Organic Voice Disorders

Question 1

Organic Voice Disorders can be separated into two categories:

Answer 1

disease or congenital/trauma

Question 2

There are three causes to granulomas or ulcers:

Answer 2

• 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)

Question 3

Excessive medial compression of posterior glottis during low pitched phonation, hard glottal attacks, increased loudness, throat clearing and coughing

Answer 3

Phonotrauma

Question 4

Stomach acid and enzymes which affect the VF tissue

Answer 4

GERD/ LPR

Question 5

trauma to VFs due to the endotracheal tube rubbing

Answer 5

Intubation

Question 6

What is this?

Answer 6

Granuloma

Question 7

Perceptual:

_____ pitch, ______, hoarse, _______

Answer 7

low, vocal fry, breathy

*Granuloma

Question 8

Acoustic:

___ habitual pitch, ________ frequency and intensity perturbations

Answer 8

low, increased

*Granuloma

Question 9

Causes VF edema, erythmea, arytenoid and posterior commissure hypertrophy, pachydermia (thickening tissue between the arytenoids)

Answer 9

Reflux Laryngitis

Question 10

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

Answer 10

E - all of the above

Question 11

Perceptual:

hoarseness, breathiness, decreased habitual pitch

Answer 11

Reflux Laryngitis

Question 12

Acoustic:

increased noise levels, increased frequency and intensity perturbations

Answer 12

Reflux Laryngitis

Question 13

Inflammatory response of the larynx due to a viral or bacterial infection

Answer 13

Infectious Laryngitis

Question 14

Perceptual:

total or partial voice loss, hoarseness, breathiness, low pitch

Answer 14

Infectious Laryngitis

Question 15

Caused by the Human Papiloma-Virus, wart-like growths, two-types (Juvenile and Adult),

Answer 15

Laryngeal Papiloma

Question 16

Perceptual:

hoarseness, breathiness, strained

Answer 16

Laryngeal Papiloma

Question 17

Acoustic & Aerodynamics:

no data; due to increased stiffness of vocal fold subglottal pressure

Answer 17

Laryngeal Papiloma

Question 18

Videostroboscopic:

incomplete glottic closure, absent mucosal wave, increased VF mass and stiffness

Answer 18

Laryngeal Papiloma

Question 19

What’s this?

Answer 19

Laryngeal Papilloma

Question 20

Congenital or acquired post-surgery or after Laryngeal Trauma

Answer 20

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

Question 21

What’s this?

Answer 21

Laryngeal Web

Question 22

soft laryngeal cartilages, may collapse into airway on inhalation, resolves with maturation

Answer 22

Laryngomalacia

Question 23

Videostroboscopic:

collapse of laryngeal cartillages in inspiration, floppy arytenoid cartilages, excessive AC mucosa

Answer 23

Laryngomalacia

Question 24

More common in boys than girls, autosomal dominant pattern of inheritance, on posterior portion of cricoid cartilage causing narrowing of airway

Answer 24

Laryngeal Cleft

Question 25

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

Answer 25

*Subglottic Stenosis*

Question 26

Pre-cancerious lesions due to constant irritation of the Vocal Folds from smoking, reflux, alcohol, etc.

Answer 26

* leukoplakia (*plaque-like whitish patches) * hyperkeratosis (*warty lesions)

Question 27

**Videostroboscopic:** increased VF mass and stiffness, decreases mucosal wave and amplitude, irregular glottic closure, aperiodicity

Answer 27

*leukoplakia/hyperkeratosis* \*voice is hoarse and rough

Question 28

What's this?

Answer 28

*hyperkeratosis*

Question 29

What's this?

Answer 29

*Leukoplakia*

Question 30

A longitudinal groove or indentation in the upper edge of the VFs that parallels the free margins

Answer 30

*Sulcus Vocalis*

Question 31

True or False: The etiology for Sulcus Vocalis is defined

Answer 31

* False -* The etiology for Sulcus Vocalis is undefined, **but** may be - congenital - related to phonotrauma - related to smoking - due to a ruptured cyst

Question 32

How many classification types are there for Sulcus Vocalis?

Answer 32

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)

Question 33

**Perceptual:** hoarse, breathy, sometimes effortful

Answer 33

*Sulcus Vocalis*

Question 34

**`Videostroboscopic:** incomplete glottic closure, spindle shaped, decreased mucosal wave and amplitude of vibration, increased VF stiffness but decreased mass

Answer 34

*Sulcus Vocalis*

Question 35

What's this?

Answer 35

*Sulcus Vocalis*

Question 36

malignant squamous cell carcinomas and can be supraglottic, glottic, and/or subglottic

Answer 36

*Laryngeal Cancer*

Question 37

**Perceptual:** chronic hoarseness, lump in the neck, swallowing problems, neck tenderness, pain during swallowing

Answer 37

*Laryngeal Cancer*

Question 38

True or False: Typically occurs to 60-65 year old males who happen to be heavy smokers and intake alcohol moderately

Answer 38

*Laryngeal Cancer*

Question 39

**Acoustic:** increased frequecy/intensity perturbations, decreased pitch range, possibly increased fundamental frequency, increased noise levels

Answer 39

*Laryngeal Cancer*

Question 40

**Aerodynamic:** increased airflow

Answer 40

*Laryngeal Cancer*

Question 41

What's this?

Answer 41

*Laryngeal Cancer*