《嗓音障碍》特殊儿童教育课件Voice6

1、organic voice disorders 3topics-Congenital abnormalities-Cysts-Endocrine changes Congenital abnormalities先天性异常1、laryngomalacia 喉软骨软化病Cause/etiology The failure of cartilage to stiffen with development Population with high riskNeonate1、laryngomalacia 喉软骨软化病LocationEpiglottis Be too pliabe and collape

2、s into the airwayTypical symptomsStridor （喘鸣）Evident at birth or within the first few hours or days of lifeNo hoasenessDyspnea（呼吸困难）In severe condition1、laryngomalacia 喉软骨软化病ExaminationsTransnasal fiberoptic laryngoscopyDirect laryngoscopeBig and pliable or curly epiglottisNo stridor after moving ep

3、iglottis 1、laryngomalacia 喉软骨软化病TreatmentsMild to moderate outgrow laryngomalacia by 18 monthsSevereSupraglottoplasty（声门上成形术）tracheostomy（气管切开术）2、subglottal stenosis 声门下狭窄DefinitionA lumen 4.0 mm in diameter or less at the level of the cricoid cartilage Cause/etiology Congenital embryological develo

4、pmentCricoid cartilageThe conus elasticus （弹性圆锥）Acquired endotracheal intubationScarringHypertrophy2、subglottal stenosis 声门下狭窄Population with high riskNeonateTypical symptoms - In severe conditionDyspnea（呼吸困难）StridorExercise intolerance2、subglottal stenosis 声门下狭窄Treatments (stenosis grading)Grade 1

5、to 2 careful observationGrade 3 to 4Endoscopic or surgical interventionVoice therapy to followed3、tracheoesophageal 气管食管瘘DefinitionTEF are opennnings that occur between the esophagus and trachea Cause/etiology Vascular compromise to developing esophagus3、tracheoesophageal 气管食管瘘Typical symptomsGastri

6、c distentionDirect tracheal aspirationReduced diaphragmatic excusionTreatments (stenosis grading)surgical interventionVoice and therapy to followedcysts囊肿cystsCause/etiology Abnormal blockage of the ductal system of laryngeal mucous glands CongenitalAcquiredLocationVocal folds inner margin, superior

7、 or inferior surfaceVentricular folds - anywhereUnilateralcystsTypical symptomsLow vocal quality - hoarsenessBreathnessLower pitch Increased aperiodicityExaminationsFiberoptic laryngoscopyStroboscopyBiopsycystscystsTreatments surgerySuperficial incision along the superior edge of the VFsNo disruptin

8、g the glottal marginVoicetherapyPostsurgicallyEliminate any voice compensationsEndocrine changes 内分泌的改变1、pituitary 脑垂体 HypofunctionLaryngeal growth retardHigh pitchLack of secondary sexual characteristicsEndocrine therapycausesymptomsTreatment 1、pituitary 脑垂体 HyperfunctionPrecocious pubertyAcromegal

9、y(肢端肥大)surgerycausesymptomsTreatment 2、adrenal glands 肾上腺 HypofunctionPrepubescent voice in maleLack of secondary sexual characteristicsEndocrine therapycausesymptomsTreatment 2、adrenal glands 肾上腺 HyperfunctionVirilization男性化Deepening of the voice嗓音低沉SurgerycausesymptomsTreatment 3、thyroid gland 甲状腺

10、 Hypothyroidism甲状腺功能低下Low pitchHoarsenessThyroid hormone therapycausesymptomsTreatment 3、thyroid gland 甲状腺 Hyperthyroidism甲状腺功能亢进Jumpinessand irritabilityBreathy voiceMedicine SurgerycausesymptomsTreatment 4、premenstrual vocal syndrom 经前期发声综合征Typical symptoms before 4-5 days before menstruation in 33% of womenVocal fatigueReduced pitch rangeHypophoniaLoss of certain harmonics4、premenstrual vocal syndrom 经前期发声综合征Videostroboscopic examinationCongestion 充血MicrovariesVF thickeningReduced vibratory amplitudeTreatmentOral contraceptive pills5、climacteric 更年期Typi