Phonotrauma & Trauma-Related Dysphonias Flashcards
Rough voice
Aperiodic vibration of the vocal folds
Breathy voice
Voice produced with incomplete closure of the vocal folds
Hoarse voice
Simultaneously rough and breathy
Jitter
Cycle to cycle frequency perturbation
Shimmer
Cycle to cycle amplitude perturbation
Harmonics-to-noise Ratio
Compares loudness of the harmonics of the vocal source vs. extraneous noise
Harmonics
Whole number multiple of the fundamental frequency
Vocal Parameters
Quality Pitch Loudness Prosody Resonance
Zemlin’s 6 parameters
Average/habitual pitch Maximum pitch range Maximum phonation time Dynamic range Harmonics-to-noise ratio Jitter
Laryngitis
Inflammation of the vocal folds and larynx
Etiology: phonotrauma, overexposure to noxious agents, GERD, LPR, environmental agents
May be acute (bacterial/viral infection) or chronic (vocal abuse/misuse)
Laryngitis characteristics
Perceptual: hoarseness, potential pitch changes
Acoustic: greater than normal amplitude and frequency perturbation
Vocal nodules
Benign growths on the vocal folds, usually in the anterior 1/3
Etiology: usually vocal abuse
Reaction of the tissue to constant stress induced by frequent, hard oppositional movement of the vocal folds
Vocal nodules characteristics
Perceptual: hoarseness, breathiness, patient may complain of soreness or pain in the neck, may complain of feeling something in their throat, May throat clear often
Acoustic: dependent on size/severity
Increased frequency and amplitude perturbation
Fundamental frequency within normal range
Vocal polyps
Fluid filled area under the mucosal layer believed to be result from period of vocal abuse but may occur from single traumatic incident
Pedunculated polyp
Localized and attached to the vocal fold by a slim stalk of tissue
Sessile polyp
Closely adhering to the mucosa
Hemorrhagic polyp
Appearance of a blood blister
Vocal polyps characteristics
Perceptual: hoarseness, roughness, or breathiness
Pt may report sensation of something in the throat
Acoustics: increased jitter and shimmer
Reduced phonation range
Reinke’s Edema (polypoid degeneration)
The buildup of fluid that occurs primarily in the superficial layer of the vocal folds
Etiology: trauma and misuse
Secondary to excessive use of the vocal folds or a result of infection and inflammation
Often seen in female smokers
Reinke’s Edema characteristics
Perceptual: low pitch, hoarseness, may have decreased pitch range and increased effort to produce voice
Acoustic: low fundamental frequency for sex and age of patient
Gray vocal folds
Vocal fold cysts
Small spheres on the margins of the vocal folds or on the superior surface of the fold
Often mistaken for early nodules or polyps
Etiology: May be caused by a blockage of a granular duct, causing a retention of mucosa possibly combined with phonotrauma or may be congenital
Vocal fold cysts characteristics
Perceptual: hoarseness, lowered pitch, patient may report a tired voice
Acoustic: reduced phonation range in females
Yellowish vocal folds
Contact ulcer
Benign lesion that develops on the vocal process of the arytenoid cartilages
May be unilateral or bilateral
Etiology: vocal abuse (regular hyperadduction of the vocal processes of the arytenoid cartilages), GERD
Contact ulcers characteristics
Perceptual: low pitch (May be glottal fry), persistent hard glottal attacks, patient may complain of pain in the larynx, vocal fatigue, or referred pain to neck or ear
