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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_4506_Библиотеки_им_академика_М_И_Перельмана.pdf
456 The Voice and Voice Therapy
Respiratory cycle
active forces in, 33–34, 35
description of, 31–32
passive forces in, 32, 33
Respiratory system, 37
Respiratory tract, in respiration, 31–32
Respiratory volumes, 36, 36–37, 188, 189–190
Rib(s), 25
Rib cage
description of, 25
muscles of, 26
Rigid laryngoscopy, 154, 156
Rima glottidis, 47, 53
RLN. See Recurrent laryngeal nerve
Rough voice quality, 66
RRP. See Recurrent respiratory papillomatosis
RV. See Residual volume
S
Sacrum, 24
Salivary gland cancer, 310
School-age children, voice disorders in, 8. See also
Children
SD. See Spasmodic dysphonia; Standard deviation
Secondary bronchi, 31
Secondary muscle tension dysphonia, 76–77
Serotonin, 123
Sex hormones, 106
SFF. See Speaking fundamental frequency
Simultaneous vocal attack, 61–62
Singers, 289
Singing, 261
SLN. See Superior laryngeal nerve
SLP. See Speech-language pathologist(s)
Smoking
emphysema caused by, 300
laryngeal cancer caused by, 311
leukoplakia caused by, 109
oral cancer caused by, 312
pharyngeal cancer caused by, 312
Snap release /s/, 346
SOC-8, 293–294
Soft palate, 68, 344–345
Somatization dysphonia, 90, 96
Sonorants, 254
Sound-level meters, 180
Sound pressure level, 179, 179–180
Spasmodic dysphonia
adductor, 136
botulinum toxin type A injections for, 139–141
essential tremor versus, 138t, 143
judgment scales for, 137–138
muscle tension dystonia versus, 138t
prevalence of, 135
voice production affected by, 135
voice therapy for, 138–141
Spastic dysarthria, 129, 136, 357, 367
Speaking fundamental frequency
age-related changes in, 280
average, 179, 179, 181
variability in, 181–182, 183
in women, 280
SPEAK OUT!, 144
Spectrogram, 175–176, 176–177
Spectrography, 351
Speech
air pressures for, 190–191
esophageal. See Esophageal speech
laryngeal adjustments for, 61–62
perceptual analysis of, 345–346
production of, nervous system control of, 55
real-time amplification of, 217
tracheoesophageal, 325
Speech breathing
abnormal client perceptions of, 189, 190
age-related changes in, 37, 279
alerting signs and symptoms, 189, 189
breathing for life versus, 38–39
case history for, 189
evaluation of, 39
in older adults, 279–280
Speech-language pathologist(s)
auditory-perceptual voice assessments used by, 164
interdisciplinary team participation by, 324
voice disorder medical evaluation by, 158
Speech-language pathologist-voice clinician, 287,
289–290
Speech range profile, 183
Sphincter pharyngoplasty, 357
Spinal accessory nerve, 128
Spinal nerves, 23–24
Spindle-shaped glottis, 113
Spirometer, 191
Index 457
SPL. See Sound pressure level
Squeezed phonation, 224
SRP. See Speech range profile
Standard deviation, intensity, 180, 186
Sternohyoid muscle, 41
Strained voice quality, 66
Stress, 262
Stridency, 365–366
Strident voice, 365–366
Stridor, 100, 108, 134
Stroboscopic laryngoscopy, 172, 315
Stroboscopy, 146–147, 156
Stroboscopy Evaluation Rating Form, 174
Stroboscopy Rating Instrument, 174
Stroke, 123, 146–147
Student teachers, voice disorders in, 9–10
Stylohyoid muscle, 41
Subglottal air pressure, 59, 63–64, 179, 243
Subglottic obstruction, 297
Subglottic space, 47
Subglottic stenosis, 101
Submucosal cleft, 345
Sulcus vocalis, 113–114
Superior horns, 44
Superior laryngeal nerve, 56, 57, 125, 126, 127
Superior thyroid notch, 43
Supplementary laryngeal muscles, 41
Supraglottic space, 47, 47
Supraglottoplasty, 100
Supralaryngeal mass obstruction, 297
Suprasegmental phonation, 5
Suprasegmental vocalization, 5
Suprasegmental voicing, 5
Surgery
adductor spasmodic dysphonia treated with, 141
esophageal atresia treated with, 101
hypernasality treated with, 356–357
laryngeal cancer treated with, 313
