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Practical Strategies for Treatment of Common Voice Disorders PowerPoint Presentation

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Description : Check out this medical presentation on Speech and Voice Disorders, which is titled "Practical Strategies for Treatment of Common Voice Disorders", to know about common voice disorders and practical strategies for their treatment.

Tags : Speech, Voice Disorders, Strategies, Treatment, Common

Published on : Jul 12, 2021 | Views : 2066 | Downloads : 0

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Slide 1-

Practical Strategies for Treatment of Common Voice Disorders Carol Krusemark, M.A., CCC-SLP Voice Pathologist/Singing Voice Specialist MGH Center for Laryngeal Surgery and Voice Rehabilitation
Slide 2-

Common Voice Disorders Muscle Tension Dysphonia Primary Secondary Vocal pathology associated with abuse/misuse Nodules Vocal scarring or loss of vibratory layer
Slide 3-

Primary Muscle Tension Dysphonia a posterior glottic “chink” caused by simultaneous activation of vocal fold “closers” and “openers” Can be normal in females
Slide 4-

Primary Muscle Tension Dysphonia False vocal fold approximation: medio-lateral supraglottic compression
Slide 5-

Primary Muscle Tension Dysphonia Supraglottic compression in the anterior to posterior axis
Slide 6-

Primary Muscle Tension Dysphonia Compression from both the A-P and medio- lateral directions
Slide 7-

Vocal Nodules Reactive fibrovascular lesions formed at the site of greatest vocal fold contact
Slide 8-

Scar or loss of vibratory layer Loss of superficial lamina propria, resulting in reduced musocal wave
Slide 9-

Treatment modalities Facilitating Strategies Reduction of vocal fold and supraglottic hyperfunction Type I: posterior glottic “chink” Glottal fry Inhalation phonation Types II-IV: Supraglottic compression Semi-occluded vocal tract tasks
Slide 10-

Type I Glottal fry phonation Low subglottal “driving” pressure Reduced tension of the muscle within the vocal folds (thyroarytenoid) Vocal folds are short and thick Increased interarytenoid activity Complete vocal fold closure front to back Eliminating posterior chink Isolation/syllables/words/etc.
Slide 11-

MTD: Posterior glottic gap Inhalation Phonation Phonation during inspiratory phase Results in improved vocal fold closure along entire length Vocal tract adjustment can assist with transition from inspiratory to expiratory phonation Hierarchy of tasks
Slide 12-

MTD: Compression Goals: Reduce supraglottic compression Reduce vocal fold medial compression Task requirements: Complete closure of the vocal folds along their length (coordination of “closers) Adduction to a “just barely touching” position
Slide 13-

Semi-occluded vocal tract tasks Lowers phonation threshold pressure Decreases medial compression Reduces laryngeal muscular tension Improves laryngeal muscular coordination “squares up” vocal fold edges for efficient vibration Phonation through a straw (small is better) Sustained phonation of voiced fricative consonants Lip bubbles/trills Tongue trills Rolled /r/ Humming Fringe benefit: highlights oral resonance
Slide 14-

Straw phonation Daily exercises program (2-3 times) Three Principles: Lips around straw Sound through straw only Vibratory feeling at the lips Four tasks: One long, slow slide from low to high and back again A series of slow slides on a single breath A series of accented slides (revving) Song phonation
Slide 15-

From straw to speech Assure correct production through straw Practice phrases before and after straw Note auditory and ideally kinesthetic contrast Maintenance of kinesthetic similarity “Make it feel like it did after you used the straw” Gradually fade straw use
Slide 16-

Circumlaryngeal massage Addresses paralaryngeal resting muscle tension Massage and manipulation of the supporting muscular “sling” Focuses on muscular attachments to the thyroid cartilage and hyoid bone Muscle relaxation encourages inferior movement of the thyroid cartilage
Slide 17-

Circumlaryngeal Massage/Evidence Significant changes in patient severity ratings (Roy, 1993) and acoustic voice measures (Roy, 1997) after one session 93% able to maintain improvement for a week without further treatment (Roy, 1993) Improved voice was maintained for up to 5 months for 72% of patients (Roy 1997)
Slide 18-

Circumlaryngeal Massage/Evidence Professional voice users with moderate to severed muscle tension dysphonia 25 sessions Improvements in acoustic measurements Strain Highest frequency Average fundamental frequency Jitter and shimmer Improvements in Dysphonia Severity Index
Slide 19-

Structure identification
Slide 20-

Muscles of the anterior neck Suprahyoid Digastric Mylohyoid Geniohyoid Stylohyoid Infrahyoid Thyrohyoid Sternohyoid Omohyoid Sternthyroid
Slide 21-

Circumlaryngeal Massage Using small circles, massage in the thyrohyoid space, moving horizontally through the space
Slide 22-

Circumlaryngeal Massage Use larger circles to massage from the thyrohyoid space to above the hyoid bone and back
Slide 23-

Circumlaryngeal Massage Massage in the thyrohyoid space moving from back to front
Slide 24-

Circumlaryngeal Massage Massage up and down in a “C” shape from the thyrohyoid space to the cricoid cartilage and back
Slide 25-

Questions??