Transcript lecture 14
Laryngeal Pathology Vocal Hyperfunction • • • • Misuse of laryngeal muscles Excessive adductory force Often results in laryngitis (inflammation of folds) Etiology: – Excessive contraction of the lateral cricoarytenoid & Arytenoid muscles – Laryngeal tension from contraction of thryoarytenoid & cricothyroid • Results in: Nodules, laryngitis, contact ulcers & vocal fatigue Vocal Hyperfunction: Therapy • Behavioral changes • Vocal Hygiene • Voice improvement through specific treatment approaches – Easy onset speech – Oral resonance – Laryngeal massage Vocal Fold Paralysis • Loss of voluntary motor function, whereas paresis refers to weakness • Forms or damage: – Damage to either upper or lower motor neurons – One side of recurrent nerve damage= unilateral – Bilateral lower motor neuron damage= bilateral • Adductor paralysis= Muscles of adduction paralyzed • Abductor Paralysis= Muscles of abduction paralyzed Vocal Fold Paralysis • Etiology: – Damage to nerve during thyroid surgery – Blunt trauma (MVA) – Cerebral vascular accident (CVA: Hemorrhage or other conditions causing loss of blood to brain) – Aneurysm (ballooning of blood vessel)compresses laryngeal nerve causing paresis or paralysis Vocal Fold Nodules • Aggregates of tissue arising from abuse – Abuses= screaming, shouting, cheerleading – Abuse causes permanent change in vocal fold tissue • Vocal hyperfunction- Laryngitis- Hardening of tissue- Nodule formation • Unilateral or bilateral • Usually arises on the anterior and middle thirds of the vocal folds (point of greatest impact) • May need surgical removal Puberphonia • Normal development- children undergo voice changes – rapid growth of thyroid cartilage & thyroarytenoid – Pitch breaks • thyroarytenoid is the maintenance of the childhood pitch despite having reached puberty • Young men with falsetto quality voices • Therapy to help achieve habitual pitch Laryngeal Stridor • Harsh sound produced during respiration • Sound associated with some obstruction in the respiratory passageway • Arise from growth in the larynx or trachea causing turbulence • May arise from vocal folds if paralyzed in adducted position