Voice Disorders Lecture (PDF)

VOICE DISORDERS Abdulrahman Al-Akeel Ph.D.-SLP, ASHA Fellow Consultant In Communication and Swallowing Disorders 22-12-1445 corr.28-6-2024 Images and Tables were taken from:  Course Journey Introduction Anatomy and physiology of voice production...

VOICE DISORDERS Abdulrahman Al-Akeel Ph.D.-SLP, ASHA Fellow Consultant In Communication and Swallowing Disorders 22-12-1445 corr.28-6-2024 Images and Tables were taken from:  Course Journey Introduction Anatomy and physiology of voice production Voice disorders Voice assessment Voice therapy  Introduction Communication Language Speech Processes of Speech Production Respiration Phonation Resonation Interaction Articulation Prosody Processes of Speech Production Respiration Phonation Resonation Articulation Prosody  Impact of a Voice Disorder Academic Social Psychological Vocational Communication  Voice Newborn infant Cry Larynx Suprasegmental Vocalization in babies (e.g. different cries)  Larynx Is phonation the main function of the larynx? Airway protection Assist in swallowing – Aspiration Breathing Help in activities demanding highly elevated abdominal pressures (e.g. childbirth, heavy lifting) Incidence and Prevalence of Voice disorders Incidence is the rate of occurrence of new cases of a disease or condition. Prevalence indicates how commonly a disease or condition occurs in a population. Figures of incidence and prevalence in voice disorders are not precise because: – Conflicting definitions of voice disorder – Methodological differences in procedures – Patient populations and sizes Incidence and Prevalence of Voice disorders Roy et al. (2005) conducted telephone interview survey of over 1,300 adults chosen at random and found: – Nearly 7% of respondents had a voice disorder at the time of the interview – Nearly 30% had experienced a voice disorder at least once in their lifetime – About 7% had missed work for more than one day because of their voice disorder. Incidence and Prevalence of Voice disorders Cohen et al. (2012) performed a retrospective analysis of data from 55 million individuals and reported that: – About 1% of patients received a diagnosis of dysphonia. – Females were almost twice as likely as males to be diagnosed with dysphonia. – Adults over the age of 70 years were two-and-a-half times more likely than those under age 70 years to be diagnosed with a voice disorder A number of researchers have concluded that between 6% and 9% of school-age children may have a voice disorder  Classification of Voice disorders Stemple (2007) introduced this classification: Congenital laryngeal pathologies Pathologies of the vocal fold cover Neurogenic laryngeal pathologies Pathologies of muscular dysfunction  Classification of Voice disorders Boone et al. (2020) suggested this classification: Muscle tension voice disorders Functional Voice Disorders Psychogenic voice disorders Organic voice disorders Neurogenic voice disorders Muscle Tension Dysphonia (MTD) – It is the most common voice disorder seen in both children and adults – It includes overuse of the respiratory, laryngeal, and supralaryngeal systems – Continued misuse of the voice over time may result in developing secondary tissue changes (e.g. nodules, polyps) – MTD responds well to voice therapy  Psychogenic Voice Disorders – Reaction to the severe emotional trauma or conflict may manifest itself in: Functional dysphonia (A dysphonia with no physical cause) Functional aphonia (conversion aphonia) – Patients with a psychogenic dysphonia may suffer severe social and vocational limitations  Organic Voice Disorders – They are related to: Structural deviations of the vocal tract (lungs, muscles of respiration, larynx, pharynx, and oral cavity) (e.g. laryngeal webbing) Diseases of specific structures of the vocal tract (e.g. papilloma) – Their primary treatment of the disorder is often medical, dental, or surgical mostly followed by voice therapy.  Neurogenic Voice Disorders – An impairment of the innervation of the muscles of respiration, phonation and resonance can result in a dysphonia. – It can be congenital or acquired  Therapy for Voice Disorders – Children and adults with voice disorders respond to therapy better than any other speech-language disorder  Therapy for Voice Disorders – The SLP Management of a voice disorder starts with an evaluation that includes: Taking a detailed history Observing the patient closely Using instrumental and noninstrumental assessment approaches. – Perceptual assessment – Aerodynamic assessment – Acoustic assessment – Laryngoscopy – Velopharyngeal closure assessment