Voice Disorders Related to Phono-Trauma Flashcards
phono-trauma
any vocal behavior that can have a traumatic effect on the vfs
2 ___ types
- edema
- hemotoma
edema
acumulation of fluid in the vfs
hemotoma
localized swelling caused by a ruptured blood vessel
phono-trauma encompasses both
vocal abuse and vocal misuse
difference between vocal misuses and vocal abuses
- all forms of vocal misuse could be considered vocal abuse
- but not all vocal abuses are vocal misues
some __ __ phono-trauma, but others ___ __ phono-trauma
come from, result int
etiology of phono-trauma
- have a predictable cycle
- first stage of reaction to phono-trauma is edema
- threshold can be crossed
first stage of reaction to phono-trauma is edema
- accumulation of the fluid in the vfs
- they get irrated and swell up
- spontaneous healing kicks in and the vfs are fine if given the opportunity
threshold can be crossed
- once crossed, spontaneous healing can no longer occur
- pushed where it can come back, or enough damaged occurred that can’t heal (lasting changes in vfs)
- voice can either remain stable or get worse
phono-traumatic behaviors
- in some way connected to vocal hyperfunction
- normal to increased loudness and pitch as well as straining
laryngeal saccules: people wit head and neck cancer frequently have issues with vfs
- typically due to radiation
- salivary glands and laryngeal saccules can get fried out
- most likely will have voice changes
each person’s point at which spontaneous healing is no longer possible is…
different, but everyone reaches it at some point
type of voice: if going with the anatomy, it is…
hypofunction
type of voice: if compensating for the anatomy, it is…
hyperfunction
therapy regimen, multi-pronged plan
- prongs are the establishment of good vocal hygiene
- as needed, a program of direct vocal intervention
- establishment of a program of vocal rest
prongs are the establishment of good vocal hygiene
- having the patient target elimination in the reduction of the abuses and misuses that they use
- has to be specific to the individual
- target these behaviorally using programs of vocal abuse/misuse production
as needed, a program of direct vocal intervention
teach the patient to use strategies that promote a less effortful, more healthy/hygenic form of phonation
establishment of a program of vocal rest
- not always needed
1. complete vocal rest
2. modified vocal rest
in other instances, not treatment of choice
may require medical interveniton or surgery
you are on a team
- always requires a medical doctor because they call the shots
- SLP cannot provide treatment until/unless the doctor sees the patient and tells us to complete treatment
2 steps with the team
- doctor diagnosis of the status and changes of anatomy to the vfs
- treatment
SLP’s role is to…
evaluate and treat the voice
who is the ideal professional for patient to see?
otolaryngologist with experience in voice disorders (ENT)
can a patient be recommended from any doctor?
yes, as long as they have looked at the patient’s vfs
treatment types
- therapy only
- therapy -> medical
- medical -> therapy
- therapy -> medical -> therapy
- medical only
therapy -> medical
- SLP sets the stage to reduce the size of the lesion if possible
- then SLP teaches the patient what they need to know so that after the surgery, the lesion doesn’t return
medical -> therapy
- surgeon decides to complete surgery
- then SLP teaches techniques to prevent recurrence
therapy -> medical -> therapy
- therapy first to reduce size of lesion
- then, lesion is removed by doctor
- then SLP retrains to prevent recurrence
medical treatment only
very rare, old style
advantages of voice therapy over surgery
- there is less time loss from work (vocally demanding jobs especially)
- can be an effective non-traumatic treatment option
- more cost effective (depends on insurance)
disadvantage of surgery over therapy
nonremoval of the behavior that caused the lesion or cause of lesion to reoccur
vocal misuse defined
the incorrect use of pitch, tone, focus, quality, volume, breath support, and/or rate that distorts the normal propensity of the phonatory mechanism to work effectively and efficiently
tone focus
use of the entire resonatory tract
problems with tone focus
only using the voice at the level of the throat/larynx
vocal misuse is directly related to voice production
screaming, whispering, loquaciousness (talking all the time/excessively), talking in a strained manner, etc.
vocal abuse defined
mistreatment of the laryngeal or voice producing mechanism
examples of vocal abuse
smoking, drinking/eating excessive dairy products, constant throat clearing, yelling, singing inappropriately, eating spicy foods, etc.
treat each patient individually
- plan accordingly
- what might be detrimental to one person may not be for another person
- physically and psychologically different
- also not blanket for the individual