DOCSLIB.ORG

University of Groningen Voice And

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text

Load more

University of Groningen Voice and speech rehabilitation following laryngectomy Mahieu, Hans Ferdinand IMPORTANT NOTE: You are advised to consult the publisher's version (publisher's PDF) if you wish to cite from it. Please check the document version below. Document Version Publisher's PDF, also known as Version of record Publication date: 1988 Link to publication in University of Groningen/UMCG research database Citation for published version (APA): Mahieu, H. F. (1988). Voice and speech rehabilitation following laryngectomy. [S.n.]. Copyright Other than for strictly personal use, it is not permitted to download or to forward/distribute the text or part of it without the consent of the author(s) and/or copyright holder(s), unless the work is under an open content license (like Creative Commons). The publication may also be distributed here under the terms of Article 25fa of the Dutch Copyright Act, indicated by the “Taverne” license. More information can be found on the University of Groningen website: https://www.rug.nl/library/open-access/self-archiving-pure/taverne- amendment. Take-down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim. Downloaded from the University of Groningen/UMCG research database (Pure): http://www.rug.nl/research/portal. For technical reasons the number of authors shown on this cover page is limited to 10 maximum. Download date: 04-10-2021 VOICE AND SPEECH REHABILITATION FOLLOWING LARYNGECTOMY ILP. Mahieu RIJKSUNIVERSITEIT GRONINGEN VOICE AND SPEECH REHABILITATION FOLLOWING LARYNGECTOMY Proefschrift ter verkrijging van het doctoraat in de Geneeskunde aan de Rijksuniversiteit Groningen op gezag van de Rector Magnificus Dr. L.J. Engels in het openbaar te verdedigen op woensdag 12 oktober 1988 des namiddags te 4.00 uur door Hans Ferdinand Mahieu geboren op 20 november 1955 te 's Gravenhage 1 Promotor: Prof. Dr. P.E. Hoeksema Referenten: Dr. H.K. Schutte Dr. A.A. Annyas Promotiecommissie: Prof. Dr. G. Boering Prof. Dr. J. Oldhoff Prof. Dr. Ir. L. de Pater 2 STELLINGEN 1. Shunt oesophageale stemgeving met behulp van een ventielprothese is momenteel de beste methode van stem- en spraakrevalidatie voor gelaryngectomeerden. 2. Bij iedere totale laryngectomie client een primaire tracheo-oesophageale punctie en plaatsing van een ventielprothese overwogen te worden. 3. Het verdient aanbeveling bij een totale laryngectomie een myotomie van bet pharyngo-oesophageale segment te verrichten, wanneer er kans bestaat op hypertoniciteit van dit segment. 4. Voor de kleine glottische larynxcarcinomen is C02 laser evaporisatie een goed alternatief voor de gebruikelijke radiotherapeutische behandeling, vooral met betrekking tot de belasting van de patient, de stemkwaliteit, en de de kosten aspecten. 5. Het merendeel van de benigne larynxafwijkingen op glottisch niveau kan beter middels klassieke microlarynx dissectie methoden verwijderd worden dan middels C02 laser dissectie of evaporisatie. 6. Logopedische behandeling van stemplooiknobbeltjes bij kinderen is over bet algemeen meer in bet belang van de logopedist dan in bet belang van bet patientje. 