quiz 5 Flashcards
1
Q
neurogenic dysphonia
A
- dysphonia of neurogenic origin
2
Q
vocal fold paralysis/paresis
A
- damage to CN X anywhere along its path
- paralysis: VF is fixed in a position
- paresis: weakness or reduced movement
- type and extent of resulting dysphonia is dependent upon lesion site and whether damage is unilateral or bilateral, and partial or complete
3
Q
4 etiologies of VF paralysis/paresis
A
- neoplastic: abnormal/uncontrolled cell growth, such as a tumor
- traumatic: surgical or nonsurgical
- medical disease
- idiopathic
4
Q
importance of discovering etiology of VF paralysis/paresis
A
- to rule out something significantly concerning, such as a tumor/cancer
5
Q
VF stuck at midline
A
- VF are stuck in adducted position
- best for voicing and swallowing safety, worst for breathing
- may require a trach if bilateral
6
Q
VF stuck open
A
- VF are fixed in abducted position
- best for breathing, worst for voicing or airway protection when swallowing
7
Q
voice in unilateral VF paralysis
A
- dysphonic or aphonic
- may be breathy or hoarse vocal quality
- reduced phonation time
- decreased loudness or monoloudness
- diplophonia
- pitch breaks
8
Q
UVFP management principles
A
- many traumatic VF paralyses have spontaneous recovery in 9-12mo
- permanent corrective procedures are delayed until after this window with trial of voice therapy
9
Q
surgical UVFP options
A
- VF medialization: injection laryngoplasty or thyroplasty
- VF reinnervation
10
Q
injection laryngoplasty
A
- filler injection into the VF to bring it to midline
- temporary, as fillers dissolve
11
Q
thyroplasty
A
- hole cut into thyroid cartilage and VF is pushed over to bring it to midline
12
Q
laryngeal dystonia/spasmodic dysphonia
A
- abnormal muscle contractions and spasms
- vegetative voicing, singing, whispering may be normal
- voice improves after glass of wine, worsens when talking on telephone
- 3 types: abductor SD, adductor SD, and mixed SD
13
Q
adductor SD
A
- adductor muscles spasm, bringing VF together
- primary voice symptoms: strained, strangled, with intermittent stoppages
- secondary voice symptoms: hoarseness, harshness, tremor
- easier to say easy onset, such as how hard did he hit him
- harder to say abrupt onset/all voiced, such as we were away a year ago and we eat eggs every easter
- easier to count from 60-69, harder to count from 80-89
14
Q
abductor SD
A
- spasm is on abduction, VF opening (PCA)
- primary voice features: breathy dysphonia
- secondary voice features: delay of voice onset after voiceless consonants
- easier to say harsh/abrupt onset sentences like we eat eggs every easter and we were away a year ago
- harder to say easy onset sentences, like how hard did he hit him
- easier to count from 80-89, harder to count from 60-69
15
Q
mixed SD
A
- spams on both abduction and adduction
- features of both
- one may be more predominant than the other
