Fast Track Treatment for Puberphonia
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Psychogenic Voice Disorders Literature Review, Personal Ex
ISSN: 2643-4059 Clarós et al. Int J Depress Anxiety 2019, 2:015 DOI: 10.23937/2643-4059/1710015 Volume 2 | Issue 2 International Journal of Open Access Depression and Anxiety REVIEW ARTICLE Psychogenic Voice Disorders Literature Review, Personal Ex- periences with Opera Singers and Case Report of Psychogenic Dysphonia in Opera Singer Pedro Clarós1*, Agata Karlikowska1,2, Astrid Clarós-Pujol1, Andrés Clarós1 and Carmen Pujol1 1Clarós Clinic Barcelona, Spain 2Scholarship Clarós Clinic, Cracow, Poland Check for *Corresponding author: Pedro Clarós, Clarós Clinic Barcelona, Spain, ORCID: 0000-0002-7567-0370 updates others do not perceive it as abnormal [2]. Abstract The point of this article is to make a diagnosis of psycho- Organic speech or voice disorder has structural or logical voice disorders easier by reviewing germane to the neurological components that cause the speech distur- subject literature. Current view on terminology, classifica- bance (e.g. vocal nodules, polyps, hematoma of vocal tion, clinical manifestation and underlying psychological folds, structural changes in the larynx due to aging, vo- background of this rare condition is given. Secondly our aim cal tremor, spasmodic dysphonia, or paralysis of vocal is to asses prevalence ratio of psychological voice disor- ders in a group of 1520 professional opera singers-people folds, among others). with the most challenging voice effort among professional On the contrary, a functional speech disorder is a voice users. Our findings contradict common belief of high occurrence rate of this disorder among opera singers. Cha- voice impairment that is caused by underlying psycho- racteristics of this professional group are discussed and a logical process with no organic pathology (or a non-se- short example case report is described. -
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. -
Mutational Falsetto
Mutational Falsetto Kristine Stanton What is Mutational Falsetto? | Mutational Falsetto: a post- adolescent male continuing to have a preadolescent voice (Stemple et al., 2000). | Juvenile Voice: a post-adolescent female having the vocal qualities of a child (Nicolasi et al., 2004). | AKA: Functional Falsetto, Puberphonia, Persistent Falsetto (Nicolasi et al., 2004). What kind of Voice Disorder is Mutational Falsetto? | Functional and | Psychogenic | Why??? z There are typically no physical anomalies z Often it is related to emotional or psychological factors Demographic | Male Dominance z Young men between age 11-15 (Dagli et al., 2008) z 1/900,000 men per year (Pau & Murty, 2001) | Juvenile Voice is very rare (Hedge, 2001) Signs and Symptoms | Increased pitch or fundamental frequency | Weak, breathy, hoarse voice | Pitch breaks | Low intensity (Dagli et al., 2008) | Psychological symptoms Etiology | Resisting change of puberty | Habitual pitch | Dislike new pitch after puberty z New pitch does not match personality | Want to remain young | More identification with females (Hedge, 2001) | Singing voice | Embarrassment (Stemple et al., 2000) | Anatomical differences (Lim et al., 2007) Diagnosis | Case History | Assessment of vocal quality and pitch | Laryngostroboscopy | Psychological Assessment Treatment of Mutational Falsetto Treatment Approach Author(s)/Year Subject(s) Method(s) Result(s) Validity Surgical Pau, H. & 24 year Surgical lowering of the 6 weeks post surgeryÆwent Clinical Case StudyÆ Murty, G.E., old male hyoidÆlowering of -
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. -
Puberophonia-Surgical Management with Modified Ishiki Thyroplasty Type III
Available online a t www.scholarsresearchlibrary.com Scholars Research Library Der Pharmacia Lettre, 2014, 6 (2):77-81 (http://scholarsresearchlibrary.com/archive.html) ISSN 0975-5071 USA CODEN: DPLEB4 Puberophonia-surgical management with modified ishiki thyroplasty type III K. Ravi Department of ENT, Guntur Medical College, Guntur, India _____________________________________________________________________________________________ ABSTRACT The case consisted of a young male with mutational dysphonia, who aged 25years. The speaking fundamental frequencies (SFFs) at the time of the initial diagnosis was174.6. In this patient, voice therapy proved ineffective; therefore, surgery was considered. In the anterior-posterior compression test performed preoperatively in this patient, the voice became low-pitched. The SFFs decreased postoperatively to 106.9, Hz, in this patient. Type 3 thyroplasty (TP3) is effective for the treatment of patients with mutational