[Functional disorders of voice changing].
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Adolescent↗
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Results for “Voice Disorders”
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Training of students in the management of disorders of voice.
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Humans↗
Laboratory investigation of the abnormal voice.
The patient with an abnormal voice has variously been investigated by laryngologists and speech pathologists, the diagnosis being based on visualization of the larynx and the sound of the voice. With the advent of phoniatric surgery, for example augmentation of the vocal cord and recurrent nerve section for spastic dysphonia, more objective means of quantifying abnormalities and results became pressing. Investigation of dysphonia where obvious lesions of the vocal cords were absent required further laboratory methods. The advent of microprocessors and fiberoptic endoscopy allows research methods to be applied clinically with better ability to diagnose and document patients with voice disorders. This paper outlines the experience of a voice laboratory and tries to assess the relevance of laboratory tests to clinical practice.
Electromyography↗
Vocal disorders and the professional voice user: the allergist's role.
BACKGROUND: As the modulating and power source for the voice, the upper and lower respiratory tracts play a key role in management of voice production. Allergic respiratory disease can impair vocalization, which can be a particular problem in the professional voice user. OBJECTIVE: The goal of this review is to facilitate the evaluation and management of professional voice users who have allergic respiratory problems contributing to their vocal dysfunction. This article discusses the anatomy and physiology of voice production, laryngeal pathology, and special diagnostic and therapeutic considerations relative to the allergist's role in treatment of these patients. METHODS: Mechanisms of voice production are reviewed, as well as common laryngeal pathology effecting voice production. Allergic respiratory diseases are summarized, with particular attention to those aspects of management that are altered in professional voice users. RESULTS: Professional voice users require modification in their management to optimize vocal function and minimize abnormalities of the vocal tract. This includes avoidance of medications that produce drying of the airway, as well as avoidance of inhaled corticosteroids. Subtle changes in respiratory function, which may be of no consequence to other individuals, may adversely affect performance ability, and need aggressive management. Allergen immunotherapy, because of its lack of adverse effects on the vocal apparatus, is particularly well suited for treatment of professional voice users. CONCLUSIONS: Allergists have an important role to play in management of the professional voice user. With careful attention to the unique requirements of these highly trained individuals, the allergist can enhance their performance ability while minimizing side effects from treatment.
Humans↗
Successful nasoendoscopic and aerodynamic examinations of children with speech/voice disorders.
An 8-year retrospective analysis of aerodynamic and nasoendoscopic examinations of children with a variety of speech and voice disorders shows that these examinations can be completed with a high rate of success. Moreover, the examinations were achieved with relative ease in children as young as 2 years old. Several clinicians were involved in the examinations, illustrating the viability of the methods. It is suspected that the failures to complete the examinations relate more to the examiners' methods and skills than to the child's tolerance of the instrumentation.
Adolescent↗
Identification of symptoms for spasmodic dysphonia and vocal tremor: a comparison of expert and nonexpert judges.
UNLABELLED: Spasmodic dysphonia is a rare voice disorder that is most successfully treated by injection of botulinum toxin (i.e., BOTOX) into the affected laryngeal muscles. BOTOX is currently available for use by professionals outside of metropolitan voice centers who may be unfamiliar with this rare disorder. Patients may seek assessment and treatment locally from clinicians who are unfamiliar with the speech symptoms for adductor-type (ADSD) or abductor-type (ABSD) spasmodic dysphonia. Although these disorders have been described in the literature, the symptoms have not been well defined and may appear similar to those of vocal tremor or muscle tension dysphonia (MTD). Thus, patients with spasmodic dysphonia might not be easily identified by local clinicians for treatment. The purpose of the current study was to determine whether voice clinicians with infrequent exposure to patients with spasmodic dysphonia could learn to identify speech symptoms for ADSD and ABSD comparable to voice clinicians with extensive experience with these disorders. The ratings of five nonexpert judges were compared to the ratings obtained from three expert judges. The results of this study demonstrated that nonexpert judges could be trained to identify the speech symptoms associated with ADSD, ABSD, and vocal tremor. While the nonexpert judges tended towards false positive judgements for the speech symptoms of interest, the overall speech symptom profiles for each type of voice disorder appeared comparable to those obtained from the expert judges. The symptom identificationscales used, therefore, have potential for use by clinicians unfamiliar with these disorders for correctly identifying persons with symptoms of ADSD and ABSD. EDUCATIONAL OBJECTIVES: Readers will be able to (1) define the predominant speech symptoms reflective of the voice disorder categories of ABSD, ADSD, and vocal tremor; and (2) describe the methods utilized in a new perceptual training protocol for teaching clinicians how to identify predominant speech symptoms associated with the voice disorder categories of ABSD, ADSD, and vocal tremor.
Humans↗
Notes on voice and speech disorders in ancient and Byzantine Greece.
