VOCAL QUALITY

Research Paper & Mock Voice Evaluation Report

Research Paper & Mock Voice Evaluation Report

Research paper/essay

Introduction To Particular Disorder

The intrinsic muscles are divided into respiratory and the phonatory muscles (the muscles of phonation). The respiratory muscles move the vocal chords apart and serve breathing. The phonatory muscles move the vocal cords together and serve the production of voice. Unilateral vocal fold paralysis occurs due to dysfunction of recurrent laryngeal or vagus nerve causes a breathy voice. The breathiness of voice is caused by glottic chink which allows air to escape when the patient attempts to speak. Normal voice production is dependent on proper glottal closure resulting from bilateral adduction of the vocal cords. This adduction of vocal folds combined with subglottic air pressure causes the vocal folds to vibrate causing phonation. (Hillel, 2006)

The most common cause of vocal fold motion impairment is injury to the recurrent laryngeal nerve, the nerve responsible for controlling the main muscles of the larynx. This may be due to injury, surgery, viral infection, a tumor pressing on the recurrent laryngeal nerve, or other causes. Occasionally, injury or diseases of the brain, including stroke, result in impaired motion. (Reisner, 2007)

Mechanical obstruction (problems with the muscles or cartilage around the larynx) can also result in vocal fold motion problems. The arytenoid cartilages can become "locked" and restrict movement. Scar tissue may also accumulate and inhibit vocal fold movement.

The Disease Process And Affect On Vocal Function Over Time

The vocal folds, because of the position in the airway, play a vital role in speech, swallowing, and breathing. In order to perform these functions normally, the laryngeal muscles must be able to abduct (open) and adduct (close) the folds. Vocal fold motion impairment is of two major types: unilateral (more common) and bilateral. These types differ in their seriousness, symptoms, and treatment. (Rusakow, 2009) Patients with unilateral paralysis may have a weak and "breathy" voice, and speaking may require considerable effort. Because the vocal folds are unable to close completely during swallowing, patients may also experience coughing and choking while eating or drinking. Patients with bilateral paralysis may experience these symptoms, but the possibility of a compromised airway is a more serious threat. (Tovar, 2006) The muscles which normally abduct the folds and provide for a patent airway are unable to function. Thus, the folds may remain adducted in the airway and block normal breathing.

Evaluation To Formulate A Viable Treatment Plan

In the patient with unilateral impairment, the left vocal fold fails to move at the same time as the right fold. These patients will also experience hoarseness and loss of voice quality. In the patient with bilateral vocal fold motion impairment, the vocal folds remain adducted (closed) at the midline and movement is minimal. This can lead to airway compromise and restriction of breathing. (Bielamowicza, 2004)

Medialization thyroplasty is a surgical procedure in which a small cut is made in the skin near the larynx and a small piece of thyroid cartilage ...