Ways to think about voice disorders? Etiologic Correlates of Vocal Dysfunction Vocal misuse Vocal Abuse Inappropriate Function of Vocal Components Medically related etiologies Direct Surgery Indirect Surgery Chronic Illness and Disorder Primary disorder etiologies Cleft palate VP Insufficiency Cerebral Palsy and other neurologic disorders Trauma Personality-related etiologies Environmental Stress Identity Conflict Stemple, et al. (2014) SPPA 6400 Voice Disorders: Tasko

Classification of Pathologies and Disorders The overly simplistic approach Organic Voice Disorders Neurogenic Voice Disorders Functional Voice Disorders SPPA 6400 Voice Disorders: Tasko

Classification of Pathologies and Disorders The more thorough approach I. Structural Pathologies of the Vocal Fold II. Inflammatory Conditions of the Larynx Malignant Epithelial Dysplasia (a.k.a cancer) Benign Epithelial and LP Abnormalities Congenital and Maturational Changes Cricoarytenoid and Cricothryoid Arthritis Acute Laryngitis Laryngopharyngeal Reflux Chemical Sensitivity/Irritable larynx Syndrome Verdolini et al. (2006) SPPA 6400 Voice Disorders: Tasko

Classification of Pathologies and Disorders III. Trauma or Injury of the Larynx IV. Systemic Conditions Affecting Voice Internal Laryngeal Trauma External Laryngeal Trauma and Arytenoid Dislocation Endocrine Disorders Immunologic Disorders Verdolini et al. (2006) SPPA 6400 Voice Disorders: Tasko

Classification of Pathologies and Disorders V. Nonlaryngeal Aerodigestive Disorders Affecting Voice VI. Psychiatric & Psychological Disorders Affecting Voice Respiratory Disease Gastroesophageal Reflux Disease (GERD) Infectious Diseases of the Aerodigestive Tract Psychogenic Conversion Aphonia and Dysphonia Factitious Disorders or Malingering Gender Dysphoria or Gender Reassignment Verdolini et al. (2006) SPPA 6400 Voice Disorders: Tasko

Classification of Pathologies and Disorders VII. Neurologic Conditions Affecting Voice VIII. Other Disorders of Voice Use Peripheral Nervous System Pathology Movement Disorders Affecting the Larynx Central Neurologic Disorders Affecting Voice Vocal abuse, misuse, and Phonotrauma Vocal Fatigue Muscle Tension Dysphonia (Primary & Secondary) Ventricular Phonation Paradoxical Vocal Fold Motion Verdolini et al. (2006) SPPA 6400 Voice Disorders: Tasko

Occurrence Rates of Voice Disorders Source: Manitoba Centre for Health Policy SPPA 6400 Voice Disorders: Tasko

Occurrence Rates of Voice Disorders Roy et. al (2004) JSLHR 47 281-93. SPPA 6400 Voice Disorders: Tasko

Occurrence Rates of Voice Disorders SPPA 6400 Voice Disorders: Tasko Roy et al. (2004)

Occurrence Rates of Voice Disorders Common Problems^ Males edema polyps Granuloma papilloma Females nodules psychogenic dysphonia * *Roy et al. (2007) ^Coyle et al. (2001) SPPA 6400 Voice Disorders: Tasko

What about the young and the old? Elderly (65-94 years)* Lifetime prevalence: 47% Current problem: 29% Negative quality of life Largest treatment seeking group  Common problems Vocal fold paralysis Cancer Presbyphonia Children^ Current problem: 6-23% Most common problems Vocal nodules Vocal fold paralysis Subglottic stenosis Laryngomalacia Functional voice problems *Roy et al. (2007) ^ multiple sources SPPA 6400 Voice Disorders: Tasko