Table Of Content

Voice Therapy Clinical Case Studies Fifth Edition Voice Therapy Clinical Case Studies Fifth Edition Joseph C. Stemple, PhD, CCC-SLP, ASHAF Edie R. Hapner, PhD, CCC-SLP, ASHAF 5521 Ruffin Road San Diego, CA 92123 e-mail: [email protected] Website: http://www.pluralpublishing.com Copyright © 2019 by Plural Publishing, Inc. Typeset in 11/13 Palatino by Flanagan’s Publishing Services, Inc. Printed in the United States of America by McNaughton & Gunn, Inc. All rights, including that of translation, reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording, or otherwise, including photocopying, recording, taping, Web distribution, or information storage and retrieval systems without the prior written consent of the publisher. For permission to use material from this text, contact us by Telephone: (866) 758-7251 Fax: (888) 758-7255 e-mail: [email protected] Every attempt has been made to contact the copyright holders for material originally printed in another source. If any have been inadvertently overlooked, the publishers will gladly make the necessary arrangements at the first opportunity. Disclaimer: Please note that ancillary content (such as documents, audio, and video, etc.) may not be included as published in the original print version of this book. Library of Congress Cataloging-in-Publication Data Names: Stemple, Joseph C. | Hapner, Edie R. Title: Voice therapy : clinical case studies / [edited by] Joseph C. Stemple, Edie R. Hapner. Description: Fifth edition. | San Diego, CA : Plural Publishing, [2019] | Includes bibliographical references and index. Identifiers: LCCN 2018028949| ISBN 9781635500356 (alk. paper) | ISBN 1635500354 (alk. paper) Subjects: | MESH: Voice Disorders — therapy | Case Reports Classification: LCC RF510 | NLM WV 500 | DDC 616.85/56 — dc23 LC record available at https://lccn.loc.gov/2018028949 Contents Preface xiii Contributors xvii 1 Principles of Successful Voice Therapy 1 Joseph C. Stemple Introduction 1 Scientific Nature of Voice Care 2 Artistic Nature of Voice Care 2 How to Use This Text 3 Historical Perspective 3 Hygienic Voice Therapy 4 Symptomatic Voice Therapy 5 Psychogenic Voice Therapy 5 Physiologic Voice Therapy 6 Eclectic Voice Therapy 6 Case Study 1.1 7 Joseph C. Stemple Voice Care Team 10 Issues Related to Successful Voice Therapy 10 Clinician Realities Associated with Voice Therapy Success 11 Interview and Counseling Skills 11 Case Vignette 1.1. A Missed Opportunity 11 Joseph C. Stemple Clinical Understanding of the Problem 12 Misapplied Management Techniques 13 Lack of Patient Education or Understanding of the Problem 14 Recognition of One Philosophical Orientation or One 14 Etiologic Factor Case Vignette 1.2. The Obvious Is Not Always the Cause 14 Joseph C. Stemple Premature Discontinuation of Therapy 15 Case Vignette 1.3. The Pseudoauthoritative Voice 15 Joseph C. Stemple The Clinical Ear 15 Patient Realities Associated with Voice Therapy Success 16 Lack of Patient Motivation for Voice Therapy 16 v vi Voice Therapy: Clinical Case Studies Case Vignette 1.4. “As Long as I Don’t Have Cancer . . .” 16 Joseph C. Stemple Case Vignette 1.5. The Role of Self-Efficacy and Adherence 17 Amanda Gillespie Resistance to Share Information 19 Perceived Need for Negative Vocal Behavior 19 Need to Identify with the Problem 20 Case Vignette 1.6. “My Chest Hurts When I Do These Exercises” 20 Jospeh C. Stemple Finances 21 Personality Issues 21 Can All Voices Be Improved? 22 Case Vignette 1.7. He Was “Fired” from Voice Therapy 22 Carissa Maira Beyond Successful Voice Therapy Techniques and Tasks: 28 The Concept of Meta-Therapy Leah Helou Chapter Summary 31 References 31 2 Comments on the Voice Evaluation 35 Joseph C. Stemple Introduction 35 Management Team 37 Medical Evaluation 37 Voice Pathology Evaluation 38 Referral 38 Reason for the Referral 38 History of the Problem 41 Medical History 42 Social History 42 Oral-Peripheral Examination 43 Voice Evaluation 43 Instrumental Voice Assessment 45 Hearing Screening 46 Impressions 46 Prognosis 46 Recommendations 46 Chapter Summary 46 References 47 3 Primary