The Voice and Voice Therapy

Cover......Page 1
Title Page......Page 4
Copyright Page......Page 5
Contents......Page 10
Preface......Page 18
Chapter 1 An Introduction to Voice Disorders and Their Management......Page 24
The Biological Function of the Larynx......Page 25
The Emotional Function of the Larynx......Page 26
The Linguistic Function of the Voice......Page 27
Prevalence of Voice Disorders in the General Population......Page 28
Prevalence of Voice Disorders in Special Populations......Page 29
Prevalence of Voice Disorders in the Elderly......Page 30
Prevalence of Voice Disorders in Teachers and Student Teachers......Page 31
Kinds of Voice Disorders......Page 32
Functional Voice Disorders......Page 33
Neurogenic Voice Disorders......Page 34
Management and Therapy for Voice Disorders......Page 35
Clinical Concepts......Page 38
Preparing for the PRAXIS™......Page 39
Chapter 2 Normal Voice: Anatomy and Physiology Throughout the Lifespan......Page 41
Normal Processes of Voice Production......Page 42
The Bony Thorax......Page 43
The Muscles of Respiration......Page 44
The Inspiratory Muscles......Page 45
The Tracheobronchial Tree......Page 49
Passive Forces......Page 50
Active Forces......Page 52
Respiratory Volumes and Capacities......Page 54
The Effects of Aging on the Respiratory System......Page 55
Breathing for Life versus Breathing for Speech......Page 56
Anatomy of Phonation......Page 57
The Supplementary Laryngeal Muscles......Page 58
Laryngeal Cartilages......Page 59
Extrinsic Laryngeal Ligaments and Membranes......Page 61
The Laryngeal Cavity......Page 62
Laryngeal Joints......Page 63
Intrinsic Laryngeal Ligaments and Membranes......Page 64
The Intrinsic Laryngeal Muscles......Page 65
The True Vocal Folds......Page 68
Nervous System Control of the Larynx......Page 70
Lifespan Changes in the Larynx......Page 73
The Myoelastic-Aerodynamic Theory of Phonation......Page 74
Voice Registers......Page 75
How We Change Vocal Pitch......Page 77
How We Change Vocal Quality......Page 78
Structures of Resonance......Page 80
Mechanism of Resonance......Page 83
Clinical Concepts......Page 85
Preparing for the PRAXIS™......Page 86
Chapter 3 Functional Voice Disorders......Page 88
Muscle Tension Dysphonia (MTD)......Page 89
Ventricular Dysphonia......Page 90
Vocal Fold Nodules......Page 92
Vocal Fold Polyps......Page 95
Reinke’s Edema......Page 96
Laryngitis......Page 97
Diplophonia......Page 98
Pitch Breaks......Page 99
Psychogenic Voice Disorders......Page 100
Puberphonia......Page 101
Functional Aphonia......Page 102
Functional Dysphonia......Page 104
Somatization Dysphonia......Page 106
Guided Reading......Page 107
Preparing for the PRAXIS™......Page 108
Chapter 4 Organic Voice Disorders......Page 110
Subglottic Stenosis......Page 111
Acid Reflux Disease......Page 112
Contact Ulcers (Granulomas)......Page 115
CYSTS......Page 117
Endocrine Changes......Page 118
Hyperkeratosis......Page 119
Infectious Laryngitis......Page 120
Recurrent Respiratory Papillomatosis......Page 121
Pubertal Changes......Page 122
Sulcus Vocalis......Page 123
Webbing......Page 124
Laryngeal Cancer......Page 125
Clinical Concepts......Page 126
Guided Reading......Page 127
Preparing for the PRAXIS™......Page 128
Chapter 5 Neurogenic Voice Disorders......Page 129
The Central Nervous System, The Cortex, and Its Projections......Page 130
Pyramidal and Extrapyramidal Tracts......Page 131
Thalamus, Internal Capsule, and the Basal Ganglia......Page 132
The Brainstem and the Cerebellum......Page 133
The Peripheral Nervous System (PNS)......Page 134
Cranial Nerves (IX, X, XI, XII)......Page 135
Vocal Fold Paralysis......Page 138
Medical Management of UVFP......Page 140
Bilateral Vocal Fold Paralysis (BVFP)......Page 142
Spasmodic Dysphonia (SD)......Page 143
Judgment Scales for SD......Page 144
Voice Therapy for SD......Page 145
Recurrent Laryngeal Nerve (RLN) Sectioning......Page 146
Botulinum Toxin Type A (BTX-A) Injections......Page 147
Essential Voice Tremor......Page 149
Parkinson’s Disease (PD)......Page 150
Traumatic Brain Injury......Page 153
Clinical Concepts......Page 154
Preparing for the PRAXIS™......Page 155
Chapter 6 Evaluation of the Voice......Page 157
Screening for Voice Disorders......Page 158
Medical Evaluation of the Voice-Disordered Patient......Page 159
The Roles of the SLP and Physician and the Need for a Medical Evaluation......Page 161
Evaluation of the Voice-Disordered Patient by the SLP......Page 162