Voice and speech were considered important by the Ancient and Byzantine Greeks and their disorders were examined and treated on a reasoned basis, without prejudice, by such famous doctors and practitioners of these periods as Hippocrates, Aristotle, Galen, Orebassius and Paul the Aeginitian. In this article, we present the voice and speech disorders which were described and analysed in the texts of Ancient and Byzantine Greek doctors and historians.
Greece↗
The prevalence of Helicobacter pylori infection in benign laryngeal disorders.
Helicobacter pylori (HP) is an accepted cause of chronic active gastritis and has a major causative role in peptic ulcers. It is a gastric carcinogen. Its role in nonulcer dyspepsia (NUD) is less clear, yet 50% of patients with NUD are infected with HP, and some recent literature demonstrates long-term improvement of symptoms following eradication. HP has been investigated in several other organ systems, but has not been investigated to any major degree in laryngeal disorders, a region that could be directly exposed to the bacterium from pharyngolaryngeal reflux. This study represents one arm of a larger study designed to investigate such a relationship. Of 101 patients with nonmalignant voice disorders presenting to our voice clinics, 54.5% tested positive for the H. pylori organism. Of the controls, 47.1% tested positive. When striated into age groups of < 45 years, 46-61 years, and > 62 years, and then age-matched with the controls, the likelihood of infection with the H. pylori organism was greater in both the experimental middle group, and in the middle group when combined with the elder group, than in the matched controls, and this difference demonstrated a trend approaching statistical significance. This finding is discussed in the light of other studies on HP and on gastroesophageal reflex (GER).
Adult↗
Voice recording and vocal fold photography in the ENT office setting.
When a laryngologist treats a patient with a voice disorder it is often important to evaluate the sound of the voice over a long period of time and to demonstrate to the patient changes due to therapy. This may be vital to patient management especially when the results fail to correspond with the patient's expectations or when the voice is used professionally. Visualization of the vocal folds by the use of a mirror may be adequate for the diagnostic needs of the laryngologist, but a permanent record of laryngological features permits the sharing of objective information with referring physician, consultant, therapist, and, most importantly, with the patient. The illustrations can also be extremely useful in teaching.
Adult↗
Application of the Voice Handicap Index in 45 patients with substitution voicing after total laryngectomy.
We tested the Voice Handicap Index (VHI) in 45 patients with substitution voicing (that is, without the use of two vocal folds), the majority of them using tracheo-oesophageal speech. We introduced a corrected VHI score (VHI(corr)) whose values are in the range from 0 to 100 and which can be expressed as a percentage. As such, the VHI(corr) is a handy and transparent tool, and it seems to be suited for representing the handicap caused by the voice disorder when some items are unanswered as experienced in patients with substitution voicing. Interestingly, our data reveal that the voice handicap severity of this particular category of patients is (1) moderate and in the range of "common" dysphonia and (2) not affected by additional radiotherapy. It seems that the E domain is overstated due to the number of problematic items in the P and F domains.
Adult↗
The psychiatric and social characteristics of patients with functional dysphonia.
Of 121 consecutive outpatients seen in an ENT clinic who received a diagnosis of functional dysphonia, 71 who were referred to the speech therapy department were interviewed. Sixty one (86%) were women, and the mean age of the group was 47.6 yr. The commonest voice disorder was huskiness or hoarseness, and only five patients had a pure 'whispering' dysphonia. There was little evidence of major psychiatric disorder in the group: eight patients had a past psychiatric history; two had histrionic personality disorder, and 22 (33%) had clinically diagnosable mood disorders which were mainly anxiety/tension states. This descriptive study formed the background for an investigation of the psychosocial stressors preceding onset of functional dysphonia.
Adolescent↗
The effect of information on listeners' attitudes toward speakers with voice or resonance disorders.
This study investigated university students' attitudes toward women with voice or resonance disorders and whether providing listeners with information about those disorders affected their attitudes towards the women. Eighty students listened to speech samples of 9 women: 3 with normal voice/resonance, 3 with moderate hoarseness/breathiness, and 3 with moderate hypernasality and nasal emission. Before listening to the speech samples, 40 students read two pages of information about the disorders, and 40 read two pages of neutral information. Attitudes were measured with 24 semantic differential scales. Results indicated that listeners perceived speakers with voice/resonance disorders more negatively than speakers without disorders. The attitudes of listeners who read voice and resonance information did not differ from those of listeners who read neutral information.
Adult↗
Communicative disorders in a group of adult female offenders.
Fifty female offenders ranging in age from 18 to 44 yr from the Purdy Treatment Center for Women (Washington state) were individually screened for articulation, hearing, receptive language, fluency (stuttering), and voice disorders. Results indicate that 44% of the 50 women evidenced a dysfunction in one or more of these areas.
Adolescent↗
Clinical research in allied health.
