answer 19

irregular involuntary contractions of the laryngeal adductor muscles

believed to be a dystonic type of movement disorder involving damage to the BG

voice is perceived as strained and contains frequent irregular vocal spasms and voice arrests

Question 20

describe the vocal freq and amp of spasmodic dysphonia

Answer 20

average F0 is higher than normal (high pitch)

higher than normal SD F0 and SD amp (bc of rapid pitch and intensity changes in spasms)

freq voice breaks

Question 21

describe cycle to cycle variation in phonation for spasmodic dysphonia

Answer 21

higher than normal jitter and shimmer = strained voice and vocal spasms

Question 22

how do you treat spasmodic dysphonia? outcomes?

Answer 22

w botox injection - either uniltaeral or bilateral injection into vocalis muscle - causes mild paralysis of VFs which sig reduce the vocal spasms - temp 4-6m

outcomes: reduced SDF0, reduced voice breaks, reduced jitter/shimmer, reduced laryngeal resistance