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organic voice disorders 2

organic voice disorders 2. - Contact ulcers(granulomas) -Reflux - Webbing. topics. Contact Ulcers( granulomas ). Cause/etiology Hard glottal attack along with throat clearing and coughing Laryngopharyngeal reflux (most common cause) Postnasal drip Endotracheal intubation

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organic voice disorders 2

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  1. organic voice disorders 2

  2. -Contact ulcers(granulomas) -Reflux -Webbing topics

  3. Contact Ulcers(granulomas)

  4. Cause/etiology • Hard glottal attack along with throat clearing and coughing • Laryngopharyngeal reflux (most common cause) • Postnasal drip • Endotracheal intubation • Surgery on the VFs • Teflon granuloma of the larynx • Removal of cysts 1、Contact Ulcers (granulomas)

  5. Segmentation of VFs • The anterior two - thirds • Muscle - vocalis portion of the thyroarytenoids • Menbrane • Posterior third • Arytenoids • Menbrane 1、Contact Ulcers (granulomas)

  6. Location • Medial aspect of the vocal processes of the arytenoid cartilages • Bilateral (mostly) • Typical symptoms • Vocal fatigue - after prolonged vocalization • Hoarseness or roughness • Pain in laryngeal area or/and one ear 1、Contact Ulcers (granulomas)

  7. 1、Contact Ulcers (granulomas) Contact ulcers with granulomas

  8. Treatments 1、Contact Ulcers (granulomas)

  9. Treatments 1、Contact Ulcers (granulomas)

  10. The focus of voice therapy • Elevate pitch • Greater mouth and jaw relaxation • Lower level of volume • Eliminate all traces of excessively hard glottal attack 1、Contact Ulcers (granulomas)

  11. Attention • If surgical revision of the larynx has resulted in a better voice, and then months or years afterwards the voice deteriorates, the larynx should be reexamined using endoscopy or stroboscopy in order to identify possible reactive granuloma 1、Contact Ulcers (granulomas)

  12. Reflux

  13. Location • Lower esophageal sphincter • Upper esophageal sphincter • Types • GERD - Gastroesophageal reflux disease • LPR or EER- Laryngopharyngeal reflux or Extraesophageal reflux 2、Reflux

  14. 2、 Reflux

  15. 2、 Reflux

  16. Symptoms 2、 Reflux

  17. Examinations 2、 Reflux

  18. Treatments 2、 Reflux

  19. Behavioral therapy • Elevating the head of the bed • Remaining upright at least 60 mins after meals • Avoid spicy food • No exercise after eating • Cutting down caffeine, carbonated drinks and alcohol, esp afternoon and evening 2、 Reflux

  20. Behavioral therapy • Don’t drink too much water right before bed • No activities that compress the abdomen • Weight loss • Wearing looser clothing around the waist • Eliminating smoking 2、 Reflux

  21. Pharmacy • PPI (proton - pump inhibitor 质子泵抑制剂) • Prokinetic agent 胃肠蠕动促进剂 • Surgery • Surgical laparoscopic fundoplication (腹腔镜下胃底折叠术) 2、 Reflux

  22. Webbing

  23. Types • Congenital • Acquired • Cause/etiology • Chromosome 22q deletion - Congenital • Bilateral trauma of the medial edges of the VFs – Acquired • Bilateral surgery (laryngeal or tracheal) • External trauma 3、Webbing

  24. Location • Anterior one-third of VFs (mostly) • Typical symptoms • High - pitched rough sound • Shorter length of VFs • Shortness of breath • Seriously compromising the open glottis 3、Webbing

  25. 3、Webbing Webbing

  26. Examinations 3、Webbing

  27. Treatments 3、Webbing

  28. Its all for today!

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