Organic voice disorders include laryngeal reflux, congenital abnormalities, contact ulcers, leukoplakia, cancer, sulcus vocalis, and papilloma. Laryngeal reflux involves acid irritating the larynx and can cause hoarseness and throat clearing. Congenital abnormalities like laryngomalacia and subglottal stenosis can result in breathing and phonation difficulties. Contact ulcers may form from vocal abuse/misuse and can cause vocal fatigue and pain. Leukoplakia is a pre-cancerous whitish lesion on the vocal folds that impacts vocal quality and mass. Cancer is caused by factors like smoking and requires surgical treatment. Sulcus vocalis impairs
The use of voice is an integral part of communication; our voice is one of the defining features of our individuality, and it shares a lot of information about you, your voice tells others if you are happy or sad, healthy or unwell, young or old. Our voice can also reveal to others our background, such as the region of the world where we live, and even our social economic status, when a voice produced that perceived by others as unusual or strange and draws attention to the person who is speaking, it is quite likely the person is demonstrating a voice disorder.
So, I am happy to introduce this presentation about Pubertal voice disorders & Puberphonia, I would like this presentation to be useful and add a lot of information on this topic.
PHONATION - DR NITIN ANIYAN THOMAS (NATS)nitin thomas
PHONATION AND ITS MECHANISM
HOW PHONATION WORKS
HOW SOUND IS PRODUCED
PHONATION DIORDERS
DIFFERENT CONDITIONS AFFECTING PHONATION
VOCAL FOLDS AND ITS ANATOMY AND FUNCTIONING
Voice therapy to treat voice disorders, basics , different techniques, methods advantages and disadvantages, where and what method to choose? otorhinolaryngology ent
The use of voice is an integral part of communication; our voice is one of the defining features of our individuality, and it shares a lot of information about you, your voice tells others if you are happy or sad, healthy or unwell, young or old. Our voice can also reveal to others our background, such as the region of the world where we live, and even our social economic status, when a voice produced that perceived by others as unusual or strange and draws attention to the person who is speaking, it is quite likely the person is demonstrating a voice disorder.
So, I am happy to introduce this presentation about Pubertal voice disorders & Puberphonia, I would like this presentation to be useful and add a lot of information on this topic.
PHONATION - DR NITIN ANIYAN THOMAS (NATS)nitin thomas
PHONATION AND ITS MECHANISM
HOW PHONATION WORKS
HOW SOUND IS PRODUCED
PHONATION DIORDERS
DIFFERENT CONDITIONS AFFECTING PHONATION
VOCAL FOLDS AND ITS ANATOMY AND FUNCTIONING
Voice therapy to treat voice disorders, basics , different techniques, methods advantages and disadvantages, where and what method to choose? otorhinolaryngology ent
Auditory brainstem response (ABR)
Approximately 1 of every 1000 children is born deaf. Many more are born with less severe degrees of hearing impairment, while others may acquire hearing loss during early childhood.
combination of technological advances in ABR and otoacoustic emissions (OAE) testing methods are used for evaluation of hearing in newborns.
A presentation about spasmodic dysphonia. this presentation composed of the definition, types, causes, pathophysiology, clinical feature, diagnosis, treatment and prognosis of spasmodic dysphonia.
the ppt includes the anatomy of larynx, the physiology of sound production and pathology of vocal cords explaining the myoelastic aerodynamic theory and bernoulli effect in phonation
Auditory brainstem response (ABR)
Approximately 1 of every 1000 children is born deaf. Many more are born with less severe degrees of hearing impairment, while others may acquire hearing loss during early childhood.
combination of technological advances in ABR and otoacoustic emissions (OAE) testing methods are used for evaluation of hearing in newborns.
A presentation about spasmodic dysphonia. this presentation composed of the definition, types, causes, pathophysiology, clinical feature, diagnosis, treatment and prognosis of spasmodic dysphonia.
the ppt includes the anatomy of larynx, the physiology of sound production and pathology of vocal cords explaining the myoelastic aerodynamic theory and bernoulli effect in phonation
Angelo Consiglio, MD, has distinguished himself as a privately practicing ear, nose, and throat physician. Dr. Angelo Consiglio draws on formal training in numerous aspects of otolaryngology care, including care of the voice and vocal folds.