Review of Auditory and Visual Status......Page 163
Description of the Problem and Cause......Page 164
Variability of the Problem......Page 165
Additional Case History Information......Page 166
Auditory-Perceptual Ratings......Page 167
Voice-Related Quality of Life......Page 169
The Oral-Peripheral Mechanism Examination......Page 173
Laryngoscopy/Phonoscopy......Page 174
The Clinical Voice Laboratory......Page 176
Fundamental Frequency......Page 177
Frequency Variability......Page 179
Maximum Phonational Frequency Range (MPFR)......Page 180
Average/Habitual Intensity......Page 181
The Voice Range Profile (Phonetogram)......Page 182
Vocal Perturbation Measures......Page 185
Electroglottographic Analysis and Instrumentation......Page 186
Aerodynamic Measurements and Instrumentation......Page 187
Lung Volumes and Capacities......Page 189
Air Pressure......Page 190
Laryngeal Resistance......Page 191
Maximum Phonation Time (MPT)......Page 192
Voice Dosage Analysis and Instrumentation......Page 194
Case Studies......Page 196
Perceptual and Noninstrumental Observations......Page 197
Recommendations......Page 199
Voice Facilitating Approaches......Page 200
Short-Term Objectives......Page 201
Perceptual and Noninstrumental Observations......Page 202
Summary......Page 205
Preparing for the PRAXIS™......Page 206
Chapter 7 Voice Facilitating Approaches......Page 208
Patient Compliance and Emerging Technologies in Voice Intervention......Page 209
Voice Therapy Facilitating Approaches......Page 210
1. Auditory Feedback......Page 212
2. Change of Loudness......Page 213
3. Chant-Talk......Page 216
4. Chewing......Page 218
5. Confidential Voice......Page 220
6. Counseling (Explanation of Problem)......Page 222
7. Digital Manipulation......Page 224
8. Elimination of Abuses......Page 226
9. Establishing a New Pitch......Page 229
10. Focus......Page 231
11. Glottal Fry......Page 234
12. Head Positioning......Page 236
13. Hierarchy Analysis......Page 238
14. Inhalation Phonation......Page 240
15. Laryngeal Massage......Page 242
16. Masking......Page 244
17. Nasal-Glide Stimulation......Page 246
18. Open-Mouth Approach......Page 247
19. Pitch Inflections......Page 249
20. Redirected Phonation......Page 251
21. Relaxation......Page 253
22. Respiration Training......Page 256
23. Tongue Protrusion /i/......Page 259
24. Visual Feedback......Page 261
25. Yawn-Sigh......Page 263
Summary......Page 265
The Aging Voice......Page 266
Pediatric Voice Problems......Page 270
Professional Voice Users......Page 273
Deaf and Hard of Hearing......Page 276
Transgender Patients......Page 278
Vocal Fold Paralysis......Page 281
Emphysema......Page 282
Faulty Breath Control......Page 283
Paradoxical Vocal Fold Movement......Page 284
Tracheostomy......Page 285
Clinical Concepts......Page 286
Preparing for the PRAXIS™......Page 287
Risk Factors, Incidence, and Demographics in Head and Neck Cancer......Page 289
Historical Review......Page 290
Case Examples......Page 291
Voice Facilitating Approaches......Page 293
Laryngectomy......Page 294
Tumor Staging......Page 295
Preoperative Counseling......Page 298
Postlaryngectomy Communication Options......Page 299
The Artificial Larynx......Page 300
Esophageal Speech (ES)......Page 301
The Injection Method......Page 302
The Inhalation Method......Page 303
Tracheoesophageal Puncture (TEP)......Page 305
Overview of the Pharyngoesophageal (PE) Segment......Page 309
Summary......Page 310
Preparing for the PRAXIS™......Page 311
Resonance Defined......Page 313
Hypernasality......Page 314
Evaluation of Nasal Resonance Disorders......Page 315
Perceptual Analysis of Speech......Page 316
Hoarseness......Page 317
Stimulability Testing......Page 318
Articulation Testing......Page 319
The Oral Examination......Page 320
Nasometry......Page 321
Radiography......Page 323
Endoscopy......Page 324
Hypernasality......Page 326
Surgical Treatment for Hypernasality......Page 328
Dental Treatment of Hypernasality......Page 329
Voice Therapy for Hypernasality......Page 331
Hyponasality......Page 333
Assimilative Nasality......Page 334
Therapy for Oral -Pharyngeal Resonance Problems......Page 335
Reducing the Strident Voice......Page 336
Improving Oral Resonance......Page 337
Preparing for the PRAXIS™......Page 340
Answer Key......Page 342
References......Page 344
C......Page 380
F......Page 381
L......Page 382
O......Page 383
R......Page 384
V......Page 385
Z......Page 386