Учебники / Voice Disorders and Their Management Freeman 2000
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Voice Disorders and their Management |
body language 265 children 23 communication 265
distribution of laryngeal pathologies 52–3
facial language 265 functional voice disorders 145
fundamental frequency 80, 234, 243–4, 255
in puberty 24, 234
speaking fundamental frequency (SFF) 26, 29, 80
hyaluronic acid 13
in neurological voice disorders 160–1 psychogenic voice disorders 54
in puberty 24, 25, 234 pulse register 8 register transition 9 respiration 3
speaking fundamental frequency (SFF) 26, 29, 80
speech habits 265 speech indicators 255
vocal tract changes in puberty 24 voice quality 26
gender reassignment preconditions for 247
see also sex-change operations; transsexualism; transsexuals
General Adaptation Syndrome 146 General Health Questionnaire GHQ-60
72
giggle posture 130 giggling 9, 236
globus, laryngeal manipulation in 324 glottal cancer
control rates 272 TNM staging 269
glottal fry (creak) 8, 112, 134, 135, 238–9
glottal gap 26
glottal incompetence, due to vocal fold paralysis 187–8, 188
glottal vibration 6 glottis, posterior 65
glycosaminoglycans (GAGs) 12, 13 Gore-Tex 187
granuloma 62
distribution by age and gender 52 prevalence 51
GRBAS scale 74, 275
group work, professional voice users 299
growth, during puberty 24–5 Guillaine–Barré syndrome, and vocal
fold movement 175 Gutzmann’s pressure test 237
H2-receptor agonists 122 habitual dysphonia 63, 139–40 haemangioma, subglottic 42
Haemophilus influenzae 41 handicap, WHO definition 287 harsh voice 57
in deaf speakers 223
mean fundamental frequency 57 head, neck and shoulder girdle dysfunc-
tion and dysphonia, research 337–9
health, beliefs and cognitions about 148 health psychology 146–8
hearing groups, non-neutral supralaryngeal, laryngeal and prosodic features 229
hearing impaired speakers, see deaf speakers
hearing loss 49
effect on voice and speech 29 height, as index of vocal maturity 25 high pitch
as compensatory behaviour in vocal fold paralysis 185
in deaf speakers 223–4 higher-pitched voices and vocal
hyperfunction 111
see also falsetto; loft register; pitch high-quiet singing 77
history taking
in multidisciplinary voice clinics 335 see also case history interviews
hoarseness 32, 57 children 23 definition 57
outcome measurement 337 priority in assessment 334
after radiotherapy 272, 277, 280
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as symptom of laryngeal cancer 37, 268, 279
homemakers 54 homosexuality 248, 250 hormonal voice disorders
distribution by age and gender 53 prevalence 51
hormone therapy, transsexuals 245, 247, 249
hormones, sex hormones 39–40 female 27–8
humming 132 Huntington’s disease 159
medical treatment 167 prevalence 160–1 symptoms and signs 161
voice characteristics, endoscopic findings 165
voice characteristics, perceptual findings 164
husky voice 57 hyaluronic acid 12–13
gender differences 13 hydration 122, 130
children, treatment of voice problems 94
see also dehydration hyperadduction 165
treatment 168–9 hyperfunction (vocal) 57
adducted 120 assessment 121 asthma and 115, 116
behaviour modification programmes 123–6
behaviours associated with 112–13 children 92
chronic obstructive airways disease and 115
classification and measurement 117–21
compensatory mechanism 116 compensatory strategies 124 damage to vocal folds 111 experimental studies 111–12
from faulty learning mechanisms 122 general use of term 110
genetic predisposition 113
‘inappropriate vocal components’ 118
indicators of 120–1
laryngeal irritants 35, 116, 122 and laryngopharyngeal reflux 114,
115, 122 learning factors 115 lung cancer 115
management of voice disorders associated with 121
measurement 117–21 medical factors 115–16
