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Evaluation and Treatment of Voice Disorders Part 1 Anatomy, History and Physical Exam
Robert Sataloff, M.D., is Professor of otolaryngology, head and neck Surgery – Thomas Jefferson University, Philadelphia, PA; adjunct professor of otolaryngology, Head and Neck Surgery – University of Pennsylvania School of Medicine, Philadelphia, PA. Thin, lubricated squamous epithelium lines the surface of the larynx, and is among the soft tissues of the larynx that are more complex than originally thought. The supraglottic vocal tract as well as the tracheobronchial tree, lungs, and thorax, the abdomen, the musculoskeletal system, and psychologic and neurologic causes can all play a role in voice disorders. The author describes the complex physiology of phonation, and stresses the importance of a comprehensive history. Questions include details of age; how and when the patient uses the voice; exposure to environmental irritants, and medication use. Some medications, says the author, can produce dehydration and laryngeal mucosal dryness. These questions, says Dr. Sataloff, can produce a diagnosis even before the physical examination. That examination, he says, should include evaluation of the ear, nose, and throat, as well as the teeth, neck and cranial nerves. All patients with voice disorders should have a laryngoscopy. For those with chronic dysphonia or lesions such as vocal nodules, he says, assessment may include strobovideolaryngoscopy, electroglottography, or laryngeal electromyography. The lecture provides several illustrations including a schematic representation of laryngeal examination, and the equipment used for objective voice evaluation. Read More from Dr. Sataloff and the Journal of Voice. |
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