SLP Voice Disorders & Treatment 2 — Questions and Answers
Question 1: A patient presents with a breathy voice quality and bowing of both vocal folds visible on laryngoscopy. This pattern is most consistent with:
- Spasmodic dysphonia
- Presbylaryngis (Correct answer)
- Reinke's edema
- Muscle tension dysphonia
Correct answer: Presbylaryngis
Presbylaryngis (aging larynx) is characterized by vocal fold bowing, atrophy, and resultant breathy voice due to incomplete glottal closure.
Question 2: Which behavioral voice therapy technique directly targets reducing excessive laryngeal muscle tension by modifying head and neck posture?
- Resonant voice therapy
- Laryngeal manual therapy (Correct answer)
- LSVT LOUD
- Semi-occluded vocal tract exercises
Correct answer: Laryngeal manual therapy
Laryngeal manual therapy involves hands-on manipulation to reduce hypertonic laryngeal musculature and reposition the larynx.
Question 3: A singer reports pitch breaks and voice fatigue after extended performance. Stroboscopy shows a left-sided vocal fold polyp with irregular mucosal wave. The MOST appropriate initial management is:
- Immediate microlaryngoscopy
- Voice rest followed by behavioral voice therapy (Correct answer)
- Botulinum toxin injection
- Proton pump inhibitor therapy alone
Correct answer: Voice rest followed by behavioral voice therapy
Initial conservative management with voice rest and behavioral therapy is recommended before surgical intervention for vocal fold polyps, particularly in professional voice users.
Question 4: The maximum phonation time (MPT) is primarily used to assess:
- Vocal pitch range
- Glottal efficiency and respiratory support (Correct answer)
- Resonance quality
- Laryngeal sensation
Correct answer: Glottal efficiency and respiratory support
MPT measures how long a patient can sustain a vowel on one breath, reflecting the combined efficiency of laryngeal valving and respiratory support.
Question 5: A patient with unilateral vocal fold paralysis in the paramedian position most likely presents with which voice quality?
- High-pitched strained voice
- Breathy, weak voice with diplophonia (Correct answer)
- Harsh low-pitched voice
- Normal voice with occasional pitch breaks
Correct answer: Breathy, weak voice with diplophonia
Paramedian paralysis results in incomplete glottal closure, causing breathiness, reduced loudness, and diplophonia due to asymmetric vibration.
Question 6: Which of the following is a hallmark acoustic characteristic of adductor spasmodic dysphonia?
- Continuous breathiness throughout connected speech
- Intermittent voice breaks on voiced sounds with strained quality (Correct answer)
- Elevated mean fundamental frequency
- Reduced shimmer values
Correct answer: Intermittent voice breaks on voiced sounds with strained quality
Adductor spasmodic dysphonia produces hyperadduction spasms causing intermittent strained-strangled voice breaks, especially on vowel-initiated words.
Question 7: Resonant voice therapy targets voice production primarily by:
- Increasing subglottal air pressure
- Achieving forward oral vibratory sensations with easy glottal closure (Correct answer)
- Strengthening thyroarytenoid muscle contraction
- Reducing fundamental frequency
Correct answer: Achieving forward oral vibratory sensations with easy glottal closure
Resonant voice therapy trains patients to perceive oral/facial vibration while maintaining gentle, nearly adducted vocal fold posture for efficient, low-effort phonation.
SLP Voice Disorders & Treatment 2
A patient presents with a breathy voice quality and bowing of both vocal folds visible on laryngoscopy.
This pattern is most consistent with: