Voice 11 Kinds of Voice Disorders
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Transcript Voice 11 Kinds of Voice Disorders
KINDS OF VOICE DISORDERS
IMPORTANCE OF VOICE
6 out of 100 people
have voice dis
voice
visual
content
Communication
7%; what to say
93%; how you say it
YOUR TITLES
SLPs with a specialty in voice
Voice specialist
Voice pathologist
Voice therapist
Voice teacher
Singing teacher
Voice coach, drama coach
WHO CAN YOU HELP?
Clients looking for better image making
Politicians
CEOs
Entrepreneurs
REAL PROBLEMS
WHO CAN YOU HELP? (CONTINUED)
Real Voice Patients (Functional Problems 功能性问题)
Professional Voice Users
1) clergymen
2) teachers (females esp English), physical ed teacher
3) coaches in a prof sports team (esp football)
4) Singers
5) SLPs
Pts w hyperfunctional(功能亢进) voice usage (mostly kids)
Pts w emotional problem (females)
WHO CAN YOU HELP? (CONTINUED)
Real Voice Patients (Organic Problems 器质性问题)
Organic VF lesions
Cancer (癌症)
papilloma (乳头状瘤)
webbing(喉蹼)
Reflux(返流)
Physical trauma on the neck
1) a youngster who had a motorcycle accident
2) a pt who had a fall by her neck
3) a lady who got strangled by her neck by a robber
-> arytenoid cartilage was dislocated
WHO CAN YOU HELP? (CONTINUED)
Real Voice Patients (Neurogenic Problems 神经性问题)
Neurogenic pts
CVA(Cerebrovascular Accident 脑血管意外)
TBI(Traumatic Brain Injury 外伤性脑损伤)
Parkinson’s dis (帕金森氏病)
Vocal Ford Paralysis(声带麻痹)
HOW TO DIAGNOSE (F, O VS N)?
1、VOICE HISTORY, EXAMINATION AND
TESTING
CASE HISTORY
Variety of types 不同类型
Observations 观察
Waiting
room 候诊室
Office/clinic room 诊室
During evaluation 评估过程
CASE HISTORY CONTINUED
Information to gain
Description
of problem 描述问题
Onset and progression 起病及发展过程
Variability and consistency 可变性和稳定性
Symptoms and sensations 症状及患者感觉
CASE HISTORY CONTINUED
Patients voice use 病人用嗓情况
Health 健康
Vocational 职业
Recreational 爱好
Psychological 心理
EXAMINATION OF THE VOICE
Indirect Laryngoscopy 间接喉镜
Flexible fiberoptic laryngoscopy 纤维喉镜
Stroboscopy 动态喉镜
LAB TESTING 实验室检查
Acoustic Studies 声学检查
Fundamental
frequencies 基频
Phonational range 发声范围
Vocal intensity 声音强度
Perturbation 微扰
Spectrogram 频谱图
PHYSIOLOGICAL STUDIES 生理学检查
Electroglottography 电声门图
Subglottal Air Pressure 声门下压
Electromyography 肌电图
CRITICAL LISTENING 听感
Pitch 音调
Loudness 响度
Voice quality 音质
Unusual vocal characteristics 异常声音的特征
Tasks
Sustained vowels 连续元音
Syllables and sentences 音节及句子
Frequency range and intensity range 基频及强度的范围
Rainbow Passage 短文
Sample of conversational speech 简单的交流语言
DIAGNOSTIC TESTING PROBES
诊断性测试
Reflexive sounds 反射性声音如哭、咳嗽
Altering pitch 改变音调
Sustaining steady, prolonged phonation 持续稳
定的发声
Altering vocal loudness 改变声音的强度
Phonation with effortful glottal closure 努力闭合
声带发声
Placing the voice 找到最好的共鸣腔
NONINSTRUMENTAL OBJECTIVE MEASUREMENTS
非设备客观检查
Maximum phonation time 最长声时
s/z ratio s/z比
2、DIFFERENTIAL DIAGNOSIS OF VOICE
