Gayle M. Belin, M.A., CCC-SLP
Speech Language Pathology Services
- Aka: GERD (Gastroesophageal Reflux) or LPR (Laryngopharyngeal Reflux)
- What It Is: Regurgitation or backflow of stomach acid up into the esophagus and sometimes spilling into the larynx.
- Symptoms: Burning sensation in the chest or throat, difficulty swallowing & lump in the throat sensation, hoarseness, chronic throat clearing, difficulty with singing high notes, some aspiration of varying severities; it has been implicated in some cases of asthma.
- Underlying Etiologies: Excess acidity, hiatal hernia, dysfunction of the lower esophageal sphincter.
- Treatment strategies
- Increase water intake.
- Do not eat within 3 hours of going to bed. In fact, don't even lie down within that same time frame. This allows the stomach to empty & acid production to decrease.
- Elevate the head of your bed 3-6 inches with blocks. Don't prop yourself up with pillows which bend you at the waist.
- Sleep on your right side since the opening to the stomach is on the left. This can help alleviate the backflow of acid into the esophagus & larynx while you sleep (nocturnal reflux).
- Take any medications for reflux that are prescribed by your doctor. Make sure to use them as directed!!
- Lose weight, if necessary.
- Stop smoking.
- Do not wear clothing tight around the waist.
- Avoid spicy, acidic, fatty, tomato-based foods (chocolate, citrus fruits & some juices), especially on an empty stomach, caffeinated beverages (colas, tea, coffee, & chocolate), all carbonated beverages, and mint in any form-candy or tea. Fatty foods take longer to digest. Spicy, acidic, and fried foods can irritate your digestive system.
- Avoid chewing on ice as this promotes flatulence.
- Avoid overeating as it puts pressure on your waist & can increase GERD.
- Communication impairment due to injury to the brain; may be characterized by the loss of ability to understand or express speech and language; may result from stroke, head trauma or other trauma to the neurological speech and language centers of the brain.
- Common Classifications of Aphasia (ASHA)
- A motor-sequencing disorder of speech/language production which may be acquired following stroke, head trauma or other brain damage; may also be developmental and present from birth.
- The process of putting sounds together to form words in speech.
- Articulation Disorder: A typical production of speech sounds characterized by substitutions, omissions, additions or distortions that may interfere with intelligibility.
ASHA (American Speech Language and Hearing Association)
- "The national professional, scientific, and credentialing association for audiologists, speech-language pathologists, speech, language, and hearing scientists, audiology and speech-language pathology support personnel, and students." (www.asha.org)
- Aka: Botulinum toxin
- It is a neurotoxic protein and, when injected, it can weaken the muscle temporarily.
- Used to treat various forms of Spasmodic Dysphonia
- Main muscle used for breathing, located just below the lungs.
- Dome-shaped sheath of a muscle, that separates the thoracic and abdominal cavities.
- A motor speech disorder whereby the musculature of the mouth, face and respiratory system may be weakened due to neurologic injury, such as stroke, head trauma, brain tumor, cerebral palsy and various dystrophies.
Foreign Accent Modification
- Changing one's accent or dialect to improve communication effectiveness.
- Emphasis on sound pronunciation of various consonants and vowels, as well as attention to stress, rhythm, and intonation of speech.
- May also include some vocabulary, but should not be mistaken for English as a Second Language Instruction.
GERD: See Acid Reflux
- Aka: Contact granuloma
- Small lesions or ulcerations that develop between the vocal processes of the arytenoid cartilages in the back part larynx.
- Typically results from irritation of the vocal fold tissues that may result from gastroesophageal reflux (GERD), laryngeal intubation during surgery or long term airway ventilation or excessive phonotrauma (e.g. hard glottal onset, excessive throat clearing and coughing).
- Aka: Loudness
- "Volume" is a term that is commonly misused as a synonym.