7. Met de huidige ontwikkeling van de phonochirurgie met name wat betreft de thyreoplastieken, client de inspuiting van Teflon of van andere materialen in een stemplooi niet Ianger beschouwd te worden als de behandeling van eerste keus bij dysfonien op basis van een enkelzijdige larynxhelftverlamming. 8. Per-operatieve electrostimulatie van de n. recurrens en simultane registratie van bet larynx-EMG zou de kans op bet ontstaan van n. recurrens laesies tijdens schildklierchirurgie aanmerkelijk kunnen verkleinen. 9. Bij de huidige stand van zaken betreffende re·innervatie procedures van de larynx moeten de positieve stemresultaten vooral toegeschreven worden aan een tonusverandering in de aangedane larynxhelft en niet aan een herwonnen mobiliteit. 10. Zolang er nog geen effectieve glottis verruimende ingreep ontwikkeld is waarbij de kwaliteit van de stem behouden blijft, clientook een tracheotomie als alternatief met de patient besproken worden. 11. Een stomp larynxtrauma met aanwijzingen voor fracturen met dislocatie of met aanwijzingen voor weke delen laesies met mobiliteitsbeperking van een of beide ware stemplooien clientin de acute fase chirurgisch behandeld te worden. 12. Wordt bij patienten, die Ianger dan 1 a 2 weken beademd worden onverhoopt niet voor een tracheotomie gekozen, dan moet minstens wekelijks endoscopische controle van larynx en trachea plaats vinden. 13. Het is niet wenselijk wanneer anders dan in een noodsituatie, een coniotomie als "hoge tracheotomie" verricht wordt in plaats van de meer caudaal verrichte tracheotomie. 14. De recente beschikking van de Staatssecretaris van Volksgezondheid om het a antal percutane transluminale coronaire cardio-angioplastieken drastisch te beperken, is wederom een bewijs van de monomane overheidsvisie op de gezondheidszorg. Een visie die aileen gericht schijnt te zijn op een snel ingevoerd beheersmodel en die volledig voorbij gaat aan de behoeften aan zorg. 15. Nu de belastingaftrek van kosten van congresbezoek afgeschaft dreigt te worden en er van rijkswege nauwelijks geld beschikbaar gesteld wordt voor wetenschappelijk person eel om congressen te bezoeken, dienen meer internationale congressen in Nederland georganiseerd te worden ten einde het peil van het wetenschappelijk onderzoek niet verder te Iaten dalen. 16. Zolang er nog typefouten voorkomen in het promotiereglement kan men in aile redelijkheid niet verwachten dat een proefschrift vrij is van typefouten. 17. Ook gelaryngectomeerden hebben stemrecht. H.F. Mahieu Groningen, 12 oktober 1988 VOICE AND SPEECH REHABILITATION FOLLOWING LARYNGECTOMY Contents PREFACE 7 TOTAL LARYNGECTOMYAND ITS CONSEQUENCES 9 1.1 TOTAL LARYNGECTOMY 9 1.2 CONSEQUENCES OF TOTAL LARYNGECTOMY 10 1.2.1 Loss of laryngeal functions 10 1.2.2 Loss of nasal functions 10 1.2.3 Tracheostoma 11 1.2.4 Swallowing 11 1.2.5 Lung function 11 1.2.6 Psychosocial consequences 11 II VOICE PRODUCTION AND VOICE REHABILITATION PROCEDURES FOLLOWING LARYNGECTOMY 13 2.1 NORMAL LARYNGEAL VOICE PRODUCTION 13 2.2 ANATOMY AFTER LARYNGECTOMY WITH REGARD TO VOICE PRODUCTION 14 2.3 PHARYNGEAL AND BUCCAL VOICE PRODUCTION 15 2.3.1 Mechanism of pharyngeal phonation 15 2.3.2 Mechanism of buccal phonation 16 2.3.3 Comment on pharyngeal and buccal phonation 