minimization of effects of underlying causes of 121–3
modification of vocal technique 126–7
nature of 112–13 non-adducted 120, 130
pitch, direct modification of 134, 135 posture 114
predisposition to 113 psychogenic factors 117, 122–3 reasons for 114–17 recuperation time 124 respiration 114
respiratory dysfunction 127–8 signs 110, 113
sinusitis and 115 situational factors 114–15
therapy, see hyperfunction (vocal), therapy techniques
voice disorders associated with 110–36
whooping cough and 115
see also coughing; screaming; shouting; throat clearing; vocal abuse; vocal misuse; yelling
hyperfunction (vocal), therapy techniques
accent method 131–2 categories of 127 chewing technique 132
diaphragmatic-abdominal breathing 128, 131–2
exercises, see exercises
focusing on support functions 127–9 giggle/laughing posture 130
holistic therapy 131–4
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modification of pitch, loudness and glottal fry 134–5
postural education 127, 128 to reduce muscle tension and
constriction 129–35 resonant voice therapy 132–4
hyperfunctional behaviours 112–13 children 92
hyperfunctional dysphonia 71 hyperfunctional voice 61 hyperfunctional voice disorders
spasmodic dysphonia (SD) associated with 200–1
see also hyperfunction hyperkeratosis 35, 62
distribution by age and gender 52 prevalence 51
‘hyperkinetic’ 61
hyperkinetic phonation, see hyperfunction
hyperkinetic voice disorders 159–60 hypertonicity, children 92 hypervalvular phonation 57, 61 hypoadduction, treatment 167–8 hypofunctional behaviour, children 92 hypofunctional voice 57, 61 ‘hypokinetic’ 61
hypokinetic voice disorders 159 hypothyroidism 60, 94 hypotonicity, children 92 hypovalvular phonation 61 hysterical aphonia 59 hysterical dysphonia 48
iatrogenic scars 315–16
IBM Phonetic Workstation 16
illness, beliefs and cognitions about 148 imagery 133
impairment, WHO definition 287 implants
cochlea implants 221
implantable electrodes in laryngeal pacing 189
‘inappropriate vocal components’ 118 Indo-European languages 5
infants 20 babbling 21–2
call signs 21 comfort/discomfort sounds 21 from vocalizations to spoken
language 21–3
see also children; neonates INSET training days, teachers 291 inspiration, prephonatory phase 6–7 inspiratory speech 193
instability, phonatory 169–70 instrumental voice measurements, see
voice measurements, instrumental interarytenoid muscle 13
intercostals 2, 5 intermittent aphonia 153–4
intermittent dysphonia 71, 143–4, 153–4 interviewing, professional voice users
289 intonation 5
in transsexuals 264 intonation patterns
adults 26 children 23
intubation, endotracheal 39, 41 intubation trauma 94
jaw exercises, professional voice users 299
jitter (frequency perturbation) 82, 83, 278
jitter factor 83 jitter ratio 84
juvenile papillomatosis 44
keratin 35
keratosis leukoplakia 65 keyboards, electronic 238 ‘kinesiologic’ 62
knowledge base, children’s 90
L-dopa (levodopa) 162, 207 labourers, vocal usage level 283 lamina propria 12–13, 28, 111 language groups and patterns 5 laryngeal cancer
hoarseness as symptom of 37, 268, 279
and radiotherapy 43, 268
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surgery 42–4, 268, 270 treatment aims 269 see also radiotherapy
laryngeal carcinoma 36–7 and alcohol 270, 274
hoarseness as symptom of 37 incidence 270
risk factors 270
and smoking 37, 270, 273–4 squamous cell carcinoma 36–7, 270 treatment for early tumours 270–2 see also radiotherapy
laryngeal diadochokinetic rates 77 laryngeal disorders
ageing 40, 67–8 benign swellings 43–4 classification 61, 62
combined treatments 33 congenital 35–6 differential diagnosis 32–3 inflammatory conditions 40 malignancies 36–7, 42–4
pathology of primary organic origin 35–40
pathology secondary to functional disorder 34–5
primary non-organic or functional (psychogenic) disorders 33–4
