Evaluation Tools
Paradoxical vocal fold movement (PVFM) is characterized by innappropriate adduction of the vocal folds during inspiration (Murry, Tabaee, & Aviv, 2004). Other names for this syndrome include Munchausen’s stridor, vocal cord dysfunction, paradoxical vocal cord motion, and irritable larynx syndrome. Some patients who present with dyspnea, strior and airway obstruction have PVFM. Patients with a… read more
Definition, Causes and Symptoms of Muscle Tension Dysphonia Muscle tension dysphonia (MTD) is also called functional dysphonia. However, muscle tension dysphonia is more appropriate and can be used for an ICD-9 code for insurance purposes. It is a voice disorder in which one or more laryngeal muscle sets are overactive, causing voice fatigue and discomfort. High risk individuals include… read more
VOCAL FOLD NODULES: DEFINITION, SYMPTOMS AND TREATMENT Definition of Vocal Fold Nodules Vocal fold nodules are benign (noncancerous) growths on both vocal cords that are caused by vocal abuse. They most often are bilateral and occur at the junction of the anterior one-third and the posterior two-thirds of the vocal folds. They are also called… read more
A More In-Depth Look at Causes for Adult Voice Disorders In general, there are five categories that characterize the underlying causes of the majority of voice disorders; in decreasing order of frequency, these are: Infectious and inflammatory conditions Vocal misuse and abuse syndromes Benign and malignant growths Neuromuscular diseases Psychogenic conditions. 1.… read more
VOICE DISORDERS Voice disorders are generally characterized by an abnormal pitch, loudness, and/or vocal quality resulting from disordered laryngeal, respiratory, and/or vocal tract functioning. Voice disorders range from a mild hoarseness to complete voice loss and may limit the intelligibility or effectiveness of oral communication. Voice disorders can occur for a variety of reasons. It can be… read more
Comparison of the Fiberoptic Endoscopic Evaluation of Swallowing with the Modified Barium Swallow Study FEES is preferable to video swallow study when: A more conservative examination than videofluoroscopy is required because of concerns about aspiration of barium, food, and/or liquid; or Need to assess fatigue or swallowing status over a meal; or Repeat examination… read more
Pharyngeal Stage The SLP will be looking at the function of the swallowing at the oral, pharyngeal and part of the esophageal phase during an MBS. Here are some pharyngeal deficits to look out for when performing an MBS: Inability to initiate the swallow in a timely and coordinated manner- occurs if the bolus rolls… read more
What to Look for During the Video Swallow Study: Oral Phase SLP’s should compare the normal swallow to the patient’s swallowing. Here is a video of the normal swallow. Oral Phase Anterior spillage- Patients may have difficulty containing the liquids in the oral cavity due to poor lip seal. Decreased mastication- due to weakness… read more
DIFFUSE ESOPHAGEAL SPASMS are abnormal contractions of the muscles in the esophagus (the tube that carries food from the mouth to the stomach). These spasms do not move food effectively to the stomach because there is intermittent loss of the peristaltic wave. The lower esophageal sphincter is normal. The dysphagia is typically intermittent and for both… read more
Diagnostic Tools for Esophageal Dysphagia Esophagram (Barium Swallow Study) Double-contrast esophagram is usually the first specific diagnostic test in the evaluation of esophageal dysphagia. It can detect subtle narrowing or esophageal webs that may not be evident with endoscopy. Endoscopy This is the procedure of choice to evaluate the mucosa of the esophagus. It… read more
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