16 2.4 MECHANICAL SOUND SOURCES 16 2.4.1 Pneumolarynges 16 1 Neck-type pneumolarynges 16 2 Mouth-type pneumolarynges 18 2.4.2 Electrolarynges 19 1 Neck-type electrolarynges 19 2 Mouth-type electrolarynges 21 2.4.3 Comment on mechanical sound sources 22 2.5 SURGICAL VOICE REHABILITATION 23 2.5.1 Surgical voice rehabilitation procedure for subtotal laryngectomies 24 2.5 .2 Surgical voice rehabilitation procedures for total laryngectomies 25 1 Shunt methods 26 2 Problems associated with shunt methods 29 3 Surgical reconstruction after total laryngectomy 29 4 Larynx transplantation 31 5 Implantation of an artificial larynx 31 2.5 .3 Comment on surgical voice rehabilitation methods 31 Ill ESOPHAGEAL VOICE 33 3.1 PSEUDOGLOTTIS: THE SOUND SOURCE 33 3.1.1 Anatomical location of the pseudoglottis 35 3.1.2 Shape of the pseudoglottis 36 3 3.1.3 Composition of the pseudoglottis 36 3.1.4 Changes in the P-E segment due to the laryngectomy procedure 37 3.1.5 Activity of the P-E segment with regard to esophageal phonation 39 3.1.6 Substitute voice production without P-E segment 42 3.1.7 Conclusions concerning the role of the P-E segment in esophageal voice production 43 3.2 AIR SUPPLY: THE ENERGY SOURCE 44 3.2.1 Air intake 45 1 Swallowing method 46 2 Inhalation method 46 3 Injection method 46 4 Shunt method 47 3.2.2 Air expulsion 48 1 Air expulsion following the non-shunt air intake methods 49 2 Air expulsion following the shunt method 50 3.3 DIFFICULTIES IN THE ACQUISITION OF ESOPHAGEAL VOICE 51 3.3.1 Failing of esophageal voice production in non-shunt methods 52 1 Physiological and anatomical factors 52 2 Patient related factors 54 3 Speech therapy related factors 57 3.3.2 Failing of esophageal voice production in shunt methods 58 1 Physiological and anatomical factors 59 2 Patient related factors 61 3 Speech therapy related factors 62 3.4 COMMENT ON THE ESOPHAGEAL VOICE 62 IV VALVE PROSTHESES IN TRACHEO-ESOPHAGEAL SHUNTS 65 4.1 TYPES OF PROSTHESES AND SURGICAL TECHNIQUES 66 4.1.1 The Semi-permanent supra tracheal valve prosthesis by Mozolewski 66 4.1.2 The Blom-Singer prosthesis 68 4.1.3 The Panje voice button 73 4.1.4 The Groningen button 76 4.1.5 The Herrmann prosthesis 78 4.1.6 The Henley Cohn voice prosthesis 80 4.1.7 The Traissac voice prosthesis 82 4.1.8 The Algaba voice prosthesis 84 4.1.9 The Staffieri prosthesis 86 4.1.10 The Bonelli valve 88 4.2 DETERIORATION OF VALVE PROSTHESES 90 4.3 PREVENTION OF VALVE PROSTHESIS DYSFUNCTION; A STUDY 94 4.3.1 Patients and methods 94 4.3.2 Results 97 4.3.3 Discussion 101 4.4 COMMENT ON VALVE PROSTHESES IN TRACHEO-ESOPHAGEAL SHUNTS 103 4 v THE GRONINGEN BUTTON: DEVICE AND TECHNIQUES 104 5.1 THE GRONINGEN BUTTON VALVE PROSTHESIS 104 5.2 TRACHEO-ESOPHAGEAL PUNCTURE AND PROSTHESIS PLACEMENT PROCEDURES 107 5.2.1 Primary puncture and placement procedure 107 5.2.2 Secondary puncture and placement procedure 112 5.3 PROSTHESIS REPLACEMENT PROCEDURE 118 5.4 INDICATIONS AND CONTRAINDICATIONS 118 5.4.1 Indications and contraindications for primary puncture 118 5.4.2 Indications and contraindications for secondary puncture 118
Recommended publications
  • Enhancement of Esophageal Speech Using Voice Conversion Techniques Imen Ben Othmane, Joseph Di Martino, Kaïs Ouni

