2. SPPA 2000 Voice Lecture Stephen Tasko The Voice & Voice Disorders SPPA 2000 Stephen Tasko

3. SPPA 2000 Voice Lecture Stephen Tasko What is voice? Do voice and speech mean the same thing? If not, how are they different?

4. SPPA 2000 Voice Lecture Stephen Tasko Source-filter theory simplified

5. SPPA 2000 Voice Lecture Stephen Tasko Same source, different filters

6. SPPA 2000 Voice Lecture Stephen Tasko Where is the voice produced? What anatomical structures do we need to produce voice?

7. SPPA 2000 Voice Lecture Stephen Tasko Location of Larynx

8. SPPA 2000 Voice Lecture Stephen Tasko

9. Larynx: View From Above back front True vocal fold esophagus epiglottis glottis

10. SPPA 2000 Voice Lecture Stephen Tasko Key Actions Move together Move apart TenseSlackenLengthenShorten Muscular Action on Vocal Folds Glottis closed (phonation) Glottis open (breathing)

11. SPPA 2000 Voice Lecture Stephen Tasko

12. How is voice produced? Essentials for producing voice Vocal folds must be approximated Vocal folds must be tensed Air pressure from respiratory system

13. SPPA 2000 Voice Lecture Stephen Tasko

14. How Do We Characterize Our Voice? PitchLoudnessRegisterQuality

15. SPPA 2000 Voice Lecture Stephen Tasko Why do men, women & children speak at different pitches? Men ↑ VF mass and length = ↓ pitch Women ↓ VF mass and length = ↑ pitch Children ↓ VF mass and length = ↑ pitch

16. SPPA 2000 Voice Lecture Stephen Tasko How Do We Vary Pitch? Make VF thinner and tenser = ↑ pitch Make VF thicker and slacker = ↓ pitch

17. SPPA 2000 Voice Lecture Stephen Tasko How Do We Vary Loudness? Respiratory Pressure –↑ pressure ↑ loudness Tighten the Valve –↑ tightening of valve = ↑ loudness

18. SPPA 2000 Voice Lecture Stephen Tasko What is a Vocal Register? Modal: Where we typically speak Falsetto: High pitched, thin voice Glottal fry: Low pitched, creaky voice

19. SPPA 2000 Voice Lecture Stephen Tasko What is Voice Quality?

20. SPPA 2000 Voice Lecture Stephen Tasko How Do We Describe Disordered Voice? General Clinical Terms PhonationDysphoniaAphonia

21. SPPA 2000 Voice Lecture Stephen Tasko Broad Types of Voice Disorders Organic Voice Disorders Neurological Voice Disorders Functional Voice Disorder

22. SPPA 2000 Voice Lecture Stephen Tasko How Do We Perform a Voice Assessment? Case History Clinical Evaluation –Voice Sample Collection –Instrumental Assessment Diagnostic Therapy DiagnosisPlanPrognosis

23. SPPA 2000 Voice Lecture Stephen Tasko What is the Range of Voice Treatment Options? Voice Therapy Medical Treatment Surgical Treatment Combination of above

24. SPPA 2000 Voice Lecture Stephen Tasko Organic Voice Disorders: Common Vocal Fold Pathologies

25. SPPA 2000 Voice Lecture Stephen Tasko Why do we get vocal fold pathologies? Vocal use patterns –Misuse –Abuse/phonotrauma Exposure to Laryngeal Irritants –Smoke –Pollutants –Acid reflux –Alcohol Infection –Bacterial –Viral Improper hydration Side effects from medication

26. SPPA 2000 Voice Lecture Stephen Tasko Normal Larynx

27. SPPA 2000 Voice Lecture Stephen Tasko Laryngitis

28. vocal fold nodules Following Treatment 3 months voice therapy Before Treatment

29. SPPA 2000 Voice Lecture Stephen Tasko Vocal Fold Polyps Following Treatment 6 months voice therapy surgery Before Treatment

30. SPPA 2000 Voice Lecture Stephen Tasko Vocal Fold Cyst Following Treatment 2 months surgery Before Treatment

31. SPPA 2000 Voice Lecture Stephen Tasko Other common pathologies Contact Ulcer Reinke’s Edema Intubation GranulomaLaryngeal papilloma

32. SPPA 2000 Voice Lecture Stephen Tasko Neurological Voice Disorders

33. SPPA 2000 Voice Lecture Stephen Tasko Vocal Fold Paralysis

34. SPPA 2000 Voice Lecture Stephen Tasko Vocal Tremor

35. SPPA 2000 Voice Lecture Stephen Tasko Spasmodic Dysphonia

36. SPPA 2000 Voice Lecture Stephen Tasko Functional Dysphonia (e.g. muscle tension dysphonia) Pre-Tx Pst-Tx