Clinical voice pathology : theory and management

Preface
Contributors
1. Voice: A Historical Perspective
	Introduction
		Definition of a Voice Disorder
		Role and Skills of the Speech-Language Pathologist
	Ancient History
		Folklore Remedies
		Egyptian Papyri
		Hindu Writings
		Hippocrates
		Aristotle
		Claudius Galenus
	The Renaissance
	The 17th to 19th Centuries
	The Laryngeal Mirror
	Further Advancements
	Voice Therapy
	Clinical Voice Pathology
		Artistic and Scientific Ingredients of Voice Pathology
	Summary and Concluding Remarks
	References
2. Anatomy and Physiology
	Anatomy
		The Laryngeal Valve
		Respiration for Phonation
	Vocal Tract Resonance
	Structural Support for the Larynx
		Hyoid Bone
		Laryngeal Cartilages
	Muscles
		Muscles for Respiration: Inspiration and Exhalation
		Laryngeal Muscles
	True Folds, Ventricular (False) Folds, and Ventricle
	Vocal Fold Microstructure
		Epithelium
		Basement Membrane Zone
		Lamina Propria
		Vocalis Muscle
	Blood Supply and Secretions
	Neurologic Supply
		Central Nervous System Control
		Peripheral Innervation
	Laryngeal Reflexes
	Developmental Changes
	Geriatric Vocal Folds
	DNA Microarray Gene Expression Analysis
	Physiology of Phonation
		Theories of Vibration
		Fundamental Frequency Control
		Intensity Control
		Phonation Modes and Voice Quality Control
	Summary
	References
3. Etiologies of Voice Disorders
	Etiologies of Phonotrauma
		Phonotrauma
		Inappropriate Vocal Components
	Medically Related Etiologies
		Direct Surgery
		Indirect Surgery
		Chronic Illnesses and Disorders
	Primary Disorder Etiologies
	Personality-Related Etiologies
		Environmental/Life Stress
		Identity Conflict
	Summary
	References
4. Pathologies of the Laryngeal Mechanism
	Prevalence of Voice Disorders
	Pathology Classifications
		Structural Pathologies of the Vocal Fold
		Congenital and Maturational Changes Affecting Voice
		Inflammatory Conditions of the Larynx
		Trauma or Injury of the Larynx
		Systemic Conditions Affecting Voice
		Allergies
		Nonlaryngeal Aerodigestive Disorders Affecting Voice
		Psychiatric and Psychological Disorders Affecting Voice
		Neurologic Disorders Affecting Voice
		Movement Disorders Affecting the Larynx
		Central Neurologic Disorders Affecting Voice
		Other Disorders of Voice Use
	Summary
	References
5. The Diagnostic Voice Evaluation
	The Management Team
	Patient Profile
	Referral Sources
	Medical Evaluation
	Voice Pathology Evaluation
	Diagnostic Voice Evaluation
		Referral
		Reason for the Referral
		History of the Problem
		Oral-Peripheral Examination
		Auditory-Perceptual Voice Assessment
		Diagnostic Probes (Stimulability)
		Focal Palpation of the Paralaryngeal Region
		Patient Self-Assessment of the Voice Disorder
		Impressions
		Prognosis
		Recommendations
		Additional Considerations
	Summary
	References
	Appendix 5–A. Sample Report
	Appendix 5–B. Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V)
	Appendix 5–C. The Rainbow Passage
	Appendix 5–D. Vocal Component Checklist
	Appendix 5–E. Voice Handicap Index (VHI)
6. Instrumental Measurement of Voice
	Clinical Utility
	Basics of Technical Instruments
	Microphones and Recording Environment
	Digital Signal Processing
	Acoustic Measures
		Pitch Detection Algorithm
		Fundamental Frequency
		Intensity
		Voice Range Profile, Phonetogram, and Physiologic Frequency Range of Phonation
		Perturbation Measures
		Signal (or Harmonic)-to-Noise Ratios
		Spectral Analysis
	Aerodynamic Measures
		Calibration
		Pressure, Flow, Resistance, and Ohm’s Law
		Airflow Equipment
		Flow Measurement
		Subglottal Air Pressure Measurement
		Phonation Threshold Pressure
		Laryngeal Resistance
		Inverse Filter
	Laryngeal Imaging
		Endoscopy
		Stroboscopy
		High-Speed Digital Imaging
		Kymography
		Criteria for Laryngeal Imaging
		Endoscopic Imaging Techniques
		Recording Protocol
		Visual Perceptual Judgments
	Electroglottography (EGG)
	Laryngeal Electromyography (LEMG)
	Normative Information
	Electrical Safety
	Hygienic Safety
	The Clinical Voice Laboratory
	Caveats and Additional Considerations
	Glossary
		Acoustics
		Aerodynamics
		Imaging
	References
	Appendix 6–A. Joint Statement: ASHA and AAO-HNS
	Appendix 6–B. Vocal Tract Visualization and Imaging: Position Statement
7. Survey of Voice Management
	Voice Therapy Orientations
		Hygienic Voice Therapy
		Symptomatic Voice Therapy
		Psychogenic Voice Therapy
		Physiologic Voice Therapy
		Eclectic Voice Therapy
		Case Study 1: Representing Voice Therapy Orientations
	Hygienic Voice Therapy
		Treatment Strategies for Vocally Traumatic Behavior
		Vocal Hygiene Therapy Approaches
		Case Study 2: The Homemaker
		Case Study 3: The Noisy Job Environment
		Case Study 4: The Public Speaker
		Case Study 5: Phonotrauma in Children
		Case Study 6: Can We Always Expect Success?