    Enhancement of Esophageal Speech Using Voice Conversion Techniques Imen Ben Othmane, Joseph Di Martino, Kaïs Ouni

    Enhancement of esophageal speech using voice conversion techniques Imen Ben Othmane, Joseph Di Martino, Kaïs Ouni To cite this version: Imen Ben Othmane, Joseph Di Martino, Kaïs Ouni. Enhancement of esophageal speech using voice conversion techniques. International Conference on Natural Language, Signal and Speech Processing - ICNLSSP 2017, Dec 2017, Casablanca, Morocco. hal-01660580 HAL Id: hal-01660580 https://hal.inria.fr/hal-01660580 Submitted on 11 Dec 2017 HAL is a multi-disciplinary open access L’archive ouverte pluridisciplinaire HAL, est archive for the deposit and dissemination of sci- destinée au dépôt et à la diffusion de documents entific research documents, whether they are pub- scientifiques de niveau recherche, publiés ou non, lished or not. The documents may come from émanant des établissements d’enseignement et de teaching and research institutions in France or recherche français ou étrangers, des laboratoires abroad, or from public or private research centers. publics ou privés. Enhancement of esophageal speech using voice conversion techniques Imen Ben Othmane1;2, Joseph Di Martino2, Kais Ouni1 1Research Unit Signals and Mechatronic Systems, SMS, UR13ES49, National Engineering School of Carthage, ENICarthage University of Carthage, Tunisia 2LORIA - Laboratoire Lorrain de Recherche en Informatique et ses Applications, B.P. 239 54506 Vandœuvre-les-Nancy,` France [email protected], [email protected], [email protected] Abstract such as smoothing [3] or comb filtering [4] have been proposed. But it is difficult to improve ES by using those simple modifi- This paper presents a novel approach for enhancing esophageal cation methods because the properties of acoustic features of speech using voice conversion techniques.
  • Vocal Yoga: Applying Yoga Principles in Voice Therapy

    Vocal Yoga: Applying Yoga Principles in Voice Therapy

    Vocal Yoga: Applying Yoga Principles in Voice Therapy Adam Lloyd, Bari Hoffman-Ruddy, Erin Silverman, and Jeffrey L. Lehman ver the past decade, principles of yoga have become inter- woven with contemporary voice therapy and the teaching of singing.1 Key principles of yoga are successfully integrated into warm-ups, cool-downs, range extension, vocal endurance, vocal Oprojection strategies, and articulatory movements for singers and occu- pational voice users. Yoga techniques direct attention toward whole body relaxation, body alignment, and breath coordination during various singing Adam Lloyd Bari Hoffman- and speaking tasks. Ruddy The benefits of yoga are described throughout the health care literature. Incorporating basic yoga postures and breathing techniques decreases stress, alleviates depression, anxiety and pain. Yoga may also improve cardio- vascular, autoimmune, and immunocompromise conditions.2 Significant improvements in diastolic blood pressure, dynamic muscular strength and endurance of the upper body and trunk, flexibility, perceived stress, and the individual’s overall sense of “wellness” have been reported in healthy adults upon implementation of yoga practice.3 Furthermore, improved pulmonary 4 Erin Silverman Jeffrey L. Lehman function has also been extensively reported. Various programs focus on incorporating concepts of yoga into voicing exercises as well as enhancing vocal sounds with yoga postures, or asanas. Over the last decade, increasing numbers of professional singers and teach- ers of singing incorporate yoga into their practice. Several books and articles by experts in voice pedagogy expound upon the benefits of yoga techniques introduced to a singer’s lifestyle and daily practice and exercise regimen. Judith Carman incorporates the Viniyoga style of yoga in her text, Yoga for Singing: A Developmental Tool for Technique and Performance.5 Viniyoga focuses on repetition and coordination with the breath in every practice, physical and mental.
  • Essential Tremor of the Voice Vs. Spasmodic Dysphonia by Michael M

    Essential Tremor of the Voice Vs. Spasmodic Dysphonia by Michael M

    Essential Tremor (ET) Essential Tremor of the Voice vs. Spasmodic Dysphonia By Michael M. Johns, MD (pictured below)- Director at Emory Voice Center, Emory University, Atlanta, GA and member of the IETF Medical Advisory Board, and Madeleine Pethan, MS, CCC-SLP - Speech Pathologist at Emory Voice Center Introduction box, is not the only structure which can cause essential tremor of the voice. Tremor of the voice can be caused Certain neurologic conditions can cause people to have when any of the structures in the speech system is problems with their voice. These voice problems can affected. Essential tremor of the voice may be caused often lead to more difficulty communicating throughout by tremor in the soft palate, tongue, pharynx, or even daily life. It is important that patients with neurological muscles of respiration. Extralaryngeal tremor (i.e., out- voice disorders are evaluated by an otolaryngologist, or side the voice box) has been reported in up to as many ENT doctor, in addition to their neurologist to determine as 93% of patients with diagnosed essential tremor of the diagnosis and discuss treatment options. Many the voice. Similarly, most patients with essential tremor patients with essential tremor also experience essential of the voice also have tremor affecting their hands, leg, tremor of the voice. Essential tremor of the voice can chin, or trunk. often be confused with another neurologic voice disor- der known as spasmodic dysphonia. Essential tremor seems to be associated with aging, al- though the reasons are still inconclusive. Most studies What is Essential Tremor? report average age of onset from the late 40s to early 50s.
  • Role of Voice Therapy in Patients with Mutational Falsetto 1Arvind Varma, 2Alok Kumar Agrahari, 3Raj Kumar, 4Vijay Kumar

