Voice Disorders

Front 1

Granuloma
Characteristics?
Causes?
Tx?

Back 1

Organic- Inflammatory vascular tissue (firm round sac)

Breathy, hoarse, clear throat often

Vocal abuse, intubation, GER, laryngeal injury, contact ulcers

Surgery, voice tx

Front 2

Granuloma vs. Hemangioma

Back 2

Hemangioma:
- Can be congenital
- Filled with blood
- Softer than granuloma

Front 3

Leukoplakia

Back 3

Benign growths of thick whitish patches on surface mucosa membrane.

Front 4

What is Laryngomalacia?

Back 4

Congenital soft "floppy" laryngeal cartilages (epiglottis)

Causes stridor and typ not treated d/t ability to resolve by 2/3 years of age.

Front 5

Papilloma

Back 5

HPV juvenile (wart-like) - Typ ceases by puberty however requires multiple surgeries (which creates scar tissue, webbing)

If its obstructing airway then it could be life threatening.

Front 6

This voice disorder can be psychological but has neurogenic causes with emotional side effects.

Back 6

Spasmodic dysphonia

Front 7

What are the characteristics of spasmodic dysphonia?
Tx?

Back 7

Focal laryngeal dystonia

Abductor SD- decreased loudness, breathy, fleeting VF abduction when pt. tries to phonate.

Tx- botox, relaxation, pharmacological

Adductor SD- overpressure/adduction- closure is too tight.

Tx- CO2 laser surgery. RLN resection, Botox injections, voice tx.

Front 8

What are some neurological voice disorders?

Back 8

- Multiple sclerosis (MS)
- Myasthenia gravis- autoimmune disease
- Amyotrophic Lateral Sclerosis (ALS)
- Parkinson's Disease

Front 9

Which neurological voice disorder doesn't not respond well to medications and typically needs AACs?

Back 9

ALS

Front 10

Which neurological voice disorder has vocal bowing and uses LSVT?

Back 10

Parkinson's Disease

Front 11

Whats the difference between vocal nodules vs. polyps?

Back 11

Nodules- typically bilateral stiff fibrous nodes and caused by chronic abusive behaviors such as yelling or singing.

Polyps- unilateral soft fluid-filled (vascular tissue) that has an acute

Front 12

Tx for Nodules vs Polyps?

Back 12

Nodules- surgery, lasers, voice tx

Polyps- voice rest, change in habits

Front 13

What causes contact ulcers?
Tx?

Back 13

Slamming together of ARYTENOIDS cartilage. Hard glottal attacks, low-pitched phonation, GERD, or intubation

Tend to be hoarse and clear throat often. Vocal pain and fatigue.

Depends on actual cause.. reducing effort of phonation, medical tx, etc. (surgery never recommended)

Front 14

How is vocal fold thickening caused?

What's another dx similar to it based on the causes.

Back 14

Prolonged use of vocally abusive behavior.. precursor to nodules/polyps.

Tx- elimination of vocal abusive behavior

Traumatic Laryngitis

Front 15

This voice disorder is commonly found with older women who smoke.

Where is found on the VFs?

Back 15

Reinkes Edema

Superficial lamina propria

Front 16

This voice disorder is commonly found with individuals who have tension in their necks and elevated laryngeal height.

Tx?

Back 16

Muscle Tension Dysphonia

Tx- circumlaryngeal massage, yawn-sign, sniffs, relaxation

Front 17

This voice disorder typically happens in children and is caused from burns, vehicular accidents, strangulation, or intubation.

Back 17

Laryngeal trauma

Front 18

This voice disorder is a membranous growth across the anterior glottis and it can be either congenital or acquired.

How is caused?
Tx?

Back 18

Laryngeal web

Caused from trauma, forceful intubation, severe laryngeal infection, or accidental injury.

Infants may need tracheostomy.

Tx- Surgery is required with laryngeal keel b/w VFs to prevent it from growing back.

Front 19

This is a psychological/physiological voice disorder when the true vocal folds ADDuct instead of adducting during inhalation and may remain closed.

Tx?

Back 19

Paradoxical Vocal Fold Motion (PVFM)

Typ appears in young women and sometimes tracheostomy is needed

Tx- combo of psch/med/behavioral approaches.

Front 20

GERD can lead to what voice disorder?

How can it be prevented?

Back 20

Contact ulcers, Granulomas

Antacids, propping head up, prescriptions, diet changes.

Front 21

What causes Paralysis/Ankylosis?

Tx?

Back 21

Damage to RLN or CN-X, ALS, Tumors, intubation, laryngeal trauma, strokes.

Ankylosis=stiffening of joints

Unilateral tx- teflon, collagen to add bulk. Throplasty, or "nerve-muscle pedicle reinnervation"

Front 22

Is laryngeal cancer functionally or organically based?

What causes it?
Tx?

Back 22

Organic and found on superficial lamina propria.

Typically smoking or drinking.

Tx- cessation of smoking advised, life-style changes to address vocal abuse. Radiation, chemo, direct incision, removal of larynx.

Front 23

What is vocal sulci?

Causes?

Tx?

Back 23

Is unilateral/bilateral stiffness that may cause bowing. It can be seen as a groove on medial surface of VF.

May be congenital or d/t scarring, aging, atrophy.

Tx- Surgery, phonotherapy techniques, relaxation, vocal function exercises, resonant voice tx, chant talk, etc.

Front 24

What voice disorder is characterized by a gap between the vocal folds on adduction (unilateral/bilateral)?

Tx?

Back 24

Vocal Bowing (neurogenic)

Tx- Surgery, Breathy voice- "pushing and pulling" tech, teach hard glottal attacks, collagen, LSVT

Front 25

What are two most common psychogenic voice disorders?

Back 25

1. Puberphonia (mutation falsetto)
2. Psychogenic Dysphonia/Aphonia (hysterical aphonial)

Front 26

How can you rule out Puberphonia?

Back 26

Blood test- test for hormones.

Front 27

What are vocal cysts?
Who are they typically found in?
What causes them?

Back 27

Fluid sacs of yellowish tissue that are typically unilateral.

Typically found in adults.

Causes are unknown.

Tx- surgery to remove but they tend to recur.
They do not resolve with voice tx or behavioral management.