laryngeal webs treated with, 115
minimally invasive, 101
Reinke’s edema treated with, 86
tracheoesophageal fistula treated with, 101
vocal fold polyps treated with, 84
vocal nodules treated with, 83
Sustained phonation, 62, 266
Swallowing, 41
S/z ratio, 193–195, 196
T
Tailbone. See Coccyx
Teachers
dysphonia in, 289
voice disorders in, 9–10, 289–290
voice use by, 9–10
TEF. See Tracheoesophageal fistula
Teleconferencing, 289
Teletherapy, 214
Templin–Darly Tests of Articulation, 348
TEP. See Tracheoesophageal puncture
Termination of phonation, 62
Tertiary bronchi, 31
Tessitura, 289
Testosterone
hormone therapy effects on, in transmasculine
individuals, 296
pubertal increases of, 106
Thalamus, 122–123
Thin voice, 366–367
Thoracic breathing, 188
Thoracic cage, 25
Thoracic cavity movements, 29
Thoracic vertebrae, 24
Thorax, bony, 23–25
Throat clearing, 261
Thyroarytenoid muscles
anatomy of, 3, 51, 51–52, 53, 55, 127, 136
botulinum toxin type A injection in, 142
myectomy of, 141
Thyrohyoid ligaments, 45, 46
Thyrohyoid membrane, 45, 46
Thyrohyoid space, 45
Thyroid cartilage
anatomy of, 43–44, 91
finger pressure on, 230, 245
tipping forward of, 171
Thyroid gland disorders, 107
Thyroid prominence, 58
Thyromuscularis muscle, 51, 64
Thyroplasty, 132–133
Thyrovocalis muscle, 51–53, 64
Tidal volume, 36, 36
Titanium medialization thyroplasty, 133
TLC. See Total lung capacity
TNM staging, 321–323, 322–323
458 The Voice and Voice Therapy
Tongue
altering position of, for hypernasality, 361
anatomy of, 68
cancer of, 312
diadochokinesis of, 16
extrinsic muscles of, 71
faulty position of, 366
hyperextending of, 270
intrinsic muscles of, 71
muscles of, 71
in speech, 364
tremor of, 16
Tongue protrusion /i/, 216, 269–270, 292, 296, 318,
366, 368
Total lung capacity, 36, 36–37, 188
Trachea
anatomy of, 31
bifurcation of, 28
hyaline cartilage of, 31
Tracheal rings, 42, 42
Tracheobronchial tree, 31
Tracheoesophageal fistula, 101
Tracheoesophageal puncture, 331–335, 332–334,
338
Tracheoesophageal speech, 325
Tracheostomy, 303–304
Transexual Voice Questionnaire, 294
Transmasculine individuals, gender-affirming voice
therapy for, 296–297
Transnasal videoendoscopy, 352
Transwomen, gender-affirming voice therapy for,
293–296, 295
Trauma. See also Phonotrauma
vocal folds, 104
voice reaction to, 13
Traumatic brain injury, 147
Traumatic laryngitis, 86
Triangular membrane. See Conus elasticus
Trilling, 261
True ribs, 25, 28
True vocal folds
description of, 3, 46, 52–55, 54, 68
in ventricular phonation, 79
Tumor staging, 321–324, 322–323
TV. See Tidal volume
TVQMtF. See Transexual Voice Questionnaire
Type 2 diabetes mellitus, 107–108
U
Um-hmm, 261
UMN lesion. See Upper motor neuron lesion
Unified Parkinson Disease Rating Scale, 143
Unified SD Rating Scale, 137
Unilateral adductor paralysis, 229
Unilateral upper motor neuron dysarthria, 129
Unilateral vocal fold paralysis
airway compromises caused by, 298
description of, 130–134, 205–206
head position lateralization for, 244
unilateral digital pressure for, 231–232
UPDRS. See Unified Parkinson Disease Rating Scale
Upper esophageal sphincter, 68
Upper motor neuron lesions, 124
UVFP. See Unilateral vocal fold paralysis
V
Vagus nerve
anatomy of, 57, 126
branches of, 50, 125–127, 126
functions of, 55
Valleculae, 68
VASTA. See Voice and Speech Trainers Association
VC. See Vital capacity
VCD. See Vocal cord dysfunction
Velopharyngeal closure
adequacy of, 361
description of, 71, 190
endoscopic evaluation of, 351–353, 352–353
in hypernasality, 355
inadequacy of, 355
patterns of, 353
Velopharyngeal dysfunction, 342, 344, 348, 355. See also
Hypernasality
Velopharyngeal mechanism
assessment of, 351
endoscopic evaluation of, 351–353, 352–353
evaluation of, 356
insufficiency of, 348–349, 356–357
pharyngeal flap surgery for, 357
in resonance, 342
