quiz 5 Flashcards

1
Q

neurogenic dysphonia

A
  • dysphonia of neurogenic origin
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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
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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
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4
Q

importance of discovering etiology of VF paralysis/paresis

A
  • to rule out something significantly concerning, such as a tumor/cancer
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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
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6
Q

VF stuck open

A
  • VF are fixed in abducted position
  • best for breathing, worst for voicing or airway protection when swallowing
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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
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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
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9
Q

surgical UVFP options

A
  • VF medialization: injection laryngoplasty or thyroplasty
  • VF reinnervation
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10
Q

injection laryngoplasty

A
  • filler injection into the VF to bring it to midline
  • temporary, as fillers dissolve
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11
Q

thyroplasty

A
  • hole cut into thyroid cartilage and VF is pushed over to bring it to midline
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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
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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
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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
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15
Q

mixed SD

A
  • spams on both abduction and adduction
  • features of both
  • one may be more predominant than the other
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16
Q
A
17
Q

treatment for laryngeal dystonia/spasmodic dysphonia

A
  • gold standard is Botox injection to temporarily paralyze spasming muscle
  • will take about 3 days to kick in
  • initially will experience some breathiness, mild symptoms of aspiration/coughing, then period of optimal voicing before it wears off
18
Q

role of SLP intervention for LD/SD

A
  • aid in differential diagnosis from functional voice disorder
  • optimize impact of medical intervention
  • reduce compensatory behaviors