Particular populations

Respiratory-Based problems

Laryngeal cancer

The aging voice

Deaf and hard of hearing

Pediatric

Professional voice users

Transgender

Airway obstructions

Asthma

Emphysema

Faulty breath control

PVFM

Tracheostomy

Medical intervention

Laryngectomy

Counseling and communication options

Voice is not affected in a sensorineural hearing loss

Until the loss exceeds 50 dB in frequencies under 2000 Hz

Voice charateristcs in deaf or profoundly hard of hearing people

Elevated F0 Varied pitch and loudness changes Downward formant shifts Resonance variations

Speech characteristics of those people Slower rate of speech by prolonging vowels Variations in the prosody or melody of speech

Voice training for the severely hearing-impaired people should not begin

Until efforts are made to provide needed amplification.

Awareness of voice

Soft ware Cue arrows

Fingers

Visual feedback

tactile feedback

2 common causes Structural and lesion mass airflow

interference Abnormal laryngeal movement

interference

2 types of airway obstructions Airflow interference Vocal fold paralysis

2 common causes Infectious

Epiglottis and supraglottal structures Result of bacterial infection

Subglottal obstruction Croup – a viral disease

Noninfectious – space occupying lesions Carcinoma Large cysts

treaments Infectious

Antibiotic therapy Corticosteroids etc.

Noninfectious – space occupying lesions Radiations therapy Surgical reduction or removal of the lesions

Mostly is larngeal paralysis

2 common types Unilateral

Contributes to some compromise of the open airway

Bilateral Bilateral abductor paralysis

A life-threatening obstacle of the open airway

3 common causes Organic disease Functional misuse Both of them

Treatments Respiration training!!!

Nonorganic disorder of the upper airway Both true and false VFs

Exhibiting paradoxical function of closure on

Inspiration Expiration Combination of them

Symptoms of respiratory distress do not respond to treatment for asthma

An excellent description and photograph of larynx during a PVFM inspiration

The membranous portion of the folds adducted

With a posterior triangular glottal chink

3 common causes Psychogenic

In conversion reaction Visceral (本能的 )

Related to irritation from LPR Upper airway sensitivity

Neurological A form of laryngeal dystonia

Aware of abnormal and normal VF positioning during inspiration and expiration

Voice therapy Yawn sign Nasal inspiration Working on /s/ duration Use of diaphragmatic-abdominal

breathing Videoendoscopic biofeedback