sphincter pharyngoplasty for, 357
transnasal videoendoscopy of, 352
videonasoendoscopy of, 352
Index 459
Velopharyngeal valve, 342
Velum, 71
Ventricular dysphonia, 78–79, 80, 315
Ventricular folds
adduction of, 52
anatomy of, 46, 47, 50
description of, 3, 31, 52
historical descriptions of, 78
in phonation, 78
Ventricular ligament, 52
Ventricular phonation, 242, 269
Ventricular space, 46, 49, 68
Ventricular voice, 79, 88
Vertebrae
cervical, 24, 40, 283
grouping of, 23–24
lumbar, 24
thoracic, 24
Vertebral column, 23–24
Vertical focus, 240
VHI-10. See Voice Handicap Index-10
Vibrato, 289
Videoendoscopy, 352, 353
Viral papilloma, of larynx, 13
Visi-Pitch with Computerized Speech Lab, 177, 178,
236, 258, 272, 365
Visual acuity, 159
Visual feedback, 216, 270–273, 363, 367–368
Vital capacity, 36, 36–37, 38, 188
Vocal abuse, 233–235, 234, 285–286
Vocal attack, 61–62
Vocal cord dysfunction, 301
Vocal fatigue
chant-talk approach for, 223
description of, 11
pitch breaks caused by, 89
poor posture as cause of, 243–244
Vocal fold(s)
abduction of, 39
adduction of, 40, 59, 61
anatomy of, 53–54, 54
atrophy of, 133, 278, 280
cover-body theory of, 60–61
cysts of, 105–106, 284
description of, 3–4
edema of, 107
false. See Ventricular folds
gender differences in, 53
granulomas of, 103–105
lengthening of, 64
medial compression of, 65
mucosal wave propagation through, 60
nodules. See Vocal fold nodules
paradoxical movement of, 206, 301
polyp of, 84–85
pubertal changes in, 106
stiffness of, from radiation therapy, 315
thickening of, 85
trauma to, 104
true, 3, 46, 52–55, 54, 68
Vocal fold nodules
case study of, 201–203
characteristics of, 81
in children, 5, 82–83
description of, 5, 81
laryngostroboscopic findings in, 174, 175
phonotrauma as cause of, 83
spectrogram findings in, 176, 177
surgery for, 83
treatment of, 82
voice facilitating approach for, 82
voice in, 82
voice therapy for, 82–83
in young male, 201–203
Vocal fold paralysis
abductor, 134
bilateral, 134–135, 297
description of, 92, 130
stroke and, 146
unilateral. See Unilateral vocal fold paralysis
voice therapy for, 298
Vocal fold vibration
description of, 40, 59–60, 60, 63, 262
mode of, 63
Vocal function, 4
Vocal hygiene, 111, 289, 318
Vocal hyperfunction
chewing approach for, 223
confidential voice for, 226, 228
counseling for, 228
features of, 138
musculoskeletal tension associated with, 251
neck flexion for, 245
variability of problem, 161
460 The Voice and Voice Therapy
Vocal hyperfunction (continued)
voice facilitating approaches for, 223, 226, 228
voice therapy for, 212, 285
yawn-sigh for, 273–274
Vocal intensity, 179
Vocalis muscle, 51–53
Vocalizations
breathing control for, 31
by infants, 4–5
Vocal ligament, 52–53, 53
Vocal limping, 89
Vocal loudness
changing of, 64–65
characteristics of, 22
Vocal misuse, 233
Vocal nodules. See Vocal fold nodules
Vocal onset, 61–62
Vocal pitch. See also Pitch
breaks in, 89
changing of, 63–64
digital pressure for lowering of, 230–231
Vocal process, 43
Vocal quality
changing of, 65–66
relaxation pressure and, 32–33, 33
Vocal rehabilitation, holistic, 17
Vocal tract
anatomy of, 69, 69–70, 319–320
F-shaped, 67, 68, 70
laryngectomy effects on, 320
resonant characteristics of, 65
Voice
acoustic analysis of
average speaking fundamental frequency, 180,
181–182, 183
cepstral peak prominence, 182–183, 183
data analysis methods, 179–186
dynamic range, 180, 180, 186–187
electroglottogram, 185–186, 187
habitual vocal SPL, 179, 179–180
intensity variability, 186
loudness variability, 180
maximum phonational frequency range, 181
spectrogram in, 175–176, 176–177
Visi-Pitch with Computerized Speech Lab, 177,
178
voice range profile, 180, 183–185, 185
aerodynamic analysis of
air pressure, 190–191
breathing patterns, 188–189
clavicular breathing, 188
description of, 187–188