surgery for airway maintenance 41–2 surgery for diagnosis 40
surgical management 32–46 see also laryngitis; and other individual disorders
laryngeal dystonia, see spasmodic dysphonia
laryngeal electromyography (LEMG), vocal fold paralysis 179
laryngeal endoscopy, vocal fold paralysis 178
laryngeal inlet 36
laryngeal irritants 35, 116, 122 laryngeal manipulation 324–5 laryngeal mucosa 62 laryngeal muscles
innervation 173–4
techniques to reduce tension 129–35 laryngeal nerve paralysis 62
unilateral recurrent laryngeal nerve paralysis, phonosurgery 314–15
indications 314
the operation 314–15 postoperative follow-up and results
315
laryngeal nerves 173–4
superior laryngeal nerve injury 39 unilateral recurrent laryngeal nerve
resection 206
laryngeal pacing, electrical 189 laryngeal vibration 16 laryngeal webs 36, 62
children 42 laryngectomy
total 38, 43, 190
voice rehabilitation after 46 laryngitis 35, 40
allergic 67 classification 62, 65
distribution by age and gender 52 non-specific, causes of 30 prevalence 51
Laryngograph 16, 78, 298 in puberphonia 238
see also electrolaryngograph laryngography 78–9
Lx waveform 78–9
see also electrolaryngography and electroglottograph
laryngologists, in multidisciplinary voice clinics 323
laryngomalacia 36 laryngopharyngeal reflux
control of 122
and vocal hyperfunction 114, 115 laryngoscopy 32, 40
direct 76 fibreoptic 32, 75 indirect 32, 75 rigid 75
see also microlaryngoscopy laryngostroboscopes 17 laryngotracheoplasty 42 larynx
ageing 40, 67–8 atresia 35
benign swellings 43–4
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Voice Disorders and their Management |
control mechanisms 10
female hormone loss affecting 28 function test categories 202 functions of 4, 37, 112
in humans 5
neuromuscular activity 13–14 physical stress and 48 physiology 4–5
posterior clefts 36 reflex mechanisms 4, 11
reinnervation techniques 45 susceptibility to vocal hyperfunction
112 transplant 46 trauma 44
distribution by age and gender 52 prevalence 51
vegetative function 4–5, 6 see also laryngeal entries
lasers
carbon dioxide (CO2) lasers 42, 43, 44, 303
laser cordotomy 190
laser excision, for early laryngeal tumours 271
lateral cricoarytenoid muscle 13 laughing 9, 113, 236
laughing posture 130 lawyers
vocal usage level 283
see also professional voice users La-zarus Training 256
learning, topographical learning 22 learning factors, vocal hyperfunction 115 learning mechanisms, faulty, resulting in
vocal hyperfunction 122 learning styles, patients’ 154–5 lecturers
vocal usage level 283
see also professional voice users Lee Silverman Voice Treatment
(LSVT(CM)) 158, 166, 170 LEMG, see laryngeal electromyography lesions
classification 65 multiple 62
leukoplakia
distribution by age and gender 52
keratosis leukoplakia 65 prevalence 51
levodopa (L-dopa) 162, 207 life events theory of stress 146 lilt, in transsexuals 264–5 limb tremor 166
listening skills, in diagnostic interview 149
locus of control 148, 149–50, 150 loft register 8–11, 234
mean air flow 9 see also falsetto
loudness 134–5
deaf vs. hearing speakers 230 LSVT(CM) (Lee Silverman Voice Treatment) 158, 166, 170
lung cancer, and vocal hyperfunction 115
lung size, during puberty 25
magnetic resonance imaging (MRI) 17 vocal fold paralysis 178
male-female differences, see gender differences
manual circumlaryngeal therapy 131 manual laryngeal musculoskeletal
tension reduction 131 marijuana, as laryngeal irritant 116, 122
Maximum Phonation Time (MPT) 77, 95 mechanical stress, see hyperfunction mechanical voice disorders, see hyper-
function medications
as laryngeal irritants 116
see also individual drugs and drug types
Meige’s syndrome 193 membrane-cushion (mucosamuscle)
theory of vocal fold function 14 meningitis, transient vocal fold paralysis
