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Infant vocal tract?
- shorter VT
- velum & epiglottis in close proximity
- VFs have not developed a VL, there are no layers, thick cover, e/ more vasularity
- Arytenoids are disproportinately large
- laryngeal position is high
- hyoid bone and thyroid cartilage are contiguous
-
Common voice disorders in children?
- Fund. freq high at infancy (55 Hz) but slowly lowers as ages
- children may have greater jitter, less vocal control
- Ps higher than for adults, lower mean airflow rates
- max phonation times are lower until puberty
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Congenital Anomalies:
___? soft cartilages, collapse of structures into airway
stridor
surgery if airway is obstructed
w/o surgery it will resolve on its own
usually detected at birth
Laryngomalacia
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Congenital Anomalies:
__? narrowing in trachea
if it involves cartilage and airway is obstructed, surgery is necessary
if it involves soft tissue only, it may resolve spontaneously
Subglottocic stenosis
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Congenital anomalies?
- laryngeal Paralyses
- laryngeal Web
- Congenital Cysts
- Vocal Fold Papilloma
-
Signs of congenital anomalies?
- stridor
- dysphonia
- difficulty breathing
- abnormal cry
- coughing, choking
-
Acquired disorders:
___: most common acquired disorder in children- accounts for 50% of acquired disorders?
__: trauma to RLN
__:
- VF nodules
- VF paralysis
- Larngopharyngeal reflux
-
Tx of nodules in children?
____ approach-
__?
__?
__?
Trend?
- conservative - no surgery
- involve family, teacher
- ID and modify causal behaviors
- minimize excessive inappropriate vocal behaviors
trend- adults who had nodules as children seem to have a higher incidence of voice problems
-
Geriatric Voice:
VF characteristics in persons ___?
what happens?
> 65 y/o
- cartilages calcify
- blood flow decreases
- lamina propria thickens: less elastin and collagen, more fibrotic tissue
- atrophy of muscle
- decreased neuronal firing rates
-
Geriatric Voice:
Perceptual?
- varies e/ gender
- pitch higher in males, lower in females
- hoarseness
- breathiness
- decr freq and intensity ranges
-
Geriactric voice
Acoustic?
- greater Fo variability
- jitter
- decr intensity variability
- slower speaking rate
-
Geriatric Voice:
Aerodynamics?
- smaller vital capacity
- decr lung pressure
- greater peak airflow and greater air leakage
- greater open quotient
- decr MFDR
-
Geriatric Voice
Laryngoscopic?
- bowing, incomplete closure, posterior gap
- atrophy and thinning of VFs
- edema
- Decr mucosal wave and amplitude of vibration
- incr VF stiffness
- incr aperiodicity
-
Geriatric Voice
most common disorders?
- laryngeal cancer (men)
- VF paralysis (women)
- Edema
- Nodules and Polyps
many voice problems in elderly are not caused by aging (4%) but by disease
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