Voice Disorders
5.5.1 Discuss the role of the larynx in phonation. What other structures of the aerodigestive tract are important in phonation as well?
5.5.2 What is the difference between hoarseness and dysarthria? What are distinguishing features of each?
5.5.3 What are some objective measures of voice disorders? What is shimmer? Jitter? S-Z ratio?
5.5.4 How can laryngeal electromyography (EMG) assist in the diagnosis and management of voice disorders?
Munin MC. Laryngeal electromyography: diagnostic and prognostic applications. Otolaryngol Clin North Am. 2000 Aug;33(4):759-70. PMID:10918659
5.5.5 What are hyperfunctional voice disorders? Give us a list and short description of each.
5.5.6 What are the characteristics of focal dystonia?
5.5.7 Discuss the etiology of dystonias.
5.5.8 Describe the clinical presentation of adductor vs. abductor spasmodic dysphonia (SD). How might you differentiate the two disorders?
5.5.9 What other neurologic disorders can produce a voice disorder. What is Meige’s disease?
5.5.10 What are the typical fiberoptic laryngoscopy findings of SD?
5.5.11 How does speech-testing help with the diagnosis of spasmodic dysphonia?
5.5.12 What are the EMG findings in SD?
5.5.13 Botulinum toxin injection is a common treatment for SD-what is the mechanism of action? Should you do unilateral vs. bilateral injection? What laryngeal muscle(s) do you inject and how do you find it? What are the outcomes of treatment, side effects of the injections, and advantages/disadvantages to other treatments?? What dosages are used?
Novakovic, D et al., Botulinum toxin treatment of adductor spasmodic dysphonia: Longitudinal functional outcomes. Laryngoscope. 2011 Mar;121(3):606-1do~/images 10.1002/lary.2139Epub 2011 Feb 4. PMID:21298641
5.5.14 Discuss recurrent nerve section for treatment of SD. What are advantages and disadvantages.
5.5.15 Describe voice therapy and SD. What role does it play for SD? What is inhalational voice therapy?
5.5.16 What systemic drugs have been used in treatment of SD and do they work?
5.5.17 What is paradoxical vocal fold motion? What are the organic and non-organic causes of the phenomena?
5.5.18 Discuss the treatment of paradoxical vocal fold movement. What techniques may be helpful?
5.5.19 Describe dysphonia plica ventricularis symptoms, etiology, diagnosis and management.
Maryn, Y et al. Ventricular Dysphonia: Clinical Aspects and Therapeutic Options. Laryngoscope. 2003 May;113(5):859-66. PMID:12792323