Allied health professionals in nutrition and medical dietetics, occupational therapy, physical therapy, and speech-language pathology and audiology play both unique and key cross-cutting roles in the furtherance of clinical research. Clinical research in nutrition and medical dietetics uniquely focuses on food nutrient intake and the metabolic utilization of nutrients. Clinical research in occupational therapy has a special focus on the relationship of impairment to disability, the adaptation to disability and the maximization of function. Physical therapy clinical research uniquely targets movement dysfunction and its evaluation and treatment within the context of quality and effective care. Clinical research in speech-language pathology and audiology is singular in its focus on deafness and hearing disorders, voice, speech, language and related disorders, and intersections among these and other neurological and physical conditions. Thus, all of these disciplines are making unique contributions to clinical research. Clinical research in these allied health professions is much more than the above specific foci. Inasmuch as these disciplines are rooted in practice, their contributions to research are inherently clinical. Many, if not most, of these contributions represent further validations of clinical practice or its underlying knowledge base. This means that, at a macro level, clinical research in allied health is very much "applied" research. Within allied health clinical research, this emphasis is redoubled at the "person," or individual level, where considerable attention is given to concepts of function and effectiveness. Clinical research in allied health has played a key cross-cutting role through its emphasis on collaboration. Possibly due to their professional maturation within multidisciplinary academic units, allied health professionals have demonstrated a level of comfort with multidisciplinary and interdisciplinary collaborations unique within many academic health science centers. While the above contributions are considerable, much more could be accomplished if identified barriers to career progression could be addressed. Principal barriers to the development of clinical research careers in allied health lie in the areas of training, mentoring, and funding. The lack of financial support for clinical research training is the major impediment. Progress in these areas, although valuable in itself, could also lead to more dedicated release time in clinical and academic settings, improved predoctoral and postdoctoral research training mechanisms, and better alignment of institutional and system reward structures with the clinical research mission. Within the existing constraints, allied health professionals have performed remarkably well in tapping into funding streams created for other disciplines and in establishing research traditions within relatively young health professions.(ABSTRACT TRUNCATED AT 400 WORDS)
Allied Health Occupations↗
[The videolaryngostroboscopy of larynx and the acoustic analysis in diagnosis of organic disorders of children voice in experience of Phoniatric Clinic IPCZD].
We present our experience in using videolaryngostroboscopy in diagnostics of organic disorders of voice and advantages of this method of examination for diagnostics of children voice. There are also presented some cases of children who suffered from different disorders of voice. We used videolaryngostroboscopy and acoustic analysis in their diagnostics and these methods help us to make a diagnosis, choose the best method of treatment and estimate the results of therapy.
Adolescent↗
A case of superior laryngeal nerve paresis and psychogenic dysphonia.
A psychogenic voice disorder co-occurred or evolved with the symptoms and signs of unilateral superior laryngeal nerve paresis. We speculated that the former was a manifestation of a musculoskeletal tension or conversion reaction disorder, whereas the latter was a sequela to a self-limiting inflammatory process. Voice therapy proved effective for alleviating the psychogenic dysphonia after the signs of the neuropathy had resolved, whereas psychotherapy offered strategies for stress management. A multidisciplinary approach to this patient provided for differential diagnosis and efficacious treatment.
Adult↗
Sentence/vowel correlation in the evaluation of dysphonia.
Considering the widespread use of the sustained vowel in the evaluation of voice disorders, our objective was to study the degree to which the vowel is representative of voice in continuous speech. Phonatory samples were recorded from 20 normal subjects and 60 patients representing commonly occurring voice problems (nodules, unilateral paralysis, and functional). The phonatory samples were evaluated by 25 listeners on the basis of 12 bipolar, semantic differential scales. Factor analysis produced two perceptual dimensions with similar loadings for both vowels and sentences. A correlation of 0.78 was obtained between vowels and sentences on factor 1 scores, "vocal severity," and a correlation of 0.77 was obtained between vowels and sentences on factor 2 scores, "pitch/quality." Six of the 80 pairs of sentences and vowels differed by two scale points or more on vocal severity. Results suggest that although a relatively strong relationship exists between the two measures, sustained vowel sounds may not be an adequate clinical index to the dysphonic severity of continuous speech.
Adult↗
Prevalence of voice problems in teachers.
Teachers are frequently cited as experiencing a high rate of vocal dysfunction (1-7). Despite considerable research in the area of voice problems in teachers, the prevalence of voice disorders in this group is unknown. This study investigated the prevalence of self-reported voice problems in teachers using a mail survey of a simple random sample of 1168 state school teachers (preschool-Grade 12) in South Australia. As part of the survey, teachers were asked to report voice problems for the day of the survey, during the current teaching year, and during their careers. The response rate was 75%, with 16% of teachers reporting voice problems on the day of the survey, 20% reporting problems during the current teaching year, and 19% reporting problems at some time during their career. Females were twice as likely as males to report voice problems. These findings clearly indicate a need for further investigation of the causes of vocal dysfunction in teachers and for the development of educational programs aimed at preventing voice problems in this group of professional voice users.
Adult↗