Organic Voice Disorders Flashcards
Organic Voice Disorders can be separated into two categories:
disease or congenital/trauma
There are three causes to granulomas or ulcers:
- GERD* or LPR
- Phonotrauma*
- Intubation Trauma*
*Form on the medial aspect of the posterior third of the vocal folds
*usually unilateral but can be bilateral
*variable glottic closure (mucosal wave decreased)
Excessive medial compression of posterior glottis during low pitched phonation, hard glottal attacks, increased loudness, throat clearing and coughing
Phonotrauma
Stomach acid and enzymes which affect the VF tissue
GERD/ LPR
trauma to VFs due to the endotracheal tube rubbing
Intubation
What is this?
Granuloma
Perceptual:
_____ pitch, ______, hoarse, _______
low, vocal fry, breathy
*Granuloma
Acoustic:
___ habitual pitch, ________ frequency and intensity perturbations
low, increased
*Granuloma
Causes VF edema, erythmea, arytenoid and posterior commissure hypertrophy, pachydermia (thickening tissue between the arytenoids)
Reflux Laryngitis
All of the following are symptoms of GERD/LPR except for:
A.) heartburn
B.) rapid vocal fatigue
C.) chronic, dry cough
D.) Acid taste in mouth
E.) All of the above
E - all of the above
Perceptual:
hoarseness, breathiness, decreased habitual pitch
Reflux Laryngitis
Acoustic:
increased noise levels, increased frequency and intensity perturbations
Reflux Laryngitis
Inflammatory response of the larynx due to a viral or bacterial infection
Infectious Laryngitis
Perceptual:
total or partial voice loss, hoarseness, breathiness, low pitch
Infectious Laryngitis
Caused by the Human Papiloma-Virus, wart-like growths, two-types (Juvenile and Adult),
Laryngeal Papiloma
Perceptual:
hoarseness, breathiness, strained
Laryngeal Papiloma
Acoustic & Aerodynamics:
no data; due to increased stiffness of vocal fold subglottal pressure
Laryngeal Papiloma
Videostroboscopic:
incomplete glottic closure, absent mucosal wave, increased VF mass and stiffness
Laryngeal Papiloma
What’s this?
Laryngeal Papilloma
Congenital or acquired post-surgery or after Laryngeal Trauma
Laryngeal Web
*Web is a band of tissue that forms in the anterior 1/3 of glottis
*Inhalatory stridor may be present, shortness of breath and high-pitched crying in infants
What’s this?
Laryngeal Web
soft laryngeal cartilages, may collapse into airway on inhalation, resolves with maturation
Laryngomalacia
Videostroboscopic:
collapse of laryngeal cartillages in inspiration, floppy arytenoid cartilages, excessive AC mucosa
Laryngomalacia
More common in boys than girls, autosomal dominant pattern of inheritance, on posterior portion of cricoid cartilage causing narrowing of airway
Laryngeal Cleft
Narrowing of the tissue below the glottis, third most common congenial condition
Symptoms:
inspiratory and expiratory stridor, dyspnea, low pitch cough, nostril flaring, excessive chest wall movement
Subglottic Stenosis
Pre-cancerious lesions due to constant irritation of the Vocal Folds from smoking, reflux, alcohol, etc.
- leukoplakia (*plaque-like whitish patches)
- hyperkeratosis (*warty lesions)
Videostroboscopic:
increased VF mass and stiffness, decreases mucosal wave and amplitude, irregular glottic closure, aperiodicity
leukoplakia/hyperkeratosis
*voice is hoarse and rough
What’s this?
hyperkeratosis
What’s this?
Leukoplakia
A longitudinal groove or indentation in the upper edge of the VFs that parallels the free margins
Sulcus Vocalis
True or False: The etiology for Sulcus Vocalis is defined
- False -* The etiology for Sulcus Vocalis is undefined, but may be
- congenital
- related to phonotrauma
- related to smoking
- due to a ruptured cyst
How many classification types are there for Sulcus Vocalis?
Two types:
Type I - entire VF length into SLP only
Type II a - entire VF length includes SLP up to the VL (moderate dysphonia)
Type II b - entire SLP and VL and may involve TA muscle (severe dysphonia)
Perceptual:
hoarse, breathy, sometimes effortful
Sulcus Vocalis
`Videostroboscopic:
incomplete glottic closure, spindle shaped, decreased mucosal wave and amplitude of vibration, increased VF stiffness but decreased mass
Sulcus Vocalis
What’s this?
Sulcus Vocalis
malignant squamous cell carcinomas and can be supraglottic, glottic, and/or subglottic
Laryngeal Cancer
Perceptual:
chronic hoarseness, lump in the neck, swallowing problems, neck tenderness, pain during swallowing
Laryngeal Cancer
True or False: Typically occurs to 60-65 year old males who happen to be heavy smokers and intake alcohol moderately
Laryngeal Cancer
Acoustic:
increased frequecy/intensity perturbations, decreased pitch range, possibly increased fundamental frequency, increased noise levels
Laryngeal Cancer
Aerodynamic:
increased airflow
Laryngeal Cancer
What’s this?
Laryngeal Cancer