dysphonia in whom voice therapy proved unsuccessful. The SFF of men is high in childhood. At the time of the second pubescent sexual orientation, the frequency usually decreases. However, in some cases, the high-pitched voice of childhood may persist without successful switch to a low-pitched voice during puberty. Thus, there are rare cases of adults with a high-pitched boyish voice. Voice therapy is usually effective for the treatment; however, it may fail in some cases. We performed TP3 for subjects in whom voice therapy proved ineffective. With TP3, the tension of the vocal folds decreases and the voice becomes low-pitched. Key words: Mutation; Voice therapy; Kayser-Gutzmann method; Androgen; Phonosurgery; Framework surgery _____________________________________________________________________________________________ INTRODUCTION The persistence of adolescent voice even after puberty in the absence of organic cause is known as puberphonia[1]. -
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 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
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. -
Hoarseness in Children 1Mary Worthen, 2Swapna Chandran
IJHNS Mary Worthen, Swapna Chandran 10.5005/jp-journals-10001-1278 REVIEW ARTICLE Hoarseness in Children 1Mary Worthen, 2Swapna Chandran ABSTRACT thinking in vocal fold pathology leading to hoarseness and recent advances in diagnosis and management. Background: The prevalence of pediatric dysphonia ranges from 6-23%. Chronic dysphonia can negatively affect the lives of children physically, socially, and emotionally. The body of ASSESSMENT OF DYSPHONIA literature continues to grow regarding the pathophysiology and Perceptual analysis is a key component of voice evaluation management of dysphonic children. in children, and several tools are currently available for Methods: This article presents a relevant literature review of assessing these qualities.3 Perceptual analysis of voice by vocal fold pathology leading to hoarseness and recent advances in diagnosis and management. Articles were retrieved using the patient, the parent, the clinician and speech language a selective search in PubMed employing the terms such as pathologist is important in the comprehensive assessment “hoarseness in children,” “pediatric dysphonia.” of pediatric hoarseness. Parental questionnaires such as Results: 42 articles from the past decade were reviewed that the Pediatric Voice outcome Survey, the Pediatric Voice- include information regarding the etiology, assessment, and Related Quality of Life questionnaire, and the Pediatric treatment of children with dysphonia. Voice Handicap Index are available. In these surveys, the Conclusion: The care of a child with a voice disorder can be child’s self-evaluation is not considered. Verduyckt et al complex and requires a multi-disciplinary approach. Current developed a questionnaire to analyze the discriminatory technological, pharmaceutical, and therapeutic advances have capacity of 5- to 13-year-old dysphonic children. -
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
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 Dr
Puberphonia Dr. Anagha A. Joshi What is puberphonia? Puberphonia is also called as Mutational Falsetto, and is the inappropriate persistence of higher- pitched prepubertal voice, much beyond puberty. In the majority of cases of puberphonia, the larynx is anatomically and physiologically normal. Is it seen only in males? It is seen in both males and females, but it is more common in men and also more noticeable in men than in women. During puberty, anatomical changes such as enlargement of the larynx (voice box), thickening and lengthening of vocal folds, occur in the larynx. Larynx descends and grows significantly larger in males which often results in a visible laryngeal prominence on the neck (Adam’s Apple). All this results in a decrease in pitch in both males and females. These changes are more significant in males than in females and contribute to a deepening of the voice, characteristic of pubescent males. On average, the male voice deepens by one octave while the female voice lowers by a few semitones. Men are expected to speak in a much lower pitch than women, and women typically speak in a much higher pitch. Hence the persistence of a high-pitched voice in adult- hood is more noticeable in men than in women. What is its cause? In the majority of cases of puberphonia, the larynx is anatomically and physiologically normal, and it is due to psychological reasons such as emotional stress, self- consciousness resulting from an early breaking of the voice. It is rarely due to immaturity of the larynx or vocal cords.