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Voice
and Speech Speech
is a complex process that starts with
muscle movement, which involves:
- phonation
(voice)
- respiration
(breathing process)
- articulation
(throat, palate, tongue, lips, and teeth)
These muscle movements
are initiated, coordinated, and controlled by
the brain, and monitored through hearing and
touch.
Voice production,
or phonation, is generating
and modulating sound as part of the speech process.
Voice is created
in the vocal cords (or vocal folds) of the larynx.
The larynx, often
referred to as the voice box,
is a two-inch long tube-shaped organ located
in the neck at the top of the trachea
(windpipe). The cartilage in front of the larynx
is sometimes called the "Adam's apple."
The vocal
cords (or vocal folds)
are two bands of muscle that form a "V"
shape inside the larynx.
The area of the
larynx where the vocal cords are located is
called the glottis. The area
above the cords is called the supraglottis,
and the area below the cords is called the subglottis.
The epiglottis is a flap at
the top of the trachea that closes over the
larynx to protect it from food that is swallowed
into the esophagus.
Breath enters the
body through the nose or mouth, and then travels
to the larynx, trachea, and into the lungs.
It exits along the same path. Normally, no sound
is made by the vocal cords during breathing
or exhaling.
When a person talks,
the vocal cords tighten, move closer together,
and air from the lungs is forced between them.
This makes them vibrate and produces sound.
Source:
National Institute on Deafness and Other Communication
Disorders
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Spasmodic
Dysphonia
What
is Spasmodic Dysphonia?
Spasmodic dysphonia, also called laryngeal
dystonia, is a voice disorder. It is
characterized by involuntary spasms or movements
in the muscles of the larynx, which causes the
voice to break, and have a tight, strained,
or strangled sound.
Difficulties that
result from spasmodic dysphonia range from occasional
problems with saying a word or two to complete
inability to communicate.
Spasmodic dysphonia
most often affects women, particularly between
the ages of 30 and 50.
What are
the Different Types of Spasmodic Dysphonia?
There are three types of spasmodic
dysphonia:
-
adductor
spasmodic dysphonia
Characterized by sudden involuntary spasms
that cause the vocal cords to slam together
and stiffen. The spasms interfere with vibration
of the vocal cords and production of sound
is difficult. Stress can make spasms more
severe.
Speech sounds are strained and full of effort.
Spasms do not occur when whispering, laughing,
singing, speaking at a high pitch, or speaking
while breathing in.
-
abductor
spasmodic dysphonia
Characterized by sudden involuntary spasms
that cause the vocal cords to open. Vibration
cannot occur when cords are open so production
of sound is difficult. Also, the open position
allows air to escape during speech.
Speech sounds are weak, quiet, and whispery.
Spasms do not occur when laughing or singing.
-
mixed
spasmodic dysphonia
Characterized by symptoms of both adductor
and abductor spasmodic dysphonia.
What Causes
Spasmodic Dysphonia?
The exact cause of spasmodic dysphonia
is not known. Most cases are believed to be
caused by a nervous system disorder, and may
occur with other movement disorders. Spasmodic
dysphonia may be a genetic disorder, or may
begin following an upper respiratory infection,
injury to the larynx, a long period of voice
use, or stress.
How is
Spasmodic Dysphonia Diagnosed?
In addition to a complete medical history
and physical examination, examination of the
vocal folds by fiberoptic nasolaryngoscopy
may be performed. This procedure involves using
a lighted tube, passed though the nose into
the larynx to evaluate movement of the vocal
folds during speech.
Treatment
for Spasmodic Dysphonia:
Specific treatment will be determined
by the physician(s) based on:
-
patient’s age,
overall health, and medical history
-
extent of the
disease
-
expectations
for the course of the disease
-
patient’s tolerance
for specific medications, procedures, or therapies
-
patient’s opinion
or preference
The
goal of treatment is to re.duce symptoms of the
disorder. Surgery to cut one of the nerves of
the vocal fold has been used, as well as counseling.
Some success has been achieved with the injection
of the botulinum toxin directly into the affected
muscles of the larynx.
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