Larynx (voice box)
- A cartilaginous and muscular structure located at the top of the trachea (windpipe), in which the vocal cords are located.
- Aka: Cough drop
- Lozenges can help soothe throat irritation and/or coughs, encourage saliva production and come in both medicated and non-medicated forms.
- Lozenges with menthol or benzocaine can be irritating to the vocal folds. They create numbness and can mask pain so that an individual may not realize how much they are hurting their voice.
- Lozenges without menthol or benzocaine include Cold-eeze, Halls Breezers, Halls Defense, FontusTM Green Apple Throat Lozenges, Luden's Wild cherry, Smith Brothers, Thayers, and Zand Herbalozenges. (These lozenges are listed alphabetically; no recommendation or endorsement is implied.)
- Aka: ENT or Ear, nose, and throat doctor
- A medical doctor who specializes in the care of the ear, nose, and throat.
- Laryngologists specialize in the care of the throat, voice problems, etc.
- A progressive neurological condition characterized by tremor, muscle rigidity, and slow and imprecise movement.
- Individuals with this disease process often have a soft voice that is also slurred, imprecise, and difficult to understand. Swallowing difficulties can also accompany other symptoms.
Paradoxical Vocal Fold Movement
- Aka: VCD or Vocal Cord Dysfunction
- When the vocal cords close instead of open, such as when breathing (inhalation), and often misdiagnosed as asthma or exercise-induced asthma.
- Triggers include: acid reflux, exercise, temperature changes (cold and hot), smoking and second hand smoke, allergies, strong odors, neurological issues.
Reflux: See Acid Reflux
- A voice disorder characterized by involuntary movements or spasms of one or more muscles of the larynx during speech; may occur as vocal folds come together and/or apart.
- A hallmark symptom is a strained and strangled vocal quality.
- Aka: Windpipe
Ventricular vocal folds
- Aka: "False" vocal folds
- Located just above the "true" vocal folds
- Not typically used for voice production but are recruited when an individual has high levels of muscular tension in the larynx. Voice is then tight and harsh.
Videolaryngostroboscopy or Laryngovideostroboscopy
- Aka: VLS or LVS
- An examination procedure using fiberoptics that allows for visualization of the laryngeal structures (vocal folds, epiglottis, etc.)
- The patient is awake and may have a topical anesthetic.
- This allows for, not only examination of the structures, but also their movement during voice production.
Vocal Cord Paralysis
- The inability of one or both vocal cords to move. This may result from trauma to or pressure on the nerve or from neurological conditions such as stroke, head trauma, or degenerative disease.
- Behaviors and behavioral techniques that assist in producing and maintaining healthy voice. This may include, but are not limited to: adequate hydration, avoidance of smoking and 2nd hand smoke, vocal warm-ups as needed, and avoidance of any behavior that will traumatize the delicate vocal fold tissues.
Vocal Nodules or Polyps
- Nodules are benign (noncancerous) growths on both vocal cords that are caused by repeated and chronic trauma to the vocal fold tissues ("phonotrauma"). Initially, the vocal folds become swollen and these areas develop into more fibrous, callous-like growths which can interfere with vocal quality.
- Polyps are similar to nodules in formation and can occur on one or both folds. They can be widely based (sessile) or on a stalk (pedunculated). They can be associated with smoking (Reinke's edema).
- Signs and symptoms (some may or may not accompany these growths): vocal roughness or scratchiness, breathiness, harshness, some strain in voice production, lump in the throat, non-productive cough, occasional neck pain, lower vocal pitch and pitch range, voice fatigue.
- Production of sound typically emanating from the larynx and produced by the vibration of the vocal folds (aka: vocal cords).
- Abnormal or unusual production of pitch, vocal quality, tone, loudness, and/or resonance, which is inappropriate for an individual's age and/or gender. An individual may present with difficulties in some or all of the above-mentioned areas. Difficulties in respiration may play a big part in voice production.