diaphragmatic-abdominal breathing, 189
laryngeal airflow, 191
laryngeal resistance, 191–192
lung volumes and capacities, 189–190
maximum phonation time, 193, 194
Phonatory Aerodynamic System for, 192, 192
s/z ratio, 193–195, 196
thoracic breathing, 188
assessment of
clinical instrumentation for, 174–175
instrumental, 167, 170, 170, 174–175
noninstrumental, 167
oral-peripheral mechanism examination in,
170–171
in resonance disorders, 346–347
auditory recording of, 288
in children, 282–287
cul-de-sac, 367–368
in deaf and hard of hearing children, 290–292
dosage analysis of, 195, 197
emotional function of, 4–5
endocrine system and, 106–108
evaluation of, 2
feminization of, 293, 296
flexibility of, 22
focus of, 216, 237–241
growth hormone imbalances and, 106–107
hygiene of, 22
jargon, 5
lifespan changes in, 58
linguistic function of, 5–6
loudness of, 22, 64–65
normal, 22, 66, 67
in older adults, 278–282, 280
pediatric, 282–287
pleasantness of, 22
professional users of, 287–290
pubertal changes in, 106
real-time amplification of, 217
representation of, 22
resonance of, 4, 23
stress-related symptoms of, 262
Index 461
strident, 365–366
teachers’ use of, 9–10
thin, 366–367
Voice and Speech Trainers Association, 16, 95
Voice clinicians
assessments by, 14–15
cross-referrals by, 17
definition of, 10
medical evaluation of voice disorders by, 157
otolaryngologist and, 14
populations treated by, 16
referral to, 14
role of, 16
sulcus vocalis management by, 114
voice disorders in, 10–11
voice stimulability testing by, 15
Voice disorders. See also specific disorder
affective excesses as cause of, 4
behavioral observation for, 162–163
case history for
additional information in, 162
description of problem and cause, 160
onset and duration of problem, 160–161
overview of, 160
variability of problem, 161
vocal demands, 161–162
in children, 8–9, 152, 282–287, 346
classification of, 11–12
communication affected by, 5
communication-related quality-of-life in, 166
Consensus Auditory Perceptual Evaluation of Voice
for, 163–164, 165
functional. See Functional voice disorders
in general population, 6–8
GRBAS scale for, 163
hyperfunctional, 34
hyperfunctional behaviors associated with, 171
kinds of, 11–12
management of, 14–17
medical evaluation of
components of, 158
laryngeal examination, 154, 156
medical history in, 154, 155
physician’s role in, 157
speech-language pathologist’s role in, 158
visual acuity assessments in, 159
voice clinician’s role in, 157
muscle tension, 12
neurogenic, 12, 14
in older adults, 9, 278
organic. See Organic voice disorders
prevalence of, 6–11
psychogenic, 12
quality-of-life measurements for, 166–170, 167–170
screening for, 152–154
in student teachers, 9–10
in teachers, 9–10, 289–290
temporary, 6
therapy for, 14–17
in voice clinicians, 10–11
Voice dosimeters, 195, 197
Voice facilitating approaches
assimilative nasality treated with, 363–364
auditory feedback, 215, 216, 217–218, 270, 288,
361–362, 364
change of loudness, 216, 218–221, 361, 367
chant-talk, 216, 221–223
chewing, 216, 223–225
confidential voice, 216, 225–228
counseling, 216, 228–230, 361–362, 364, 366
description of, 66, 214–215
digital manipulation, 216, 230–232, 367
dysphonia treated with, 317–318
elimination of abuses, 216, 232–235, 234
establishing a new pitch, 216, 235–237, 361,
366–367
focus, 216, 237–241, 361, 363, 367–368
functional dysphonia treated with, 95
glottal fry, 32, 216, 241–243, 317, 366–368
head positioning, 216, 243–245
hierarchy analysis, 216, 246–248, 263, 274, 366–368
hypernasality treated with, 360–361
hyponasality treated with, 362–363
inhalation phonation, 216, 248–250, 262, 315, 365
masking, 216, 252–254
nasal-glide stimulation, 216, 254–256, 363, 368
open-mouth approach, 216, 256–258, 361, 366–367
pitch inflections, 216, 258–259
redirected phonation, 216, 259–262
