Lecture 14 Irritable Larynx, Chronic Cough and PVFM Flashcards
What is Irritable Larynx?
It is a hyperkinetic laryngeal dysfunction that results from a variety of specific causes and is a response to a definitive triggering stimulus that can either be internal or external
What are some possible causes for ILS?
Viral infection in CNS
Damaged sensory nerves ‘regrow’ and branch in abnormal manner
emotional states and defense reactions
asthma-like upper airway reactions
True or False:
Individuals who have ILS, 85% are female with average age of 50
True
The following are common symptoms of ILS:
A.) chronic cough
B.) laryngospasm
C.) globus pharyngeus
D.) MTD (muscle tension dysphonia)
E.) all of the above
E - all of the above
What are some triggers of ILS?
airborne irritants
reflux and postural changes
voice use
exercise
emotional stressors
What are the three levels of treatment for ILS?
HINT: M. R. R.
1 - minimize sensory stimuli & minimize exposure
2 - reprogram maladaptive responses by decr. muscle tension (pursed lip breathing)
3 - reprogram CNS via motor relearning and centrally active medications
*Meds: tricylic antidepressants (Baclofen, Gabapentin)
Botox into TA muscle
Seratonin ruptake inhibitors
What is PVFD?
Paradoxial Vocal Fold Dysfunction
-an upperway disorder that results in episodes of partial to complete VF adduction, (during inhalation)
*not a disorder of vocal quality
*can occur while awake or asleep
often misdiagnosed as asthma
How do you treat PVFD?
Frist: thorough case history interview
(i.e. trouble inhaling/exhaling?
do you make noise when this happens?
tightness?
etc.)
Second (Three Components - Body Awarness training via progressive tightening/relaxing activities / training lower abdominal ~ rib cage expansion during inhalation / and rapid deep nasal sniff followed by complete exhalation or oral straw inhalation followed by exhalation (s or f)
