Spasmodic dysphonia

Question 1

What is spasmodic dysphonia?

Answer 1

Voice disorder characterized by spasms of adductor or abductor intrinsic laryngeal muscles. Spasms happen when the person try to talk normally. May not appear when they are singing.

Question 2

What are the different types of adductor SD?

Answer 2

1. Psychogenic
   
   • conversion
   • muskuloskeletal tension
     2.Neurologic
   • organic or essential tremor
   • dystonic type
     3.Idiopathic
     -

Question 3

What are vocal features of SD?

Answer 3

Characterized by strain, struggle, voice breaks

Question 4

SD ADD ( Pscyhogenic type)- what is a conversion disorder related to?

Answer 4

Strong relation between unresolved conflict and abnormal voice; feelings of rage, loss of control

Question 5

SD ADD (Pscyhogenic type)- What is musculoskeletal tension related to?

Answer 5

Related to heightened anxiety, tension, depression; not as serious as conversion type

Question 6

SD ADD (Neurologic)- what are the causes?

Answer 6

caused by lesions in extrapyramidal system, especially basal ganglia

Question 7

SD ADD (Neurologic)- Organic or Essential Tremor vocal feature?

Answer 7

shaky voice ( quavery).

Question 8

SD ADD (Neurologic)- what is organic or Essential Tremor related to?

Answer 8

Rhythmic alternating movements of muscle groups- (laryngeal, extrinsics, pharyngeal muscles or elsewhere in body).

Question 9

SD ADD (Neurologic)- what is dystonic type related to?

Answer 9

slow, uncontrolled non-rhythmic contractions of muscle groups. Can be any muscle group, including isolated to larynx

** if generalized to other areas besides the larynx it is a hyperkinetic disorder.

Question 10

SD ADD- what occurs?

Answer 10

the vocal cords are pressed tightly and try to squeeze air through. the spasms cause the vocal cords to close.

Question 11

SD ABD- what occurs?

Answer 11

the spasms cause the vocal cords to open.

Question 12

Treatment for a person with SD ADD?

Answer 12

• can sometimes be started without ENT clearance or etiology

- get vowel prolongation and production in different phonemic contexts.

Question 13

What is the onset of SD ADD sudden or gradual?

Answer 13

gradual

Question 14

Evaluation of SD ADD. ?

Answer 14

Team approach:
ENT needs to rule out tumor or lesions secondary to hyperadduction.
View the rhythmic movements.
SLP- very careful oral mech ( Structure, Symmetry, Strength and Rate Range)

Question 15

Treatment for SD ADD?

Answer 15

usually not voice TX alone. need psychosocial too.

Question 16

What to do for voice tx for SD ADD?

Answer 16

trial of vowel prolongation and varied phonemic contexts ( add why) . test for musculoskeletal tension and release (by digital manipulation of larynx? )
- easy onset, and yawn/sigh because they lessen the force of vocal fold closure.

Question 17

SD ABD- voice quality?

Answer 17

Normal or hoarse voice interrupted by moments of breathiness or whispered segments

Question 18

DX of AD ABD?

Answer 18

have them read voicelss consonants followed by vowels.

Question 19

acoustic findings of SD ABD?

Answer 19

abnormal pitch changes, long voice onset for VL C’s, increased aperiodicity, and long word and sentence durations.

Question 20

acoustic findings of SD ADD?

Answer 20

lots of aphonic breaks, noise, abrupt pitch shifts.

Question 21

tx for SD abd?

Answer 21

voices sounds because the transition of vowel . using a higher pitch can help with this because cricothyroid stretches vocal cords.