		Hydration
		Confidential Voice
	Symptomatic Voice Therapy
		Therapy Approaches for Respiration
		Therapy Approaches for Phonation
		Therapy Approaches for Resonance
		Therapy Approaches for Pitch
		Case Study 7: The Pseudoauthoritative Voice
		Case Study 8: The Voice Saver
		Case Study 9: Emotional Voice Changes
		Voice and Communication Modification for Gender Diverse People
		Therapy Approaches for Loudness Modification
		Therapy Approaches for Rate Modification
		Treatment Approaches for Laryngeal Area Muscle Tension
		Case Study 10: Ventricular Phonation
	Psychogenic Voice Therapy
		Functional Aphonia/Dysphonia
		Functional Falsetto
		Vocal Cord Dysfunction (VCD)
	Physiologic Voice Therapy
		Case Study 11: Laryngeal Muscle Imbalance
		Case Study 12: The Postsurgical Patient
		Case Study 13: The Aging Voice
		The Semi-Occluded Vocal Tract
		Speech-Based SOVT Therapy
		Accent Method of Voice Therapy
		Flow Phonation
		Lee Silverman Voice Treatment (LSVT)™
		Phonation Resistance Training Exercise (PhoRTE™)
		Conversation Training Therapy (CTT)
	Team Management of Specific Laryngeal Pathologies
		Vocal Fold Cover Lesions
		Laryngopharyngeal Reflux (LPR) and Gastroesophageal Reflux Disease (GERD)
		Unilateral Vocal Fold Paralysis
		Case Study 14: Unilateral Vocal Fold Paralysis
		Spasmodic Dysphonia
		Organic (Essential) Tremor
	Successful Voice Therapy
	References
	Appendix 7–A. Phrases and Sentences Graduated in Length
8. The Professional Voice
	Overview
	The Professional Voice User
	History
	The “At-Risk” Status
	Professional Roles
		The Otolaryngologist
		The Voice Pathologist
		The Producer
		The Agent or Manager
	Clinical Pathways
		Otolaryngology-Voice Pathology-Voice Pedagogy
		Voice Pedagogy-Otolaryngologist-Voice Pathology
		Voice Pedagogy-Voice Pathology-Otolaryngology
		Otolaryngology-Voice Pedagogy
		Voice Pathologist-Voice Pedagogy
		Vocal Types and Vocal Range
	Categories of Singers
	Vocal Registers
	Common Etiology Factor
		Personality Factor
		Phonotrauma
		Drugs
		Hydration
	Common Pathologies
		Acute and Chronic Noninfectious Laryngitis
		Vocal Nodules
		Contact Ulcers and Granulomas
		Gastroesophageal Reflux Disease/Laryngopharyngeal Reflux
		Voice Fatigue
		Vocal Fold Hemorrhage and Vascular Pathologies
	Clinical Assessment of the Vocal Performer
	Supportive Training and Techniques
		Alexander Technique
		The Linklater Method
		The Feldenkrais Method
		The Lessac System
		Estill Voice Training
	Summary
	Glossary of Terms Used in Singing
	References
9. Rehabilitation of the Laryngectomized Patient
	Overview
	Incidence of Laryngeal Cancer
	Etiology
	Symptoms of Laryngeal Cancer
	Medical Evaluation
	Staging and Tumor-Node-Metastasis Classifications
	Lymph Node Distribution
	Treatment Options
		Conservation
		Combined Treatments
		Radiation Therapy
		Surgery
		Concurrent Chemoradiotherapy
	Methods of Reconstruction
	Need for Follow-up Treatment
	Multidisciplinary Rehabilitation Team
	Special Concerns of the Laryngectomized Patient
		Communication
		Physical Concerns
		Psychosocial Concerns
	Speech Rehabilitation
		Artificial Larynges
		Esophageal Speech
		Surgical Prosthetics
	Role of the Speech-Language Pathologist and Surgical Prosthetics
		Patient Evaluation
		Patient Fitting
		Independent Care
		Maximizing Communication
		Hands-Free Speaking Valve
	Summary
	Helpful Websites on Head and Neck Cancers
	References
10. Artificial Airway and Mechanical Ventilation
	Introduction
	Artificial Airway
		Nasopharyngeal Airway
		Oropharyngeal Airway
		Laryngeal Mask Airway
		Endotracheal Intubation
	Tracheotomy
		Tracheostomy Complications
		Communication Options for Patients with a Tracheostomy
	Mechanical Ventilation
		Mechanical Ventilation Terminology
		Strategies for Restoring Verbal Communication for Ventilator Dependent Patients
		Noninvasive Ventilation Speech Challenges
		Invasive Ventilation Speech Challenges
	Summary
	References
Index