    Role of Voice Therapy in Patients with Mutational Falsetto 1Arvind Varma, 2Alok Kumar Agrahari, 3Raj Kumar, 4Vijay Kumar

    IJOPL Role of Voice Therapy10.5005/jp-journals-10023-1098 in Patients with Mutational Falsetto ORIGINAL ARTICLE Role of Voice Therapy in Patients with Mutational Falsetto 1Arvind Varma, 2Alok Kumar Agrahari, 3Raj Kumar, 4Vijay Kumar ABSTRACT The mutational period of human development Background: Mutational falsetto is the most common muta­ represents dramatic physical and emotional trans for­ tional voice disorder, found in all ages. Clinicians often miss mation of the individual. Principal changes that take this diagnosis due to unfamiliarity with the condition. The voice place during puberty are as follows: of a person with mutational falsetto is high pitched, weak, thin, • Considerable increase in vital capacity secondary to breathy, hoarse and monopitched. increase in the size and strength of thoracic muscles. Objective: This study was carried out to evaluate the efficacy of voice therapy in persons with mutational falsetto. • An increase in length and width of neck. • A descent of larynx producing greater length and width Methods: Eleven male patients with ages between 18 and 26 years (mean age 22.18 years, SD 2.52) diagnosed with of pharynx thus, enlarging the resonatory system. mutational falsetto underwent acoustical analysis using The basic difference between the pubertal development Praat Software, perceptual analysis using grade, roughness, of the male and female larynx has to do with direction of breathiness, asthenia and strain (GRBAS) scale and psycho­ social analysis using emotional component of voice handicap the growth. Until puberty, they are essentially the same index (VHI). All the components were analyzed pre­ and post­ in size and form; however, during pubertal development, voice therapy.
  • Clinical Policy: Voice Therapy Reference Number: HNCA.CP.MP.134 Effective Date: 4/10 Coding Implications Last Review Date: 02/21 Revision Log

    Clinical Policy: Voice Therapy Reference Number: HNCA.CP.MP.134 Effective Date: 4/10 Coding Implications Last Review Date: 02/21 Revision Log

    Clinical Policy: Voice Therapy Reference Number: HNCA.CP.MP.134 Effective Date: 4/10 Coding Implications Last Review Date: 02/21 Revision Log See Important Reminder at the end of this policy for important regulatory and legal information. Description Voice therapy refers to any non-surgical techniques employed in the management of individuals with voice disorders. The goal is to modify vocal behaviors to reduce or correct maladaptive and inappropriate vocal behaviors and laryngeal trauma. Voice therapy is usually subject to speech therapy benefits. Policy/Criteria I. It is the policy of Health Net of California that voice therapy is medically necessary when provided by a qualified speech language pathologist for the following indications: A. Post vocal cord surgery or vocal cord trauma, or B. Post laryngeal (glottic) carcinoma, or C. Paradoxical vocal cord motion, or D. Functional or spastic (spasmodic) dysphonia, or E. Vocal cord nodules/lesions, or F. Vocal cord paralysis, or G. As part of gender affirming services. II. It is the policy of Health Net of California that voice therapy is not medically necessary to improve voice quality due to such conditions as laryngitis or for occupational or recreational purposes. Background Voice disorders are characterized by pitch, loudness, resonance, quality or duration of voice or by the inability to use one’s voice. The disorders result from abnormal laryngeal, respiratory or vocal tract functioning. Voice therapy includes four major components: vocal hygiene, vocal production, muscle relaxation and respiratory support. Disorders of the vocal cords such as surgical procedures, trauma, cancer, nodules and issues regarding motility (spasm, paralysis) can all affect speech.
  • Voice and Communication Change for Gender Nonconforming Individuals: Giving Voice to the Person Inside