in 176 menopause 28, 234 menstruation 25, 27 Mestinon 166 metaplasia 35
microlaryngoscopy 43, 44
suspension microlaryngoscopy 301, 302
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microsurgery
in children 316–17 for singers 317–18 ‘middlescents’ 54, 67
military training instructors falsetto voice 8–9, 236 vocal attrition 285
modal register 6–8 mean air flow 8
Mood Adjective Check List (MACL) 205 motor neuron disease 62
movement disorders, organic 66 MRI, see magnetic resonance imaging MS, see multiple sclerosis
mucosa
fusiform thickening 304 see also nodules
mucosal bridge, phonosurgery 313–14 mucosal wave 75–6
mucosamuscle (membrane-cushion) theory of vocal fold function 14
mucositis 274
mucus retention cysts, phonosurgery 308–9
indications 308–9 the operation 309
postoperative follow-up and results 309
multidisciplinary teams children’s voice therapy 91
in spasmodic dysphonia diagnosis 205
multidisciplinary voice clinics 319–39 acoustics department 327 administration 334–9
advantages 319–22 assessment 332–4 audit 336–7 clinical records 335
continuity of care 320 contributory medical factors 321 cost-effectiveness 319 counsellors in 326–7 disadvantages 322–3 equipment 327–32 explanations to patients 335–6 funding 323
head, neck and shoulder girdle
dysfunction research 337–9 history taking 335 laryngologists in 323 osteopaths in 324–5
outcome and audit 336–7 patient numbers 335
patient satisfaction questionnaires 337
personnel 323–7 phoneticians in 327 physiotherapists in 324–5 psychologists in 326–7 psychotherapists 326–7 referrals, inappropriate 321–2 singing coaches in 325–6
speech and language therapists in 323–4
support staff 336 team decisions 320–1 see also voice clinics
multiple sclerosis (MS) classification 62
intensive voice treatment 170 prevalence 161
symptoms and signs 162
and vocal fold movement 175 multiple system atrophy, vocal cord
adduction and abduction 200 muscle tension, vs. stiffness 8 muscle tension dysphonias (MTDs)
anteroposterior supraglottic contraction (Type 3) 118, 119, 130
laryngeal isometric pattern (Type 1) 118
lateral contraction (Type 2) 118, 119 types of 118–19
see also hyperfunction muscles
functions of, in vocal fold adjustments 13
growth during puberty 24–5 see also laryngeal muscles
muscular tension classification 62, 66
stressors, exogenous and endogenous 140
muscular tension dysphonias, see hyperfunction
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Voice Disorders and their Management |
musculoskeletal tension 150–1 see also hyperfunction; stress
mutational falsetto 66
mutational retardation, male sexual 62 mutational voice disorders 234–44
see also fundamental frequency; puberphonia
myasthenia gravis 39, 158 classification 66 pharmacological treatment 166 prevalence 160
surgical treatment 166 symptoms 161
transient vocal fold paralysis in 176 voice characteristics, endoscopic
findings 164–5
voice characteristics, perceptual findings 163
myoelastic-aerodynamic theory of vocal fold function 14
myopathic dysphonia 63 myotomy, cricopharyngeal 46 myotonic muscular dystrophy 158
prevalence 160 symptoms 161
voice characteristics, endoscopic findings 164–5
voice characteristics, perceptual findings 163
myxoedema 62
nasal consonants 132, 133 nasal obstruction 62
nasal voice, in deaf speakers 224 nasendoscopy
advantages 328–9 disadvantage 329 fibreoptic 75, 328
nasolaryngoscopy, fibreoptic 199 nasopharyngoscopes, fibreoptic 329 National Technical Institute for the Deaf
(NTID) 223 neonates 19–20
feeding difficulties 36 subglottic stenosis 35–6 see also infants
nerve-muscle junction dysfunctions 66
nerves
vagus nerve 173, 179 see also laryngeal nerves
neurochronaxic theory of vocal fold function 14
neurogenic voice disorders distribution by age and gender 52 prevalence 51