Hoarseness, also known as a hoarse voice, is the medical term for disorders of the voice: an impairment in the ability to produce voice sounds using the vocal organs, which is distinct from dysarthria which signifies dysfunction in the muscles needed to produce speech. More info visit: http://www.elabscience.com
DEFINATION
ATIOPATHOGENESIS
FEATURE AND PREDISPOSING FACTER
SYMPTOMS
DIAGNOSIS
DEFFERENTIAL DIAGNOSIS
TREATMENT
Also known as Singer’s or Screamer's Nodes
Vocal cord nodules are benign growths on both vocal cords that are caused by vocal abuse
They appear symmetrically on the free edge of vocal cord
At the junction of anterior 1/3 and posterior 2/3 *area of maximum vibration of vocal cord.
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The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
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Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
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This audio lecture corresponds with chapter three in your textbook titled “Organic Voice Disorders.” Here I will be discussing some of the most prevalent types of organic disorders, though you should make sure that you thoroughly read your textbook so that you understand the other, perhaps less common, types of voice disorders. Before we get started, remember that by organic voice disorders we mean those disorders which are related to structural deviations within the speech mechanism as well as diseases which affect specific structures within the vocal tract.
Laryngeal reflux is a disorder that can contribute to many of the organic voice disorders that we will discuss in this unit. That’s why, even though your authors introduce this topic toward the end of your chapter, I wanted to talk about it right away. You’ve probably seen the ads on TV for Prilosec and other acid reflux medications, and a lot of people are diagnosed with reflux. What we call reflux is the coursing of acid from the stomach, where it helps to digest food, to areas where it shouldn’t be, such as the esophagus and/or the larynx. When the stomach acid travels up to the esophagus, it is known as GERD, or gastroesophageal reflux. And when this same acid travels further up, into the larynx, it is known as LPR, or laryngopharyngeal reflux. While some people with reflux don’t experience any symptoms, other symptoms can have an effect on the voice. In particular, the voice may be hoarse or raspy, especially in the morning, as acid is more likely to travel up toward the larynx after lying down. Some people have a burning feeling in their throat, and a sour taste in their mouth. My own mother, and I hope she’ll forgive me for sharing this, was diagnosed with acid reflux after a chief complaint of bad breath which had no other causes. She went in for a barium swallow study, which included her esophagus. The radiology department was able to visibly seen the liquid barium reflux up her esophagus and into the larynx immediately after she had swallowed. Another symptom is of LPR or GERD is a globus sensation, or a feeling like there’s something in the throat. This is because the acid is irritating the throat, and it can cause throat clearing. We usually divide treatment for reflux into three types: behavioral, in which lifestyle and diet changes are made; pharmacological, where medications are prescribed by a physician (not an SLP); and surgical. For more information about the surgery for LPR and GERD, you can click the hyperlink in the PowerPoint document to see a WebMD web page on this topic.
There are a number of conditions which are largely congenital, meaning that the disorder is present from birth. One of these conditions, laryngomalacia, is a disorder in which there is a delay in the stiffening of the laryngeal cartilages, including the epiglottis and/or the arytenoid cartillages. In the first picture shown on your PowerPoint slide, you can see how the epiglottis is curled in on itself and prevents adequate air intake on inspiration. Laryngomalacia results in stridor, or a high pitched wheeze upon inhalation. Usually this is not a life threatening disorder, though the deviation in laryngeal structures may contribute to GERD or feeding problems in severe cases. By age two, the cartilages seem to stiffen, and the stridor goes away. Another disorder, subglottal stenosis, is a narrowing of the subglottal space. This disorder, shown as the second picture on the PowerPoint slide, may be congenital but can also be caused by difficulties following surgical intubation. A relatively new system has been developed to grade the severity of the stenosis. Usually SLPs do not need to intervene if the narrowing is less than 75%, but if it is greater than 75%, the patient may need to have surgical intervention with voice therapy follow-up. Finally, two conditions, called tracheoesophageal fistulas and esophageal atresia, may require surgical intervention with subsequent voice and feeding therapy by SLPs. Tracheoesophageal fistulas are small holes between the trachea and esophagus. Esophageal atresia is a blockage to the esophagus.