    Voice and Communication Change for Gender Nonconforming Individuals: Giving Voice to the Person Inside

    International Journal of Transgenderism ISSN: 1553-2739 (Print) 1434-4599 (Online) Journal homepage: http://www.tandfonline.com/loi/wijt20 Voice and Communication Change for Gender Nonconforming Individuals: Giving Voice to the Person Inside Shelagh Davies, Viktória G. Papp & Christella Antoni To cite this article: Shelagh Davies, Viktória G. Papp & Christella Antoni (2015) Voice and Communication Change for Gender Nonconforming Individuals: Giving Voice to the Person Inside, International Journal of Transgenderism, 16:3, 117-159, DOI: 10.1080/15532739.2015.1075931 To link to this article: https://doi.org/10.1080/15532739.2015.1075931 Published online: 16 Nov 2015. Submit your article to this journal Article views: 9294 View related articles View Crossmark data Citing articles: 13 View citing articles Full Terms & Conditions of access and use can be found at http://www.tandfonline.com/action/journalInformation?journalCode=wijt20 Download by: [73.111.253.98] Date: 10 January 2018, At: 14:10 International Journal of Transgenderism, 16:117–159, 2015 Copyright Ó Taylor and Francis Group, LLC ISSN: 1553-2739 print / 1434-4599 online DOI: 10.1080/15532739.2015.1075931 Voice and Communication Change for Gender Nonconforming Individuals: Giving Voice to the Person Inside Shelagh Davies Viktoria G. Papp Christella Antoni ABSTRACT. In the seventh version of their Standards of Care, WPATH recognizes that, as each person is unique, so is the person’s gender identity. The goal of speech-language therapists/ pathologists is to help transgender people develop voice and communication that reflects their unique sense of gender. When outer expression is congruent with an inner sense of self, transgender people may find increased comfort, confidence, and improved function in everyday life.
  • Fast Track Treatment for Puberphonia

    Fast Track Treatment for Puberphonia

    Scholarly Journal of Otolaryngology DOI: 10.32474/SJO.2020.03.000173 ISSN: 2641-1709 Research Article Fast Track Treatment for Puberphonia Kumaresan M* and Navin Bharath ENT Surgeon, Madras University, India *Corresponding author: M Kumaresan, ENT Surgeon, Madras University, India Received: January 13, 2020 Published: February 05, 2020 Abstract Puberphonia is most often treated using voice therapy (vocal exercises) by speech-language pathologists or speech therapists performedthat have experience by the, a psychologist, in treating voiceor counselor, disorders. can The help duration patients identifyof treatment the psychological is commonly factors one to that five contribute weeks. Indirect to their treatment disorder options for puberphonia focus on creating an environment where direct treatment options will be more effective. Counseling, and give them tools to address those factors directly. It may take long time. Patients may also be educated about good vocal hygiene and how their behavior could have long term effects on their voice. In some cases when traditional voice therapy is ineffective, surgical interventions are considered. This can occur in situations where intervention is delayed or the patient is in denial, causing the condition to become resistant to voice therapy. Surgical treatment correction needs voice therapy for a long time follow up. We use voice pitch analyzer to detect puberphonia and get the confidence of the patient. We explain the clients how by our method of pharyngeal resonance manipulation we get the male voice. By our procedure using uvula and soft palate as a source of generating male voice we eliminate high pitch voice and nasal phonation.99% of the cases we get the male desired voice in the first instant of pharyngealKeywords: resonance manipulation.
  • Speech-Language Pathology Page 1 of 2 Cincinnati Children's Hospital Medical Center

    Speech-Language Pathology Page 1 of 2 Cincinnati Children's Hospital Medical Center