PROBLEMS
PROCEDURES
Interview
Examination of medical records
Rating of auditory perceptual characteristics
Measurement of acoustic, aerodynamic, vibratory, and
muscle action events
Examination of the laryngeal structures and their
function
Evaluation of other bodily functions and systems as
deemed appropriate
Experimental therapy, or treatment probing
SYMPTOMS VS SIGNS
A symptom(症状) is a complaint or
perceptual characteristics of the voice
A sign (体征)is a characteristic of the voice
that can be observed or tested
PRIMARY SYMPTOMS OF VOICE PROBLEMS
Hoarseness 粗糙声
Vocal fatigue 声带疲劳
Breathy voice 气息声
Reduced phonation range 发声范围减小
Aphonia 失声
Pitch breaks or inappropriate high pitch 怪声怪调
Strain/struggle with voice 声音发紧
Tremor 声颤
Pain and other physical sensation 发声痛
MAJOR SIGNS OF VOICE PROBLEMS
Pitch
Monopitch 音调单一
Inappropriate pitch 怪声怪调
Pitch breaks 音调变化过大
Reduced pitch range 音调范
围减小
Loudness
Monoloudness 响度单一
Loudness variation 响度变化
大
Reduced loudness range响度
变化范围减小
Quality
Other behaviors
Hoarse or rough 嘶哑或粗糙声
Breathy 气息声
Tension 声音紧刺
Tremor 声颤
Strain/struggle声音发紧
Sudden interruption of voicing 突
然失声
Diplophonia 复音
Stridor 尖锐声
Excessive throat clearing 清嗓过
度
Aphonia失声
Consistent 持续失声
Episodic 偶发失声
ACOUSTIC ASSESSMENT 声学评估
Frequency
Fundamental
frequency 基频
Phonational range 基频变化范围
Frequency perturbations – Jitter 基频微扰
Intensity
Mean
intensity level 平均强度
Dynamic range 强度变化范围
Amplitude perturbation – Shimmer 振幅微扰
ACOUSTIC ASSESSMENT CONTINUED
Respiratory and Laryngeal Control
Maximum phonation time (MPT)
S/Z ratio
Noise related measures
Signal to noise ratio 信噪比
Spectral analysis 频谱分析
Dr Speech
CSL
MDVP
Praat
LET’S EXPERIENCE!
1) Dr. Speech measurements (next 2 slides)
very useful both in assessment and in Rx
2) CSL info is in the DVD clip
3) Praat
Please download the program! It’s free!
Experience it yourself!
It’s more of a research tool than clinical tool.
VOICE DISORDERS TREATMENT
THYROPLASTY (BEFORE & AFTER SURGERY)
VOICE DISORDERS TREATMENT
THYROPLASTY (BEFORE & AFTER SURGERY)
AERODYNAMIC MEASUREMENTS
空气动力学测试
Airflow 空气流量
Subglottal pressure 声门下压
Respiratory movements 呼吸运动
PAS
VOCAL FUNCTION TESTS CONTINUED
Electroglottography 电声门图
Electromyography 肌电图
Dr Speech
CSL
STROBOSCOPIC OBSERVATIONS 动态镜观察
Degree of glottal closure 声门关闭程度
Phase closure 关闭相
Vertical level 室带水平
Amplitude of vibration 振幅
Mucosal wave 粘膜波
Vibratory behavior 振动
Phase symmetry 两边声带时否同步运动
Periodicity 周期性
LARYNGOSCOPIC SIGNS 喉镜检查
Vocal fold approximation 声带靠近程度
Vocal fold movement 声带运动
Tissue changes 组织变化
Pyriform changes 梨状窝改变
Anteroposterior laryngeal dimensions 喉的前后大小
Ventricular folds 室带
Anatomical malformations and congenital anomalies 喉的
畸形和先天性异常
Vocal fold lengthening 声带的长度
Vertical laryngeal position 喉室的位置
Involuntary laryngeal activity 喉的不随意运动
THAT’S ALL FOR TODAY!
Thanks for your attention!
Hope you have a nice
lunch!