Clinical Voice Pathology: Theory and Management

Chapter 1: Voice: A Historical Perspective Ancient History The Renaissance The 17th to 19th Centuries The Laryngeal Mirror Further Advancements Voice Therapy Clinical Voice Pathology References Chapter 2: Anatomy and Physiology Anatomy The Laryngeal Valve Respiration and Phonation Vocal Tract Resonance Structural Support of the Larynx Hyoid bone Laryngeal cartilages Muscles Muscles for Respiration: Inspiration and Exhalation Laryngeal Muscles Extrinsic Laryngeal Muscles Intrinsic Laryngeal Muscles Vocal Fold Microstructure Epithelium Basement Membrane Zone Lamina Propria Connective Tissue Vocal Muscle Blood Supply and Secretions Neurologic Supply Central Nervous System Control Peripheral Innervation Laryngeal Reflexes Developmental Changes Geriatric Vocal Folds DNA Microarray Gene Expression Analysis Physiology of Phonation Theories of Vibration Fundamental Frequency Control Intensity Control Phonation Modes and Voice Quality Control References Chapter 3: Some Etiologic Correlates Etiologies of Vocal Misuse Voice abuse Inappropriate vocal properties Medically-Related Etiologies Direct surgeries Indirect surgeries Chronic illnesses/disorders Primary Disorder Etiologies Personality-Related Disorders References Chapter 4: Pathologies of the Laryngeal Mechanism Incidence of Voice Disorders Pathology Classifications Structural Pathologies of the Vocal Fold Malignant Epithelial Dysplasia of the Larynx Benign Epithelial and Lamina Propria Abnormalities of the Vocal Fold Vocal nodules Vocal fold polyps Vocal fold cysts Reactive vocal fold lesion Reinke's edema and Polypoid degeneration Vocal fold scarring Vocal fold sulcus/Sulcus vocalis Vocal fold granuloma and Contact ulcer Keratosis, Leukoplakia, and Erythroplasia Recurrent Respiratory Papilloma (RRP) Subglottic and Laryngeal/Glottic Stenosis and Acquired Anterior Glottic Web Vascular Lesions: Vocal Fold Hemorrhage, Hematoma, Varix and Ectasia Congenital and Maturational Changes Affecting Voice Congenital Webs (Synechia) Laryngomalacia Puberphonia: Mutational Falsetto and Juvenile Voice Presbyphonia or Presbylaryngeus Inflammatory Conditions of the Larynx Cricoarytenoid and Cricothyroid Arthritis Acute Laryngitis Laryngopharyngeal Reflux Chemical Sensitivity / Irritable Larynx Syndrome Trauma or injury Internal Laryngeal Trauma: Thermal & Chemical Exposure Intubation/Extubation Injury External Trauma and Arytenoid Dislocation Systemic conditions affecting voice Endocrine disorders Hypothyroidism & Hyperthyroidism Sexual Hormonal Imbalances Growth Hormone Abnormalities (Hyperpituitarism) Immunologic disorders Systemic Lupus Erythematosus (SLE) Sjogren's Syndrome Scleroderma Fibromyalgia Allergies Non-Laryngeal Aerodigestive Disorders Affecting Voice Respiratory Diseases Asthma & Chronic Obstructive Pulmonary Disease Gastroesophageal Reflux Disease (GERD) Infectious Diseases of the Aerodigestive Tract Laryngotracheobronchitis (Croup) Mycotic (Fungal) Infections: Candida Psychiatric or psychological disorders affecting voice Psychogenic Conversion Aphonia and Dysphonia Factitious Disorders or Malingering Gender Dysphoria or Gender Reassignment Neurologic voice disorders Peripheral Nervous System Pathology Superior Laryngeal Nerve Paralysis: Unilateral or Bilateral Recurrent Laryngeal Nerve Paralysis: Unilateral Recurrent Laryngeal Nerve Paralysis: Bilateral Superior Laryngeal Nerve (SLN) or Recurrent Laryngeal Nerve (RLN) Paresis Myasthenia Gravis Movement disorders affecting the voice Spasmodic Dysphonia Adductor Spasmodic Dysphonia (ADSD) Abductor Spasmodic Dysphonia (ABSD) Mixed Adductor and Abductor Spasmodic Dysphonia Essential Vocal Tremor Central Neurological Disorders Affecting Voice Amyotrophic Lateral Sclerosis Parkinson Disease Multiple Sclerosis Huntington's Chorea Other disorders of voice Vocal Abuse, Misuse, and Phonotrauma Vocal Fatigue Muscle Tension Dysphonia (Primary and Secondary) Ventricular Phonation (Plica Ventricularis) Paradoxical Vocal Fold Motion (Vocal Cord Dysfunction) or Episodic Dyspnea References Chapter 5: The Diagnostic Voice Evaluation The Players Patient Profile Referral Sources Medical Examination Voice Pathology Evaluation Diagnostic Voice Evaluation Referral Reason for the referral History of the problem Medical history Social history Oral-peripheral examination Auditory perceptual voice assessment Impressions Prognosis Recommendations Patient self-analysis of the voice disorder References Appendix 5.1 Sample Report Appendix 5.2 Consensus Auditory Perceptual Evaluation of Voice Appendix 5.3 The Rainbow Passage Appendix 5.4 Vocal Component Checklist Appendix 5.5 Voice