Cases reported "Voice Disorders"

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1/6. Tracheo-tracheal puncture for voice rehabilitation after laryngotracheal separation.

    For patients with intractable aspiration, laryngotracheal separation (LTS) may be the only means of protecting the airway. The LTS prevents pulmonary compromise caused by aspiration; however, airway separation from the larynx also prevents laryngeal phonation. This case report suggests a supplemental procedure to the LTS, which maintains airway protection yet allows for laryngeal communication.
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ranking = 1
keywords = communication
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2/6. Inspiratory speech as a management option for spastic dysphonia. Case study.

    A case study is reported of a subject who has used inspiratory speech (IS) for 6 years as a means of overcoming the communication problems of long-standing adductor spastic dysphonia (ASD). The subject was studied to confirm his use of IS, determine the mechanisms of its production, investigate its effects on ventilatory gas exchange, and confirm that it was perceptually preferable to ASD expiratory speech (ES). Results showed that the production and control of a high laryngeal resistance to airflow were necessary for usable IS. voice quality was quantitatively and perceptually poor; however, the improved fluency and absence of phonatory spasm made IS the preferred speaking mode for both the listener and the speaker. Transcutaneous measurements of the partial pressures of oxygen and carbon dioxide in the subject's blood were made during extended speaking periods. These measurements indicated that ventilation was unchanged during IS, and that ventilation during ES was similar to the "hyperventilation" state of normal speakers. The reasons for the absence of phonatory spasm during IS are discussed, and the possibility of its use as a noninvasive management option for other ASD sufferers is addressed.
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ranking = 1
keywords = communication
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3/6. EMG biofeedback treatment of pediatric hyperfunctional dysphonia.

    A 9-year-old boy with a long history of impaired communication resulting from hyperfunctional dysphonia and vocal nodules had proven to be unresponsive to traditional voice therapy. In this study, he engaged in biweekly visual EMG biofeedback training to reduce laryngeal muscle tension. In a multiple baseline design across two responses with changing criteria, results demonstrated sequential stepwise reductions in muscle tension with each new criterion. Concomitant improvements were found in laryngeal aerodynamic functioning and in voice quality. The treatment also resulted in the elimination of the vocal nodules without surgical intervention. These effects were maintained at 6 month follow-up.
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ranking = 1
keywords = communication
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4/6. Neurogenic stuttering as a manifestation of stroke and a mask of dysphonia.

    R. L. was a 52-year-old man who was referred for an SLP consultation to determine the nature of his fluency disorder, whether or not treatment would be beneficial, and finally whether resumption of pre-trauma vocational status was feasible. The patient was involved in a motor vehicle accident with no resulting detectable trauma. However, shortly after the accident, R. L. developed a severe dysfluency that was later described as cortical stuttering. We reviewed the medical and rehabilitation work-up that attempted to determine whether the communication disorder was functional or organic in origin. Once the fluency disorder was determined to be caused by a suspected small, focal, hemispheric lesion, a five-month treatment program was undertaken that used a noval prosthetic approach to restore fluency. Once fluency was restored with the use of an artificial larynx, a residual anomia was detected and treated. The case of R. L. illustrates a stuttering that appeared to be caused by a combined neurogenic dyspraxic (vocal control), dysarthric (motor control), and dysnomic (word-finding) dysfluency. The literature on this issue was reviewed and the underlying mechanism of recovery was discussed.
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ranking = 1
keywords = communication
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5/6. nasal obstruction and human communication.

    nasal obstruction may cause a variety of communication disorders, particularly in children. The effects of nasal obstruction on hearing, speech, language, and voice are examined. methods for assessing the effects of nasal obstruction are delineated, and recommendations for therapeutic interventions are described.
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ranking = 5
keywords = communication
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6/6. Functional dysphonia in adolescence: two case reports.

    Reports of functional dysphonia in children and adolescents under 16 years of age are few. Approximately a dozen cases have been reported in the English literature over the past 35 years. Most of the articles appear in journals related to the fields of speech, hearing and communication with a few in the Otorhinolaryngologic journals. Published papers in psychiatric journals dealing with voice or speech disorders are virtually nonexistent. In children and adolescents the two most common varieties are the Whispering syndrome, which occurs predominantly in girls, and the Hysterical High Pitched Voice seen mostly in boys. This paper discusses these two varieties of functional dysphonia and presents a case example of each.
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ranking = 1
keywords = communication
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