    Vocal Nodules What are vocal nodules? Vocal nodules are callus-like bumps on the vocal cords (in the larynx or “voice box.”). When they are present, the vocal cords cannot close completely when they vibrate to produce the voice. This causes the voice to sound breathy and hoarse. Normal Vocal Folds Vocal Nodules What causes vocal nodules? The most common cause of vocal nodules in children is vocal abuse. Vocal abuses include: • Excessive shouting, screaming, whining, cheering, crying, etc. • Strained vocalizations, such as imitating the sounds of motors • Animal noises, super hero sounds, etc. • Excessive talking • Excessive coughing or throat clearing Vocal nodules can also be caused by vocal misuse. Vocal misuse can include: • the use of an incorrect pitch or volume • Poor breath support for speaking or singing • Controlling the voice at the level of the larynx ©2015 Division of Speech-Language Pathology Page 1 of 2 Cincinnati Children's Hospital Medical Center. All Rights Reserved www.cincinnatichildrens.org/speech Other factors that may be associated with the development of nodules include: • Chronic upper respiratory infections or allergies • Reflux • Smoking or secondary smoke • Air pollution When there is chronic abuse, misuse, or irritation of the vocal cords, this can cause a slight reddening on the edge of the vocal cord. If this continues, the reddening is followed by swelling or thickening on the edge of the fold. Finally, a definite bump or nodule develops on the upper one- third of the vocal cord, where maximum vibration occurs. Nodules can range in size from as small as a pin head to as large as a split pea.
  • A Review of Related Literature

    A Review of Related Literature

    DOCUMENT RESUME ED 391 703 SO 025 705 AUTHOR Sipley, Kenneth L. TITLE The Adolescent Female Voice: A Review of Related Literature. PUB DATE Sep 95 NOTE 48p. PUB TYPE Information Analyses (070) EDRS PRICE MF01/PCO2 Plus Postage. DESCRIPTORS *Adolescents; Choral Music; *Females; Fine Arts; Literature Reviews; Music; *Singing; *Vocal Music; Voice Disorders; *Womens Studies ABSTRACT This paper discusses the research findings in voice mutation, vocal instruction, and the application of knowledge to vocal instruction. Much research involves changes in the male aad female adolescent voices, especially of interest to choral directors and music educators. The research defines the vocal development categories as:(1) posture; (2) breath management; (3) relaxation; (4) phonation;(5) resonance; (6) registration; and (7) articulation. A segment on therapy and exercise suggests ways to develop the voice that has been abused. An extensive list of references offers further topics for research. (EH) *********************************************************************** Reproductions supplied by EDRS are the best that can be made from the original document. * *********************************************************************** U.S. DEPARTMENT OF EDUCATION OfficemEftm=a1Re.mchamirmovereem EDUCATIONAL RESOURCES INFORMATION v / CENTER (ERIC) "PERMISSION TO REPRODUCE THIS is, (his document has been reproducedas MATERIAL HAS BEEN GRANTED BY received from the person or organization originating it. I (,),. 0 Minor changes have been made to 10..014\)`" improve reproduction quality. The Adolescent Female Voice: Points of view or opinions stated in this A review of Related Literature document do not necessarily reprssent officiat OERI position or policy. TO THE EDUCATIONAL RESOURCES INFORMATION CENTER (ERIC)." Introduction This article will present and discuss research findings in voice mutation, vocal instruction, and the application of CD knowledge to vocal instruction.Vocal pedagogues and laryngologists have studied the human voice extensively.
  • Puberphonia Conservative Approach a Review

    Puberphonia Conservative Approach a Review

    ISSN: 2250-0359 Volume 5 Issue 1.5 2015 Puberphonia Conservative approach A review Balasubramanian Thiagarajan Stanley Medical College Abstract: Pathophysiology: Puberphonia is persistence of adolescent voice In infants the laryngotracheal complex lies at after puberty in the absence of organic cause. a higher level. It gradually descends. During This common condition is seen in males. These puberty in males this descent is rapid, the larynx patients have a high pitched voice. This article at- becoming larger and unstable and on top of it the tempts to review published literature on this topic brain is more accustomed to infant voice. The with specific focus on conservative management. boy may hence continue to use a high pitched This condition is also considered to be a psycho- voice or it may break into higher and lower pitch- genic voice disorder. Conservative management es 3. has met with excellent success. Conservative man- agement modalities for this condition ranges from Etiology: include voice therapy to laryngeal manipulation. 1. Emotional stress 2. Delayed development of secondary sexual Introduction: characters The persistence of adolescent voice even after pu- 3. Psychogenic berty in the absence of organic cause is known as 4. Hero worship of older boy or sibling Puberphonia1. This condition is commonly seen 5. Excessive maternal protection in males. This is uncommon in females because 6. Non fusion of thyroid laminae laryngeal growth spurt occurs commonly only in 7. Increased laryngeal muscle tension causing males. According to Banerjee the incidence of laryngeal elevation Puberphonia in India is about 1 in 900,000 pop- Complaints: ulation 2.
  • The Use of Inhalation Phonation in the Voice Studio: a New Approach to Addressing MTD in Singers