Handicap Index Chapter 6: Instrumental Measurement of Voice Clinical Utility Basics of Technical Instruments Microphones and Recording Environment Digital Signal Processing Acoustic Measurements Pitch Detection Algorithm Fundamental Frequency Intensity Voice Range Profile, Phonetogram, and Physiological Frequency Range of Phonation Perturbation Measures Signal (or Harmonic)-to-Noise Ratios Spectral Analysis Aerodynamic Measurements Calibration Pressure, Flow, Resistance and Ohm's Law Airflow Equipment Flow Measurement Subglottal Air Pressure Measurement Phonation Threshold Pressure Laryngeal Resistance Inverse Filter Laryngeal Imaging Endoscopy Stroboscopy High Speed Digital Imaging Kymography Criteria for Laryngeal Imaging Endoscopic Imaging Techniques Rigid Scope Flexible endoscope Patient Comfort Recording Protocol Visual Perceptual Judgments Structural appearance of the entire larynx Glottic closure pattern Supraglottic hyperfunction Mucosal wave Amplitude Symmetry Periodicity Electroglottography (EGG) Laryngeal Electromyography (LEMG) Normative Information Electrical Safety Hygienic Safety The Clinical Voice Laboratory Glossary References Appendix 6.1 Joint Statement: ASHA and AAO-HNS Appendix 6.2 Vocal Tract Visualization and Imaging: Position Statement Chapter 7: Survey of Voice Management Voice Therapy Orientations Hygienic Voice Therapy Evidence Symptomatic Voice Therapy Evidence Psychogenic Voice Therapy Evidence Physiologic Voice Therapy Evidence Eclectic Voice Therapy Case Study Illustrating Voice Therapy Orientations Hygienic Voice Therapy Treatment Strategies for Voice Abuse and Misuse Vocal Hygiene Therapy Approaches The Homemaker The Noisy Job Environment The Public Speaker Voice Abuse or Misuse in Children Can We Always Expect Success? Hydration Confidential Voice Symptomatic Voice Therapy Therapy Approaches for Respiration Therapy Approaches for Phonation Therapy Approaches for Resonance Therapy Approaches for Pitch Therapy Approaches for Loudness Therapy Approaches for Rate Treatment Approaches for Laryngeal Area Muscle Tension Psychogenic Voice Therapy Functional Aphonia/Dysphonia Functional Falsetto Vocal Cord Dysfunction (VCD) Physiologic Voice Therapy Laryngeal Muscle Imbalance The Post-Surgical Patient The Geriatric Voice Vocal Function Exercises (VFE) Resonant Voice Therapy (RVT) Accent Method of Voice Therapy Lee Silverman Voice Treatment (LSVT) Team Management of Specific Laryngeal Pathologies Vocal Fold Cover Lesions Laryngopharyngeal Reflux (LPR) and Gastroesophageal Reflux Disease (GERD) Unilateral Vocal Fold Paralysis Spasmodic Dysphonia Successful Voice Therapy References Appendix 7-1. Phrases and Sentences Graduated In Length Chapter 8: The Professional Voice The Professional Voice User History The "At-Risk" Status Professional Roles The Otolaryngologist The Voice Pathologist The Producer The Agent of Manager Clinical Pathways Otolaryngology-Voice Pathology-Voice Pedagogy Voice Pedagogy-Otolaryngologist-Voice Pathology Voice Pedagogy-Voice Pathology-Otolaryngology Otolaryngology-Voice Pedagogy Voice Pathologist-Voice Pedagogy Common Etiologic Factors Personality Factors Phonotrauma Drugs Hydration Common Pathologies Acute and Chronic Non-infectious Laryngitis Vocal Nodules Contact Ulcers and Granulomas Gastroesophageal Reflux Disease (GERD)/Laryngoesophageal Reflux (LPR) Voice Fatigue Vocal Fold Hemorrhage and Vascular Pathologies Supportive Training and Techniques Alexander Technique The Linklater Method The Feldenkrais Method The Lessac System Estill Voice TrainingA' Summary Glossary of Terms References Chapter 9: Rehabilitation of the Laryngectomized Patient Incidence of Laryngeal Cancer Etiology Symptoms of Laryngeal Cancer Medical Evaluation Staging and TNM Classification Lymph Node Distribution Treatment Options Conservation Combined Treatments Radiation Therapy Surgery Concurrent Chemoradiotherapy Methods of Reconstruction Myocutaneous Flaps Free Flaps Jejunal Free Flap Gastric Pull-Up Need for Follow-Up Treatment Multidisciplinary Rehabilitation Team Head and Neck Surgeon Plastic and Reconstructive Surgeon Radiation Oncologist Medical Oncologist Speech-Language Pathologist Oncology Nurse Dietician Radiologist Physical Therapist Dentist and/or Prosthodontist Psychologist Audiologist The Laryngectomized Visitor Special Concerns of the Laryngectomized Patient Communication Physical Concerns Respiration Coughing and Sneezing Tracheal Tubes and Tracheostoma Vents Swallowing Smell and Taste Safety Lifting Psycho-Social Concerns Speech Rehabilitation Artificial larynx Esophageal speech Surgical prosthetics Helpful Web Sites on Head and Neck Cancers References