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Hoarseness of Voice and voice disorders

Hoarseness of Voice and voice disorders. HOARSENESS. ROUGHNESS OF VOICE RESULTING FROM VARIATIONS OF PERODICITY AND/OR INTENSITY OF CONSECUTIVE SOUND WAVES. HOARSENESS. NORMAL VOICE 1.VOCAL CORDS(VC) SHOULD BE ABLE TO APROXIMATE PROPERLY WITH EACH OTHER 2.PROPER SIZE AND STIFFNESS

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Hoarseness of Voice and voice disorders

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  1. Hoarseness of Voice and voice disorders

  2. HOARSENESS • ROUGHNESS OF VOICE RESULTING FROM VARIATIONS OF PERODICITY AND/OR INTENSITY OF CONSECUTIVE SOUND WAVES

  3. HOARSENESS • NORMAL VOICE 1.VOCAL CORDS(VC) SHOULD BE ABLE TO APROXIMATE PROPERLY WITH EACH OTHER 2.PROPER SIZE AND STIFFNESS 3.ABILITY TO VIBRATE REGULARLY IN RESPONSE TO AIR COLUMN

  4. AETIOLOGY

  5. DIAGNOSIS

  6. DYSPHONIA PLICA VENTRICULARIS (VENTRICULAR DYSPHONIA) • VOICE IS PRODUCED BY VENTRICULAR FOLDS • VOICE IS ROUGH ,LOW PITCHED AND UNPLEASANT • SECONDARY TO IMPAIRED FUNCTION OF THE TRUE CORD OR FUNCTIONAL

  7. DIAGNOSIS • ON ILS/FLEXIBLE SCOPY FALSE CORDS APPROXIMATE OBSCURING THE VIEW OF TRUE CORDS

  8. TREATMENT TREAT THE CAUSE VOICE THERAPY PSYCHOLOGICAL COUNCELLING

  9. FUNCTIONAL APHONIA • FUNCTIONAL DISORDER • SEEN IN EMOTIONALLY LABILE FEMALES • AGE 15-30 • SUDDEN ONSET WITHOUT ANY OTHER LARYNGEAL COMPLAINTS • COMMUNICATES WITH WISPER

  10. ON EXAMINATION • VOCAL CORDS ARE SEEN IN ABDUCTED POSITION AND FAIL TO ADDUCT ON PHONATION • ADDUCTION CAN BE SEEN WHEN PT COUGHS – INDICATES (N) ADDUCTOR FUNCTION

  11. TREATMENT • REASSURE • PSYCHOTHERAPY

  12. PUBERPHONIA (Mutational Falsetto voice) • IN MALES AT PUBERTY THE VC LENGTHEN AND VOICE CHANGES TO LOWER PITCH • FAILURE OF THIS CHANGE LEADS TO PERSISTENCE OF CHILDHOOD HIGH PITCHED VOICE.

  13. CLINICAL FEATURES • SEEN IN BOYS WHO ARE EMOTIONALLY IMMATURE • FEEL INSECURE AND SHOW EXCESSIVE FIXATION TO THEIR MOTHERS • PSYCHOLOGICALLY THEY SHUN TO ASSUME MALE RESPONSIBILITIES • (N) PHYSICAL –SEXUAL MATURITY

  14. TREATMENT • VOICE TRAINING –TO PRODUCE LOW PITCHED VOICE • PRESSING THE THYROID IN BACKWARD AND DOWNWARD DIRECTION RELAXES THE STRECHED CORD. (GUTZMANN’S PRESSURE TEST) • PROGNOSIS IS GOOD.

  15. PHONASTHENIA • WEAKNESS OF VOICE DUE TO FATIGUE OF PHONATORY MUSCLES • THYROARYTENOID AND INTER ARYTENOID AFFECTED • SEEN IN ABUSE OR MISUSE OF VOICE • EASY FATIGUABILITY OF VOICE

  16. TYPES & TREATMENT • Elliptical space- thyroarytenoid weakness. • Triangular gap near posterior commissure- interarytenoid. • Key hole app- Both thyroid and interarytenoid. • Rx-Voice rest ,vocal hygiene.

  17. Hyponasality (Rhinolalia Clausa) • Lack of nasal resonance for words like m, n, ng. • Due to blockage of nose / nasopharynx. • Common cold, nasal allergy, nasal polypi, nasal growth, adenoids, nasopharyngeal mass, habitual.

  18. Hypernasality (Rhinolalia Aperta) • Words with little nasal resonance are resonated through nose. • Failure of nasopharynx to cut off from oropharynx / abnormal communication b/w oral & nasal cavities. • Velopharyngeal insufficiency, cleft palate, paralysis of soft palate, post-adenoidectomy, oronasal fistula, habitual

  19. Stuttering • Disorder of fluency of speech - hesitation to start, repetitions, prolongations or blocks in the flow of speech • Well-established- may develop secondary mannerisms - facial grimacing, eye blink and abnormal head movements.

  20. Too much attention/ child reprimanded by parents & peers- behaviour pattern may become fixed - may develop into an adult stutterer. • Education of parents- not to overreact to child's dysfluency in early stages of speech development.

  21. Treatment • Speech therapy and Psychotherapy- improve his image as a speaker and reduce his fear of dysfluency.

  22. THANK YOU

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