Voice Therapy Flashcards by Lori Glidden

What factors should you consider when planning therapy

Cause
Background history
Voice demands
Work and social issues 
Motivation 
Patient skills

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What are the 2 most important goals of therapy

Voice quality and QOL

Eliminate phonotrauma

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What should short term goals include

Specific exercises
Accuracy
# of sessions
Homework plans

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What should an education plan include

Larynx model or pictures 
Normal physiology of voice
What causes the disorder
How you will manage and why
8th grade level

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What is an indirect method of therapy

Vocal hygiene

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What is a direct method of therapy

Physiologic methods

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What are typical voice therapy methods

Vocal wellness
Respiratory training 
Relaxation training 
Phonotory retraining 
Medical coordination 
Singing training 
Referral as needed

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What is vocal wellness

Vocal hygiene

Phonotrauma management

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What is respiratory training

Lower abdominal breathing
Use of breath in speech
Expiratory training

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What is relaxation training

Whole body relaxation
Stress reduction
LAB
Laryngeal massage

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What is phonotory retraining

Easy voice 
Challenge principles 
Rate and intonation 
Vocal function exercises 
Valsalva
Resonant voice therapy (mask focus)

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What do you ultimately want to see as a result of therapy

Increased efficiency of phonation

Generalization

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What is the biggest factor when choosing a therapy

Evidence based practice

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What is voice efficiency

Max use airflow

Min use muscles

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What are good sounds to begin therapy

Wh words because of airflow

Nasals because they move the effort forwards

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Describe a therapy session

Describe normal anatomy and physiology, causes of disorder,
Correlate cause with their symptoms and impact

Measure motivation
Discuss a timeline
Give homework materials

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When do you end therapy

Problem resolved 
Patient satisfied 
Clinician satisfied 
Other issues (reimbursement, health, travel)
Document everything

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What are therapy approaches

Voice rest
Modified voice rest 
Treat symptoms 
Psychogenic therapy 
Physiologic therapy 
Eclectic therapy
Combined modality

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What is eclectic therapy

Using a combination

Holistic

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What is combined modality

The use of other modalities such as biofeedback

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What is physiologic voice therapy

Direct exercises that activate laryngeal muscles and subsystems

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What are examples of physiologic therapy

Vocal function exercises 
Flow phonation 
Lessac madsen resonant voice therapy 
Lee Silverman loud
Inspiratory and expiratory muscle strength

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What causes breathing problems

Poor posture

Lack of LAB

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What are examples of breathing therapy

LAB exercises
Single and double hold breathing 
Relaxation and improving breath support 
Prolonged inhalation and expiration 
Quick breathing
Breathing in speech

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What is the purpose of double hold breathing

Voluntary control

What is the purpose of relaxation and improving breath support

Working against resistance

What is the goal of prolonged inhalation and exhalation

Use more air over more time

What is the purpose of quick breathing

Coordination

What is the problem with breathing exercises

Lack of evidence

What vowel do you typically use for max phonation

/i/

What is the goal for breathing exercises

Increase air effort

What are 3 components of vocal hygiene

Vocal health Vocal abuse Vocal misuse

What are some strategies for good vocal hygiene

``` Adapt the environment Reduce loudness Vocal rest Nonverbal feedback Vocal hygiene ```

What are good activities for getting syllables per breath

Rainbow passage Counting to 100 Progressively longer sentences

What do flow phonation exercises do

Widen the vocal tract | Reduce tension in the folds

What does semi occluded vocal tract exercises mean

Mouth is partially closed

How does SOVT work

Less impact and stress on muscles while they stretch

What are the benefits of SOVT

Mouth closed makes more air stay in tract Fold vibrations are easier Positive pressure helps push folds apart Negative pressure helps pull them together Less vocal fatigue Helps the folds align

Who is SOVT good for

Vocal fold lesions

Name office based surgeries

Indirect laryngoscopy (mirror and flexible) KTP laser Injection laryngosplasty Botox

What proceedures are done in the operating room

``` Microexcision Microflap dissection Laser Microdebrider dissection Injection laryngoscopy Thyroplasty Ini and bilateral cordectomy Complete cordectomy ```

What is the benefit of office procedures

Immediate feedback No anesthesia Cost effective

What does botox do

Temporarily paralyzes fold

What is laser surgery do

Burns out abnormal cells

What are disadvantages to office procedures

Limited surgery Not for more advanced cases Patient comfort

What surgical procedure would be used for nodules or small polyps

Microlaryngoscopy

How do you treat cysts

Microflap incision

What would you use a microflap dissection for

Large lesions | Submucal lesion

What is the benefit of laser surgery

More precise with less burning Less obstruction in surgical field Less risk of airway fire

What is an SLP role in surgery

Educate about voice rest and hygiene Therapy after procedure Videostroboscopy to document improvement

What is the criteria for performing an injection laryngoscopy

Within one year No permanent damage to RLN Paralysis negatively affecting vouce or swallowing

When do you do a thyroplasty implant

If over one year | Permanent damage to nerve

What is thyroplasty

Medializes cord prrmanently by implant | Creates better glottal closure

What is a type 2 or lateral thyroplasty

Move fold permanently to side | Abductor paralysis

How do you determine type of surgical treatment

How active patient is Timeline Cause

When would you use a unilateral transverse cordectomy

Abductor paralysis

What is a bilateral cordectomy

Both folds are divided from the process

What is AAC

Augmented alternative communication

What are the Isshiki classification for phonosurgerylengthens cricothyroid for higher voice

Type 1: medialization laryngoplasty Type 2: lateralization resulting in soft breathy voice Type 3: anterior posterior thyroid cartilage. Shortens length lowers voice Type 4

What are type 3 and 4 thyroplasty surgeries used for

Transgender