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Copyright, ii
Contents to the DVD, xi
Preface, xii
1. The Voice and Voice Therapy, 1
The Biological Function of the Larynx, 2
The Emotional Function of the Larynx, 3
The Linguistic Function of the Voice, 4
Voice Disorders in the Normal Population, 5
Kinds of Voice Disorders, 6
Organic Voice Disorders, 8
Neurogenic Voice Disorders, 8
Psychogenic Voice Disorders, 9
Muscle Tension Dysphonia, 9
Management and Therapy for Voice Disorders, 10
Summary, 13
Thought Questions, 13
2. The Normal Voice, 14
Normal Aspects of Voice, 15
Normal Processes of Voice Production, 15
Respiration, 16
Anatomy of Phonation, 25
Principles of Phonation, 41
Resonance, 48
Structures of Resonance, 48
Mechanism of Resonance, 49
Summary, 53
Thought Questions, 53
3. Organic Voice Disorders, 54
Cancer, 56
Congenital Abnormalities, 56
Laryngomalacia, 56
Subglottal Stenosis, 57
Tracheoesophageal Fistulas and Esophageal Atresia, 57
Contact Ulcers (Granulomas), 58
Cysts, 61
Endocrine Changes, 61
Hemangioma, 63
Hyperkeratosis, 63
Infectious Laryngitis, 64
Laryngectomy, 64
Leukoplakia, 65
Papilloma, 66
Pubertal Changes, 68
Reflux, 69
Sulcus Vocalis, 71
Webbing, 73
Summary, 74
Thought Questions, 74
4. Neurogenic Voice Disorders, 76
A Working View of the Nervous System, 77
The Central Nervous System (CNS), the Cortex, and Its Projections, 77
Pyramidal and Extrapyramidal Tracts, 78
The Peripheral Nervous System (PNS), 82
Flaccid Dysarthria, 87
Vocal Fold Paralysis, 87
Myasthenia Gravis, 92
Guillain–Barré, 93
Unilateral Upper Motor Neuron Dysarthria (UUMND), 93
Spastic Dysarthria, 94
Hypokinetic Dysarthria, 95
Parkinson’s Disease, 95
Hyperkinetic Dysarthria, 97
Spasmodic Dysphonia, 98
Essential Tremor, 104
Differences among Spasmodic Dysphonia, Essential Tremor, and Vocal Hyperfunction, 105
Huntington’s Disease, 106
Ataxic Dysarthria, 107
Mixed Dysarthria, 108
Amyotrophic Lateral Sclerosis (ALS), 108
Multiple Sclerosis (MS), 109
Traumatic Brain Injury, 110
Summary, 111
Thought Questions, 112
5. Functional Voice Disorders, 113
Psychogenic Voice Disorders, 114
Falsetto, 114
Functional Aphonia, 116
Functional Dysphonia, 118
Somatization Dysphonia (Briquet’s Dysphonia), 120
Excessive Muscle Tension Disorders, 120
Muscle Tension Dysphonia, 120
Reinke’s Edema, 122
Vocal Fold Nodules, 123
Vocal Fold Polyps, 125
Traumatic Laryngitis, 126
Ventricular Dysphonia, 127
Diplophonia, 130
Phonation Breaks, 130
Pitch Breaks, 131
Summary, 132
Thought Questions, 132
6. Voice Evaluation, 133
Screening for Voice Disorders, 134
Medical Evaluation for Voice Disorders, 135
Assessment, Evaluation, and Diagnosis of Voice Disorders by the Clinician, 138
Review of Auditory and Visual Status, 142
Case History, 142
Noninstrumental Assessment, 146
Instrumental Assessment, 150
The Clinical Voice Laboratory, 161
Clinical Instrumentation for Acoustic Analysis, 162
Clinical Instrumentation for Aerodynamic Analysis, 168
Three Case Studies Comparing Noninstrumental and Instrumental Assessment Approaches, 171
Summary, 178
Thought Questions, 179
7. Voice Therapy, 180
Voice Management and Therapy for Children, 181
Voice Therapy for Adolescents and Adults, 184
Voice Therapy Facilitating Techniques, 185
1. Auditory Feedback, 186
2. Change of Loudness, 189
3. Chant–Talk, 192
4. Chewing, 194
5. Confidential Voice, 196
6. Counseling (Explanation of Problem), 198
7. Digital Manipulation, 200
8. Elimination of Abuses, 203
9. Establishing a New Pitch, 205
10. Focus, 207
11. Glottal Fry, 211
12. Head Positioning, 213
13. Hierarchy Analysis, 215
14. Inhalation Phonation, 218
15. Laryngeal Massage, 220
16. Masking, 222
17. Nasal/Glide Stimulation, 224
18. Open-Mouth Approach, 226
19. Pitch Inflections, 228
20. Redirected Phonation, 230
21. Relaxation, 233
22. Respiration Training, 236
23. Tongue Protrusion /i/, 239
24. Visual Feedback, 241
25. Yawn–Sigh, 243
Summary, 246
Thought Questions, 246
8. Management and Therapy for Special Problems, 247
Management–Voice Therapy for Particular Populations, 248
The Aging Voice, 248
Deaf and Hard of Hearing, 252
Pediatric Voice Problems, 255
Professional Voice Users, 256
Transgender (Transsexual), 259
Management–Voice Therapy for Respiratory-Based Voice Problems, 261
Airway Obstructions, 261
Asthma, 262
Emphysema, 263
Faulty Breath Control, 264
Paradoxical Vocal Fold Movement, 265
Tracheostomy, 266
Management–Voice Therapy Following Laryngeal Cancer, 266
Facilitating Techniques, 270
Laryngectomy, 270
Counseling and Communication Options, 270
The Electrolarynx, 272
Traditional Esophageal Speech, 272
Tracheoesophageal Puncture Shunt (TEP), 273
Summary, 275
Thought Questions, 275
9. Therapy for Resonance Disorders, 276
Nasal Resonance Problems, 277
Hypernasality, 277
Hyponasality, 278
Assimilative Nasality, 278
Evaluation of Nasal Resonance Disorders, 279
The Oral Examination, 283
Laboratory Instrumentation, 284
Treatment of Nasal Resonance Disorders, 290
Therapy for Oral–Pharyngeal Resonance Problems, 301
Summary, 306
Thought Questions, 306
References, 307
Index, 335

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