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Unit 3: Organic Voice Disorders

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Unit 3: Organic Voice Disorders

  1. 1. Organic Voice Disorders
  2. 2. Laryngeal Reflux <ul><li>Gastroesophageal reflux disease (GERD) and laryngopharyngeal reflux (LPR). </li></ul><ul><li>Acid irritates the larynx and can contribute to cancer and pre-cancerous conditions. </li></ul><ul><li>Voice may be hoarse or raspy; may have low-grade burning or globus sensation in throat, often with throat clearing. </li></ul><ul><li>Treatment is typically behavioral or pharmacological, but can also involve surgery . </li></ul>
  3. 3. Congenital Abnormalities <ul><li>Laryngomalacia – epiglottis and/or arytenoids do not stiffen with development and threaten the airway. </li></ul><ul><li>Subglottal Stenosis – narrowing of the space below the VFs. Can be congenital or acquired after intubation. Results in dysphonia and difficulty breathing which may ultimately require tracheostomy. </li></ul>
  4. 4. Contact Ulcers and Granuloma <ul><li>May result from slamming arytenoids together in hard glottal attacks or frequent throat clearing; GERD/LPR; and intubation. </li></ul><ul><li>Are formed on the medial aspect of the vocal processes of the arytenoid cartilages. </li></ul><ul><li>The small ulcerations are typically accompanied by edema and can become covered by granulated tissue (granuloma), particularly in the case of intubation. </li></ul><ul><li>Symptoms are vocal fatigue after prolonged use, pain in larynx, throat clearing, hoarse voice </li></ul><ul><li>Voice therapy recommended, surgery usually ineffective except in the case of large granulomas. </li></ul>
  5. 5. Leukoplakia <ul><li>Whitish lesions on the vocal folds </li></ul><ul><li>Is technically a benign condition, but also a pre-cancerous one </li></ul><ul><li>Smoking and reflux are considered primary causes </li></ul><ul><li>Adds to the mass of the VFs (hoarseness, decreased pitch) and may inhibit VF adduction (breathy voice) </li></ul><ul><li>Must do a biopsy to tell if it is leukoplakia or cancer!! </li></ul>
  6. 6. Cancer (carcinoma) <ul><li>Can be caused by smoking, excessive alcohol, tobacco, reflux, infections. </li></ul><ul><li>Surgery is necessary to remove cancerous portions of the laryngeal mechanism. </li></ul><ul><li>Sometimes a laryngectomy may be warranted. </li></ul><ul><li>The voice will sound hoarse, possibly breathy, and can have decreased intensity. </li></ul><ul><li>Note that oral cancer can interfere with articulation and resonance, and laryngeal cancer may occur subglottally, supraglottaly, or at the level of the glottis (VFs) </li></ul>
  7. 7. Sulcus Vocalis <ul><li>Can be congenital, acquired, or idiopathic </li></ul><ul><li>May be related to reflux and abuse/misuse </li></ul><ul><li>Breathy, hoarse, quiet voice </li></ul><ul><li>May be seen as a longitudinal line (depression) running along the length of one or both VFs. </li></ul><ul><li>Along the sulcus, the mucosal cover is scarred down to the underlying vocal ligament and impairs vibration. </li></ul>
  8. 8. Papilloma <ul><li>Wartlike growths that are a form of HPV </li></ul><ul><li>Most often occurs in children under age six (juvenile papilloma) </li></ul><ul><li>Symptoms include hoarse, breathy voice </li></ul><ul><li>Can be a severe threat to respiration and multiple surgeries are often required, as the papilloma may reoccur until the child reaches puberty. </li></ul><ul><li>Newer therapies including injections and vitamins may help the papilloma from returning. </li></ul>
  9. 9. Summary <ul><li>Be sure to read your textbook chapter thoroughly! </li></ul><ul><li>SLPs must work closely with medical doctors in order to treat organic voice disorders. </li></ul><ul><li>We can counsel patients on their options, but only within our scope of practice. </li></ul>

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