    The Use of Inhalation Phonation in the Voice Studio: a New Approach to Addressing MTD in Singers

    The Use of Inhalation Phonation in the Voice Studio: A New Approach to Addressing MTD in Singers Kate Emerich Gordon and Ona Reed [Editor’s Note: A tutorial video illustrating procedures outlined in this article may be accessed on the official NATS YouTube channel, https://youtu.be/ uMgaW4ckuws.] INTRODUCTION inging is both an art and an athletic endeavor. It requires a perfect coordination of the respiratory, phonatory, and resonance systems for an optimized vocal production. However, just as athletes can experi- ence decreased performance because of a physical imbalance (e.g., Kate Emerich Gordon Smuscular injury or weakness), a singer can be challenged with a loss of range, power, vocal quality, and decreased ease of phonation with an imbalanced speaking or singing voice. Muscle tension dysphonia (MTD) is a voice disor- der related to muscular imbalance in and around the vocal mechanism.1 The muscle tension patterns in MTD can be significant in nature and even prevent normal phonation from taking place, which is why aphonia (the inability to produce sound) is often grouped with MTD as the letter A (MTD/A).2 Most singers experience a mild to moderate form of MTD, but it is possible for sing- ers to become aphonic because of extreme muscle tension patterns. Singers with MTD present with symptoms that include a high laryngeal carriage, Ona Reed hyperactive contraction of the ventricular folds, and an anterior-posterior squeeze from the arytenoid cartilages forward to the epiglottis.3 Symptoms of MTD include difficulty singing in a particular range of the singing voice, effortful voice production, fatigue and/or hoarseness after singing for a short period of time, and discomfort with voice use.
  • Exploring Intelligibility in Tracheoesophageal Speech: a Descriptive Analysis

    Exploring Intelligibility in Tracheoesophageal Speech: a Descriptive Analysis

    Western University Scholarship@Western Electronic Thesis and Dissertation Repository 6-19-2012 12:00 AM Exploring Intelligibility in Tracheoesophageal Speech: A Descriptive Analysis Lindsay E. Sleeth The University of Western Ontariio Supervisor Dr. Philip C. Doyle The University of Western Ontario Graduate Program in Health and Rehabilitation Sciences A thesis submitted in partial fulfillment of the equirr ements for the degree in Master of Science © Lindsay E. Sleeth 2012 Follow this and additional works at: https://ir.lib.uwo.ca/etd Part of the Speech Pathology and Audiology Commons Recommended Citation Sleeth, Lindsay E., "Exploring Intelligibility in Tracheoesophageal Speech: A Descriptive Analysis" (2012). Electronic Thesis and Dissertation Repository. 623. https://ir.lib.uwo.ca/etd/623 This Dissertation/Thesis is brought to you for free and open access by Scholarship@Western. It has been accepted for inclusion in Electronic Thesis and Dissertation Repository by an authorized administrator of Scholarship@Western. For more information, please contact [email protected]. EXPLORING INTELLIGIBILITY IN TRACHEOESOPHAGEAL SPEECH: A DESCRIPTIVE ANALYSIS (Spine title: Intelligibility in Tracheoesophageal Speech) (Thesis format: Monograph) by Lindsay E. Sleeth BHSc. Graduate Program in Health and Rehabilitation Science A thesis submitted in partial fulfillment of the requirements for the degree Master of Science School of Graduate and Postdoctoral Studies The University of Western Ontario London, Ontario, Canada © Lindsay Eileen Sleeth, 2012.