neurolaryngology 173–4, 189 neurological voice disorders
aetiology 158–60
ataxic voice disorders 159, 170 augmentative communication 170 behavioural treatment 167 classification 61, 62, 156–8 definition 156
demographic information 160–1 diagnosis and findings 161–2 flaccid voice disorders 158 hyperadduction treatment 168–9 hyperkinetic voice disorders 159–60 hypoadduction treatment 167–8 hypokinetic voice disorders 159 incidence 160–1
mixed voice disorders 160 pathogenesis 158–60 pharmacological treatments 166–7 phonatory instability treatment
169–70 prevalence 160–1 prognosis 170
spastic (pseudobulbar) voice disorders 159, 163, 165
speech pathology 167–70 surgical treatment 166 swallowing 162
treatment options and outcomes 165–70
voice characteristics endoscopic findings 164–5 perceptual findings 163–4 voice evaluation 162
neurosis 62 nodules 34
classification 62, 63, 65 development of 58–9
distribution by age and gender 50, 52
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and hyperfunction 111 phonosurgery 303–5 indications 304–5
the operation 304–5
postoperative follow-up and results 305
preoperative speech therapy 304 prevalence 50, 51
noise, in speech signal 83 ‘non-organic’, meaning 137 non-organic voice disorders 137, 138,
141 classification 66
in deaf speakers 231
non-verbal communication, transsexuals 265
nucleus ambiguus 7
occupational factors, in patient assessment 72–3, 85
occupations requiring use of voice 284–5
see also professional voice users oedema
classification 62
distribution by age and gender 50, 52 and pitch range 67
prevalence 50, 51
after radiotherapy 272–3, 279 vocal folds 34, 44
see also Reinke’s oedema oesophagoscopy 40 oestradiol 28
oestrogen 28 omeprazole 122 opera singers
vocal usage level 283
see also professional voice users; singers
‘organic’
functional-organic dichotomy 58–61, 139, 142
meaning 137
organic movement disorders 66 organic voice disorders
classification 62, 64
in deaf speakers 231, 232
definition 58
osteopaths, in multidisciplinary voice clinics 324–5
over fortis 222, 225
Paedpharma 329 pallidotomy 166 palpation 325, 333, 339 palsy
bulbar 62 pseudobulbar 62
papilloma 65
distribution by age and gender 52 prevalence 51
papillomatosis 62 juvenile 44
paralysis
peripheral and central 66
see also abductor paralysis; adductor paralysis; laryngeal nerve paralysis; vocal fold paralysis
paralytic dysphonia 63 paresis, see vocal fold paresis parkinsonism 62, 159 Parkinson’s disease
classification 66
hypokinetic voice disorders and 159 idiopathic 160, 166 neuropharmacological treatment
166–7 prevalence 160 prognosis 170
surgical treatment 166 symptoms and signs 161, 162
vocal cord adduction and abduction 199–200
and vocal fold movement 175 voice characteristics, endoscopic
findings 165
voice characteristics, perceptual findings 163
patient assessment 69–88
case history interviews, see case history interviews
instrumental voice measurements, see voice measurements, instrumental
multi-dimensional approach 69
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in multidisciplinary voice clinics 332–4
perceptual judgements, see perceptual judgements in patient assessment
before phonosurgery 302 professional voice users 289–93 psychosocial 205
reasons for 69
of spasmodic dysphonia (SD) 199–202, 215
transsexuals, male to female 259–61 of vocal hyperfunction 121
Patient Questionnaire of Vocal Performance 76, 86–8
patient satisfaction questionnaires 337 patients
degree of effort 55 discomfort to 55 learning styles 154–5
with ongoing problems 155 psychological/psychosocial character-
istics 143–5
unable to respond to voice therapy 154–5
PCLX voice analysis system 78 peaking, in transsexuals 264
perceptual judgements in patient assessment 73–7
auditory voice quality ratings 73–5 patient’s opinion 76
