Voice Case Study
Shannon McChesney
SUNY New Paltz
Introduction to Patient:
Evaluation, diagnosis and treatment for voice disorders is a complex process based on the individual and unique characteristics each patient presents with. This is a case study for Sue Chang, who recently referred herself to the voice clinic. Her complaints include her voice giving out and losing her voice when faced with heavy speaking demands and recent international travel. This has affected Ms. Chang’s career aspirations. The ENT found nothing physically wrong with the vocal mechanism. Assessment, referrals and treatment will be included in the case study for Ms. Chang.
Assessment:
I would begin the assessment by learning more case history information …show more content…
Chang has Muscle Tension Dysphonia. According to Colton, Casper and Leonard, Muscle Tension Dysphonia is a type of “functional” dysphonia that refers to “…voice disorders of supposed psychological origin, with no actual tissue pathology” (2011, p. 83). This disorder often results as a response to the way a patient is handling stress and how they are using his or her voice. Muscle Tension Dysphonia may manifest itself through a variety of symptoms including a hoarse, breathy, aphonic, or dysphonic voice with excess muscular tension. This disorder is most commonly found in middle aged females and begins when the individual adjusts the way they vocalize in order to react to stressors in the environment (Colton, Casper and Leonard, 2011). Ms. Chang is not accustomed to speaking at length because her current occupation does not require strain on her voice or pressure to speak in front of groups of people. When speaking for extended lengths of time, or teaching students, she is placing heavy demands on her voice compared to what is typical for her. In response to these demands, and the pressure of speaking extensively in front of a group, Ms. Chang may be changing her vocal patterns and increasing tension in her entire body, including her vocal folds. She likely experienced a tremendous amount of stress while in China due to experiencing a different environment and attempting to use her voice …show more content…
The approaches I would use would be teaching the client many relaxation techniques. If anxiety and stress are major factors that affect the way Ms. Chang is using her vocal mechanism, teaching relaxation would limit tension in the vocal folds and allow for a more healthy vibration of the vocal folds. Techniques may include the yawn/sigh because “…the physiology of the yawn is incompatible with the excessive laryngeal tension that many patients exhibit. Easy, natural airflow and phonation are fostered. The intent is to eliminate tight initiation and maintenance of phonation and to reduce laryngeal tensions” (Colton, Casper and Leonard, 2011, p. 329). Pressure and massage of the laryngeal area may also relax the muscles and permit the “ease of phonation” (Colton, Casper and Leonard, 2011, p. 335). I would also encourage proper vocal hygiene techniques, vocal rest, and introduce whole body relaxation techniques, such as the spinal roll. Vocal hygiene techniques include rest, limiting talking time, avoiding unhealthy environments, avoiding throat clearing, maintaining whole body health and hydration (Hester, 2014). The end result of all of these treatments along with a referral to a psychologist would most likely aid in Ms. Chang’s recovery.
Summary:
Ms. Chang came into the voice clinic with several complaints including her voice giving out during prolonged speech, losing her voice, and a lack of vocal strength
Shannon McChesney
SUNY New Paltz
Introduction to Patient:
Evaluation, diagnosis and treatment for voice disorders is a complex process based on the individual and unique characteristics each patient presents with. This is a case study for Sue Chang, who recently referred herself to the voice clinic. Her complaints include her voice giving out and losing her voice when faced with heavy speaking demands and recent international travel. This has affected Ms. Chang’s career aspirations. The ENT found nothing physically wrong with the vocal mechanism. Assessment, referrals and treatment will be included in the case study for Ms. Chang.
Assessment:
I would begin the assessment by learning more case history information …show more content…
Chang has Muscle Tension Dysphonia. According to Colton, Casper and Leonard, Muscle Tension Dysphonia is a type of “functional” dysphonia that refers to “…voice disorders of supposed psychological origin, with no actual tissue pathology” (2011, p. 83). This disorder often results as a response to the way a patient is handling stress and how they are using his or her voice. Muscle Tension Dysphonia may manifest itself through a variety of symptoms including a hoarse, breathy, aphonic, or dysphonic voice with excess muscular tension. This disorder is most commonly found in middle aged females and begins when the individual adjusts the way they vocalize in order to react to stressors in the environment (Colton, Casper and Leonard, 2011). Ms. Chang is not accustomed to speaking at length because her current occupation does not require strain on her voice or pressure to speak in front of groups of people. When speaking for extended lengths of time, or teaching students, she is placing heavy demands on her voice compared to what is typical for her. In response to these demands, and the pressure of speaking extensively in front of a group, Ms. Chang may be changing her vocal patterns and increasing tension in her entire body, including her vocal folds. She likely experienced a tremendous amount of stress while in China due to experiencing a different environment and attempting to use her voice …show more content…
The approaches I would use would be teaching the client many relaxation techniques. If anxiety and stress are major factors that affect the way Ms. Chang is using her vocal mechanism, teaching relaxation would limit tension in the vocal folds and allow for a more healthy vibration of the vocal folds. Techniques may include the yawn/sigh because “…the physiology of the yawn is incompatible with the excessive laryngeal tension that many patients exhibit. Easy, natural airflow and phonation are fostered. The intent is to eliminate tight initiation and maintenance of phonation and to reduce laryngeal tensions” (Colton, Casper and Leonard, 2011, p. 329). Pressure and massage of the laryngeal area may also relax the muscles and permit the “ease of phonation” (Colton, Casper and Leonard, 2011, p. 335). I would also encourage proper vocal hygiene techniques, vocal rest, and introduce whole body relaxation techniques, such as the spinal roll. Vocal hygiene techniques include rest, limiting talking time, avoiding unhealthy environments, avoiding throat clearing, maintaining whole body health and hydration (Hester, 2014). The end result of all of these treatments along with a referral to a psychologist would most likely aid in Ms. Chang’s recovery.
Summary:
Ms. Chang came into the voice clinic with several complaints including her voice giving out during prolonged speech, losing her voice, and a lack of vocal strength