Clinical Voice Pathology Theory and Management 6th Edition by Joseph Stemple,Nelson Roy,Bernice Klaben 163550029X 9781635500295

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