Lecture 12 Surgical and Pharmacological

Question 1

What are the five major groups of phonosurgeries?

Answer 1

removal of pathological issue

surgical correction of VF shape, position, or tension

alteration or restoration of laryngeal neuromuscular function

surgical reconstruction for partial loss or deformity of larynx

surgical reconstruction for total larynx loss-laryngectomy

Question 2

There are two methods of VF medialization for unilateral paralysis, bowing, and glottic incompetency:

Answer 2

Intrafold injection

medializationi surgery (augmentation, medial shift of thyroid cartilage, and rotation of arytenoid cartilage)

Question 3

What is the goal for Endolaryngeal Microsurgery?

Answer 3

To remove the lesion by only taking as much VF tissue necessary and preserving as much of the mucosa as possible

Question 4

What are some pharmacological treatments for tremor?

Answer 4

Propranolol (beta blocker) and Primidone (anticonvulsant)

Question 5

What are the pharmacological treatments for Papilloma?

Answer 5

Interferons - aggressive VFP

Indole 3 carbinol - alters growth pattern of VFP

Cidofovir - antiviral injected into papilloma

Methatrexate - chemotherapy (blocks growth of papilloma)

Question 6

What are pharmacological treatments for Spasmodic Dysphonia?

Answer 6

Botox

Question 7

What are some therapy approaches for vocal tremor?

Answer 7

Crescendo exercises (soft to loud)

Decrease negative compensatory strategies

different pitch and loudness

Staccato speech / easy onset

Breath support

Question 8

What is the role of voice therapy treatment in Spasmodic Dysphonia?

Answer 8

Elminate negative compensatory strategies

Improve breath support

Decrease muscle tension (jaw, face, neck, shoulders)

Question 9

What is the voice treatment for Parkinson’s Disease?

Answer 9

Lee Silverman Voice Therapy

*consists of sustained /a/ phonation at a loud level

pitch glides up and down

use of loud voice in functional phrases, sentences, paragraphs, and conversations

use loud voice out of clinic into real world settings

Question 10

True or False:

LSVT improves glottic closure, louder voice, improved vocal quality, and articulation and swallowing

Answer 10

True

Question 11

What therapy treatments are there for TBI, Hyperkinetic Dysarthria, and CP?

Answer 11

• increase breath support (inspiratory and expiratory volume)
• teach easy onsets and linking to decrease excessive muscle activity
• utilize aspiration i.e. air flow prior to voicing
• use LSVT (especially for TBI and CP)