This document discusses functional voice disorders and their management. It defines functional voice disorders as issues caused by improper use of the vocal mechanism rather than structural problems. The main type of functional voice disorder discussed is muscle tension dysphonia (MTD). MTD occurs when the laryngeal muscles do not function properly due to prolonged voice use, illness, trauma, or emotional problems. Symptoms include high or low pitch, hoarseness, inability to speak loudly or clearly. Treatment involves functional therapy conducted by a speech language pathologist, with occasional Botox injections or surgery. Other functional disorders covered include hyperadduction, hyperabduction, pharyngeal constriction, ventricular phonation, and vocal fold bowing.

1. FUNCTIONALVOICE DISORDERS&
ITS MANAGEMENT
Presented By:
Imrana Shakoor
Iqra Fatma
Faiza Fatma
Kulsoom Ajmal
Farheen
20th April 2015

2. Voice Disorder
Organic
Neurogenic
Psychogenic
Functional
MuscleTension
Dysphonia
The vocal mechanism is being
used improperly
Laryngeal mechanism does not
meet the voicing requirements
due to poor muscle functioning.
All Fun. Disorders considered
to be type of MTD.

3. MuscleTension
Dysphonia
Pharyngeal Constriction
Hyper Abduction
Hyper Adduction
Ventricular Phonation
Vocal Fold Bowing

4. One most common voice disorders. MTD is
Functional disorder as nothing structurally
wrong with the voice. .. Rather, the muscles
do not function properly.
MuscleTension Dysphonia
Primary MTD
Secondary MTD

5. MTD
Causes
Symptoms
1. Mimic features of
structural voice
disorders .
2. Very high or low pitch
3. Rough, hoarseness
4. Inability to produce a
Loud & Clear voice
5. Lump feeling in
throat.
1. Prolonged illness
2. Prolonged overuse /
underuse ( as after
surgery)
3. Trauma, e.g injury,
chemical exposure,
or emotional
problem

6. Treatment
Medical Aspects
SLP Aspects
1. Occasionally
Botox injections
are helpful.
2. Surgery to
reduce the size
of ventricular
folds.
FunctionalTherapy is
usually the only
treatment
ReliefTime: 4 to 6
sessions.
In emotional stress,
counseling or stress
management.

7. Assessment
1. ATeam of professionals is required
,Consists on Specialized;
 ENT
 Otolaryngologist,
 Gastroenterologist,
 Neurologist, Rheumatologist,
 Speech language pathologist etc.
2. Specific tools to individualize care to the
voice patient.

8. 3.These tools include taking a
sophisticated voice history, assessment
of the voice’s capabilities and
limitations and a high quality laryngeal
exam often including
videostroboscopy.
Assessment

9. The vocal folds do not come together to
produce voice.They may appear to be
pulled apart as the person phonates.
Hyper Abduction

10. Hyper Abduction
Symptoms Causes
1. Pain
2. Emotional
Shock &
Stress is
Common.
1. Weak, breathy,
airy and hollow
Voice.
2. Breaks in voicing.
3. Effort and fatigue
from voice use.

11. Treatment
Medical Aspects
SLP Aspects
1. Functional therapy.
2. F.T combined with
psychotherapy.
3. Occasionally,Use
injections of a
substance as a
temporary measure
1.Improving hydration
(80 ounces of
water/day)
2. Relaxations of vocal
cords(Avoidance of
speaking in loud
voice)
3. Improving Breathing
Exercises.

12. The vocal folds adduct (come together)
very tightly, producing a valve that
restricts airflow.
Hyper Adduction

13. Hyper Abduction
Symptoms Causes
1. Prolonged voice
use during
impairment of
vocal mechanism.
2.Tense style of voice
3.Emotional
component
1. Poor voice quality
2. Effort and fatigue
during Speaking
3. Pain
4. Discomfort

14. Treatment
Medical Aspects
SLP Aspects
1. Functional
therapy.
2. Occasionally
Botox injections
are helpful.
1. Increase level of
hydration.
2. Eliminating caffeine
and alcohol.
3. Avoid vocal abuse
behaviors .

15. Muscle of the pharynx (throat) contract
excessively while talking, leaving the
throat very constricted.
Pharyngeal Constriction

16. Pharyngeal Constriction
Symptoms Causes
1. Prolonged voice
use during
impairment of
vocal mechanism.
2.Tense style of
voice.
3.Emotional Stress
or Shock.
1. Poor voice
2. Effort and fatigue
3. Pain
4. Discomfort
5. Decline of voice
quality

17. Treatment
Medical Aspects
SLP Aspects
1. Functional therapy.
1. Vocal hygiene
• Reduced
Dehydration
2.Control the abusage
of alcohol etc.
3. Set limits on volume
and quantity of
talking.

18. The ventricular folds come together and
vibrate instead of, or along with, the vocal
folds. The ventricular folds, also known as
the false vocal cords. they were not meant to
vibrate, so they can't vibrate very fast (for
high pitches).
Ventricular Phonation

19. Ventricular Phonation
Symptoms Causes
1.RoughVoice
2.StrainedVoice
3. Limited in pitch and
volume.
4.Pain or dryness with
voice use
1.Continued use of
voice.
2.True vocal folds are
impaired.
3.Trauma etc

20. Treatment
Medical Aspects
SLP Aspects
1. Functional therapy.
2. Medical or surgical
treatments may be
tried,When F.T has
failed.
3. Ventricular
phonation is the
best alternative.
1.Vocal hygiene.
2. Breathing Exercises.
3. Relaxed efficient
voice production.

21. Vocal folds don't come together to vibrate.
Instead, they leave a gap, allowing air to leak
through.
Vocal fold Bowing

22. Vocal fold Bowing
Symptoms Causes
1. WeakVoice
2. BreathyVoice
3. HollowVoice.
4.RoughVoice
5.ScratchyVoice
1. It’s referred to as
Presbylarynges,
which means the
laryngeal status
of old age.
2. Compensatory
muscle tension.

23. Treatment
Medical Aspects
SLP Aspects
1. Functional therapy.
2. Rarely find surgery
if necessary.
1.Improving hydration
(80 ounces of
water/day)
2.Slow rate of Speaking
3. Improve breathing
to maximize
support.

24. References
http://emedicine.medscape.com/article/865191
http://www.lionsvoiceclinic.umn.edu/page3b.htm
http://www.msma.org/docs/communications/MoMed
http://www.wakehealth.edu/ENT/Voice-and-
Swallowing/Functional-Voice-Disorders.htm

25. Thank you