Voice Disorders & Treatment Flashcards

A patient with a history of GERD presents with globus sensation, throat clearing, and mild dysphonia. Laryngoscopy reveals posterior commissure erythema and interarytenoid edema. This presentation is most consistent with:

Answer: Laryngopharyngeal reflux

Laryngopharyngeal reflux characteristically causes posterior laryngeal erythema, interarytenoid edema, globus, and chronic throat clearing.

Which instrumental assessment provides the MOST direct visualization of vocal fold mucosal wave dynamics during phonation?

Answer: Videostroboscopy

Videostroboscopy uses a strobe light synchronized to vocal frequency to create apparent slow-motion images of mucosal wave motion.

A 45-year-old teacher with muscle tension dysphonia demonstrates elevated laryngeal position and hard glottal attacks. Which therapy approach is LEAST appropriate as a starting point?

Answer: Pushing/pulling exercises

Pushing/pulling exercises increase laryngeal muscle tension and are contraindicated in muscle tension dysphonia where hyperfunction is already the problem.

Phonation threshold pressure (PTP) is defined as:

Answer: The minimum subglottal air pressure needed to initiate and sustain oscillation

PTP is the minimum lung pressure required to set vocal fold tissue into oscillation and is sensitive to changes in vocal fold hydration and stiffness.

Botulinum toxin injection for adductor spasmodic dysphonia is typically administered into the:

Answer: Thyroarytenoid/lateral cricoarytenoid muscles

Botox is injected into the thyroarytenoid (and sometimes lateral cricoarytenoid) muscle to weaken hyperadduction spasms in adductor spasmodic dysphonia.

A child with bilateral vocal fold nodules and a hyperfunctional voice pattern would MOST benefit from which initial treatment approach?

Answer: Indirect voice therapy addressing vocal hygiene and vocal load

Pediatric vocal fold nodules typically resolve with indirect therapy focused on reducing vocal misuse, improving hydration, and decreasing vocal load.

The s/z ratio is used clinically to identify:

Answer: Glottal insufficiency affecting phonation relative to airflow

An s/z ratio greater than 1.4 suggests the patient can sustain /s/ (airflow only) significantly longer than /z/ (voicing required), indicating glottal inefficiency.