performance measures 77 posture and body alignment 76–7
visual laryngoscopic judgements 75–6 perceptual voice quality, after radio-
therapy 275–7, 280 pergolide mesylate 166 period variability index 84
personal factors, in diagnosis and therapy 151
personality
affecting voice disorder in deaf speakers 232
and coping styles 147
personality factors in patient assessment and management 72
personality projection, transsexuals 265
perturbation
amplitude, see amplitude perturbation
frequency, see frequency perturbation after radiotherapy 278
pharyngeal constriction, deaf vs. hearing speakers 230
pharyngitis 30 phenobarbital 167 phenothiazines 167 phonaesthesia 153, 154 Phonagel 314 phonation
and articulation 1 changes over time 234 children 96 hypervalvular 57, 61 hypovalvular 61 instability 169–70
mode shift difficulties 236 physiology of 1–17
see also ventricular phonation phonatory registers 6–11
loft register 8–11 modal register 6–8, 8 pulse register 8 register transitions 9
phoneticians, in multidisciplinary voice clinics 327
Phonetograms 81–2, 331–2 phoniatrists 63 phonosurgery 44–6, 301–18
acquired benign lesions 303–9 capillary telangiectases 305–6 in children 316–17 congenital lesions 309–15 description 301
epidermoid cysts 309–11 equipment 302–3 iatrogenic scars 315–16 mucosal bridge 313–14 mucus retention cysts 308–9 nodules 303–5
the operation 302–3 polyps 306–7
postoperative follow-up 303 preoperative assessment 302 Reinke’s oedema 307–8
Index |
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sulci 311–13
unilateral recurrent laryngeal nerve paralysis 314–15
videolaryngostroboscopy recording in assessment of 302
vocal assessment 302 vocal fold paralysis 186–9 future direction 189
intrafold injection procedures 186–8 laryngeal framework surgery 188–9 reinnervation techniques 189
see also microsurgery phonotrauma, see hyperfunction physicians, vocal usage level 283 physiotherapists, in multidisciplinary
voice clinics 324–5
pitch
alteration of 45
deaf speakers 223–4, 230
direct modification of, in vocal hyperfunction 134, 135
establishment of, in transsexuals 263 voice breaks 25
see also high pitch polyps
classification 62, 63, 65
distribution by age and gender 50, 52 and hyperfunction 111 phonosurgery 306–7
indications 306 the operation 307
postoperative follow-up and results 307
prevalence 50, 51
posterior cricoarytenoid (PCA) muscle 13, 174
posture patient’s 76–7
postural education 127, 128 professional voice users 293, 297, 298 vocal hyperfunction 114
pregnancy 28 presbylaryngis 30, 68 primidone 167
professional voice users 50–4, 283–300 achieving change 294–6
acoustics, effect of 294, 296 and ageing 294
anxiety 289
breathing exercises 299
case history information 289–90 environmental factors 286, 293–4,
296–7 exercises 298–9
factors in poor vocal practice 297–8 group voice work 300
intervention and management 288–93, 299–300
interviewing 289 jaw exercises 299
levels of vocal usage 283 occupational demands on the voice
293–4
patient’s perspective 290–2 posture 293, 297, 298 stress and 292
treatment regimes 298–9 vocal abuse and misuse 287 vocal attrition incidence 284–5 vocal problems 299
voice care and development 285–6 voice care training 283–4, 285–6, 291,
294–5
voice loss 287–8 voice production 286 voice use 286
see also occupations requiring use of voice; singers; teachers
progesterone 28 propranolol 167 prostaglandins 116 proteoglycans 12 pseudo-cysts 304
‘pseudoauthoritative’ voice 135 pseudobulbar palsy 62, 163 pseudobulbar voice disorders, see
spastic (pseudobulbar) voice disorders
psychodynamic theory 139–40 ‘psychogenic’
vs. ‘functional’ 141 meaning 137–8, 141–2
psychogenic aphonia, studies 143–4 psychogenic dysphonia 48, 63
distribution by age and gender 52 examination for 200