Voice Assessment, Descriptors, Examples

Question 1

What is the most important assessment tool of the SLP?

Answer 1

The ear

• listen for the quality of the voice
  i. Dysphonic
  ii. Breathy
  iii. Rough
  iv. Strained- strangled
  v. Hoarse- combo of strained, strangled and breathy
  vi. Aphonic

Question 2

What are the gold standards for measurements of what you hear? (instrumental)

Answer 2

a. Endoscopy
b. Visipitch
c. Nasometer

Question 3

Observations

Answer 3

a. Symmetry
b. Periodicity (Regularity)
c. Glottal closure
d. Amplitude
e. Mucosal Wave
f. Vibratory behavior
g. Other pertinent information

Question 4

Symmetry

Answer 4

Look at both vocal folds- are they vibrating in sync with one another, look like mirror images, in the same vibratory cycle at the same time

Question 5

Periodicity (Regularity)

Answer 5

Examining the periodicity of successive vocal fold vibrations. Do they look the same time after time or are they aperiodic, taking longer and shorter amounts of time for each vibratory cycle

Question 6

Glottal Closure

Answer 6

Is it complete from front to back at the apex of the closed phase? Is there an opening left anteriorly, posteriorly, medially, when the next vibratory cycle begins and the vocal folds open again? Describe the shape of the opening. Nodules will make an hourglass shape. There may be a posterior chink or anterior chink. The vocal folds may be bowed. There may be a gap the length of the vocal folds resulting in complete closure.

Question 7

Amplitude

Answer 7

The maximum amplitude of the horizontal excursion of the vocal folds. This is described as normal, greater than normal, less than normal, or zero. Differences in the amplitude of each vocal fold should also be described, if present.

Question 8

Mucosal Wave

Answer 8

The size of the mucosal wave is descried as normal, greater than normal, less than normal or none. Differences in the mucosal wave should also be described, if present.

Question 9

Vibratory Behavior

Answer 9

Describing any portion of the vocal folds that does not vibrate.

Question 10

Other pertinent information

Answer 10

Include description of vocal fold edges, presence of any abnormal tissue, unusual anatomical structures, unusual physiology, participation of the ventricular folds.

Question 11

Disorders and Lesions

Answer 11

a. Hyperfunction: misuse and abuse, neurologic
b. Hypofunction: incorrect learning, neurologic
c. Benign Lesions- nodules, polyps, cysts, Reinke’s Edema, Ulcer, Granuloma
d. Trauma- Hematoma, fracture, torn vocal fold, webbing, Stenosis, surgery
e. Disease- Papillomatosis (HPV), Sarcoidosis, Keratosis and Leukoplakia, Carcinoma
f. Neurological

Question 12

Neurological Disorders

Answer 12

i. Paresis and Paralysis
1. Stroke
2. Viral
3. Birth Defect
ii. Progressive Neurological Disease
1. ALS
2. MS
3. MD
4. Parkinson’s
iii. Spasmodic Dysphonia
iv. Paradoxical Vocal Fold Disorder