The larynx is susceptible to ulcers, as are other parts of the body. Contact ulcers within the larynx affect the medial portion of the arytenoid cartilages and have three usual causes. One of these causes is GERD or LPR. That acid reflux should cause ulcers is perhaps not surprising if we consider how ulcers can develop in the stomach as a result of excess stomach acid. Also, many people use hard glottal attacks which sound like this: (demonstrates a forceful slamming together of the vfs). Unfortunately using such a voice, along with frequent throat clearing, brings the arytenoids forcefully together and can cause ulcers to develop. And finally, sometimes people who undergo surgery, particularly emergency surgery, must be intubated. Often surgical tubing may be a little too large for the airway, and abraids the surface of the arytenoids. The small ulcerations are typically accompanied by swelling, known as edema. Eventually these ulcerations can be covered by a thick covering of epithelial tissue, known as granuloma. This is especially true in the case of contact ulcers caused by surgical intubation. You can see the large round blobs of tissue covering the arytenoid cartilages on the PowerPoint picture and in your textbook. Obviously voice quality is not good with such an obstruction in the larynx, and pain, hoarseness, throat clearing, and vocal fatigue are symptoms. For contact ulcers in general, without much granular tissue, voice therapy focusing on good vocal hygiene is usually recommended. Surgery tends to be ineffective except in the case of larger granulomas which will not resolve on their own.
Leukoplakia is characterized by whitish lesions on the vocal folds and other mucosal surfaces within the body. In the first picture on the Powerpoint, you can see leukoplakia on the vocal folds, and in the second picture you can see it on the tongue. Leukoplakia of the vocal folds can interfere with vocal quality and can result in a hoarse, effortful voice due to the additional weight on the vocal folds. While technically a benign condition, leukoplakia looks identical to cancer. A biopsy has to be performed by an ENT to determine whether the whitish lesions are benign or cancerous. Smoking and reflux are considered to be the primary causes. Next we’ll talk about laryngeal cancer. Brace yourself for some graphic pictures on the next slide!
As you can see from the pictures on this slide, cancerous lesions in the vocal folds usually appear as white patches, or as a tumor. Like many voice disorders, a hoarse, breathy voice quality with decreased intensity is a major symptom. So it’s really important that SLPs do not assume that someone has nodules when they may have cancer instead. Reflux, alcohol and smoking, and repeated infections can cause cancer. It’s absolutely necessary that an ENT evaluate, diagnose, and treat patients with laryngeal cancer, and surgery is necessary to remove the cancer so that it doesn’t spread. We will talk more toward the end of the term about laryngectomy, or the surgical procedure of having all or part of the larynx removed.
Finally, let’s talk about sulcus vocalis. This is a disorder which can be congenital, acquired, or idiopathic, meaning we’re not sure what causes it for a particular individual. Sulcus vocalis can be caused by reflux, but also by vocal abuse and misuse. The term sulcus refers to the depression, or vertical line, that runs along the length of one or both of the vocal folds. Sometimes it looks like a small chunk is missing out of the lateral edge of the vocal fold, or that there is a grove in the vocal fold tissue. This is because the mucosal cover is scarred down to the underlying vocal ligament. This impairs vibration of the vocal folds, resulting in a voice that is breathy, hoarse, and quiet.
One disorder that tends to affect children and can be potentially life threatening is referred to as papilloma. In juvenile cases, children who are typically under the age of 6 develop wart-like growths in the larynx. These growths spread across the vocal folds, limiting air supply and necessitating surgery. Unfortunately, the papilloma tends to recur, meaning that multiple surgeries are often required. Laser surgeries tend to have the best results, but even so, children with histories of repeat surgeries may have hoarse voices due to vocal fold scaring. There are some newer therapies, including injections and vitamins, which may help the prevent recurrence. The SLPs job, however, is to help the child develop functional communication. This may include teaching a child with a tracheostomy how to speak to the best of their ability and to use good vocal hygiene strategies. It is important to note that papilloma usually resolves itself around adolescence, though adults with no prior history can develop the disorder too.
In summary, I’ve only touched on some of the more common types of organic voice disorders, but there are many others, such as cysts, hyperkeratosis, and laryngitis, as well as those disorders which can be caused by changes in puberty and to the endocrine system. Do be sure to read up on these disorders in your textbook. Also, recall from our discussion on the first night of class that while SLPs can evaluate clients for a voice disorder, they can’t begin treatment until they have permission from a medical doctor to do so. Preferably this individual is an ENT who has evaluated the client via laryngoscopy to visualize the vocal folds. And while we can counsel patients on their options, we can only do so within our scope of practice. This means that we can’t make recommendations for specific medications or surgeries, though we can educate patients and help them to better discuss these issues with their doctors and other relevant health care providers. See you next time!