relaxation, 216, 262–265, 366–368
resonance improvements using, 367
respiration training, 216, 265–269, 301, 361, 367
strident voice treated with, 365–366
462 The Voice and Voice Therapy
Voice facilitating approaches (continued)
tongue protrusion /i/, 216, 269–270, 292, 296, 318,
366, 368
types of, 93, 214–215, 215
unilateral vocal fold paralysis treated with, 131
visual feedback, 216, 270–273, 363, 367–368
vocal nodules treated with, 82
yawn-sigh. See Yawn-sigh
Voice Fatigue Index, 77
Voice Handicap Index-10, 106, 159, 166, 167–169, 228
Voice Handicap Index-Partner, 228
Voiceless plosives, 328
Voice of agreement, 261
Voice perceptual scales, 163
Voice production
assessment of, 167
auditory feedback for, 290
central control of, 55–56
description of, 59–66
laryngeal adjustments for speech, 61–62
normal processes of, 22–23
posture and, 24, 243–244
psychological upset effects on, 90
spasmodic dystonia effects on, 135
vocal fold vibration in, 59–60, 60
voice registers in, 62–63, 241
Voice quality
description of, 65–66, 163
head and neck position changes on, 245
Voice range profile, 180, 183–185, 185
Voice–reflex effect, 252–253
Voice registers, 62–63, 241
Voice-related quality-of-life, 166–170, 167–170, 282
Voice stimulability testing
diagnostic probes for, 15
purpose of, 347
in resonance disorders, 347–348
Voice Symptoms Scale, 77
Voice therapy
adherence to, 212–213
airway interference treated with, 297–298
airway obstruction treated with, 297–298
asthma treated with, 298–299
in children, 285
diplophonia treated with, 88
direct, 285
evidence levels used in, 16
facilitating approaches for. See Voice facilitating
approaches
forms of, 15
functional aphonia treated with, 93–94
gender-affirming
overview of, 293
for transmasculine individuals, 296–297
for transwomen, 293–296, 295
hypernasality treated with, 359–362
hyponasality treated with, 362–363
indirect, 285
individualized nature of, 212
motivation for, 213
muscle tension dysphonia treated with, 17, 213
pediatric voice disorders treated with, 283
Reinke’s edema treated with, 86
spasmodic dystonia treated with, 138–141
strident voice treated with, 365–366
telepractice for, 213
unilateral vocal fold paralysis treated with, 131
video recordings of, 213
vocal fold paralysis treated with, 298
vocal fold polyps treated with, 84–85
vocal hyperfunction treated with, 285
vocal nodules treated with, 82–83
Voice tremor, 142
Voice-Vibratory Assessment with Laryngeal Imaging, 174
Voicing–reflex test, 252
Vowel duration, 217
Vowel prolongation, 266
VPD. See Velopharyngeal dysfunction
VP valve. See Velopharyngeal valve
VRP. See Voice range profile
W
Water manometer test, 191
WebWhispers, 325
Wet spirometer, 191
Wideband filtering, 176
Women. See also Females
hormonal changes in, 106
speaking fundamental frequency in, 280
transwomen, gender-affirming voice therapy for,
293–296, 295
World Professional Association for Transgender Health
(WPATH), 293–294
Index 463
Y
Yawn-sigh
laryngeal lowering using, 230
procedural aspects of, 273–274
resonance improvements using, 367
strident voice treated with, 366
uses of, 90, 251, 273
vocal hyperfunction treated with, 273–274
voice facilitating approach of, 66
I–1
Normal vocal folds
Amyloid deposits Anterior web
Atrophy abducted Atrophy adducted Bilateral nodules 1 abducted
Bilateral nodules 1 adducted Bilateral nodules 2 adducted Bilateral adductor paralysis
Photos courtesy of Ozlem Tulunay-Ugur, M.D., UAMS Voice and Swallowing Center
(https://uamshealth.com/provider/ozlem-e-tulunay-ugur/)
I–2
Photos courtesy of Ozlem Tulunay-Ugur, M.D., UAMS Voice and Swallowing Center
(
Cyst 1 Cyst 2 Glottal gap pre-laryngoplasty
Glottal gap post-laryngoplasty Granuloma 1 Granuloma 2
Hemorrhage Laryngeal cancer 1 Laryngeal cancer 2
https://uamshealth.com/provider/ozlem-e-tulunay-ugur/)