and Secondary Muscle Tension Dysphonia 49 Introduction: Muscle Tension Dysphonia: An Overview 49 Nelson Roy Contents vii Primary MTD 51 Case Study 3.1. Management of Primary MTD in a 13-Year-Old 51 Using Falsetto Voice to Modify Functional Aphonia Joseph C. Stemple Case Study 3.2. Flow Phonation in a Teenager with Primary 55 Muscle Tension Dysphonia (Aphonia) Jackie Gartner-Schmidt Case Study 3.3. Manual Circumlaryngeal Techniques in the 63 Assessment and Treatment of Primary Muscle Tension Dysphonia in a 55-Year-Old Woman Nelson Roy Case Study 3.4. Management of a Functional Dysphonia 70 Mimicking a Superior Laryngeal Nerve (SLN) Paresis Claudio Milstein Case Study 3.5. The Use of Hard Glottal Attacks to Facilitate 76 Age-Appropriate Pitch in a 16-Year-Old Male with Mutational Falsetto Lisa Fry Case Study 3.6. The Use of Glottal Attack in the Treatment of 82 Primary MTD in an Adult Female Presenting with Persistent Falsetto Joseph C. Stemple Secondary MTD 84 Case Study 3.7. Using Patient-Family Education and Behavior 84 Modification to Treat MTD Secondary to Vocal Nodules in a School-Aged Child Leslie Glaze Case Study 3.8. Pediatric Vocal Nodules and Secondary Muscle 90 Tension Dysphonia Treated in Connection with a School-Based SLP Rebecca Hancock Case Study 3.9. Treating a Child with Muscle Tension Dysphonia 98 Secondary to Vocal Nodules Using Concepts from “Adventures in Voice” Rita Hersan Case Study 3.10. The Use of Vocal Function Exercises in the 106 Treatment of an Adult with Secondary Muscle Tension Dysphonia Joseph C. Stemple Case Study 3.11. The Accent Method (AM) of Voice Therapy in 116 Clinical Practice Sara Harris Case Study 3.12. The Use of Intensive Short-Term Voice Therapy 126 (aka Voice Therapy Boot Camp) in a Professional Voice User with Vocal Hyperfunction Rita Patel viii Voice Therapy: Clinical Case Studies Case Study 3.13. Lessac-Madsen Resonant Voice Therapy in a 132 Young Woman with Vocal Nodules Diana Marie Orbelo, Nicole Yee-Key Li, and Katherine Verdolini-Abbott Case Study 3.14. Multimodal and Multidisciplinary Treatment of 141 Vocal Process Granulomas and Secondary Muscle Tension Dysphonia Heather Starmer Case Study 3.15. An Eclectic Approach in the Management of an 148 Individual with Vocal Fatigue Chaya Nanjundeswaran Case Study 3.16. Conversation Training Therapy (CTT) Applied 154 to a Patient with Benign Mid-Membranous Lesions Jackie L. Gartner-Schmidt and Amanda I. Gillespie References 160 4 Management of Glottal Incompetence 171 Introduction: Bridging “Gaps” with Voice Therapy in Patients 171 with Glottal Dysfunction Aaron Ziegler Case Study 4.1. The Use of PhoRTE for Presbyphonia 175 Aaron Ziegler and Edie Hapner Case Study 4.2. The Use of Vocal Function Exercises in an 183 Elderly Man with Presbyphonia Steve Gorman Case Study 4.3. Eclectic Voice Therapy to Treat Glottal 188 Incompetence with Secondary MTD in a Patient with Unilateral Vocal Fold Paralysis Maria Dietrich Case Study 4.4. A Case of Superior Laryngeal Nerve Paralysis in a 195 Patient After Subtotal Thyroidectomy Daniel Croake Case Study 4.5. LaxVox Therapy Used in a Case of Muscle Tension 201 Dysphonia Hiding an Underlying Glottal Incompetence Ilter Denizoglu Case Study 4.6. Treatment of Glottal Incompetence Caused by 212 Sulcus Vocalis: Evidence of a Team Approach for Vocal Rehabilitation Amanda I. Gillespie and Clark Rosen Case Study 4.7. Improvement of Vocal Fold Closure in a Patient 217 with Voice Fatigue Joseph C. Stemple Case Study 4.8. The Use of Expiratory Muscle Strength Training 222 in a Case of Unilateral Vocal Fold Paralysis with Weak Cough and Aspiration Pneumonia Bari Hoffman Ruddy, Christine M. Sapienza, Erin Pearson, and Henry Ho Contents ix Case Study 4.9. The Use of Semi-Occluded Vocal Tract Methods and 225 Resonant Voice Therapy to Habilitate Unilateral Vocal Fold Paralysis Julie M. Barkmeier-Kraemer References 235 5 Dystonia, Essential Tremor, and Parkinson’s Disease 243 Introduction: Neurogenic Voice Disorders 243 Richard Andreatta Spasmodic Dysphonia 245 Joseph C. Stemple Case Study 5.1. Functional Voice Therapy for Spasmodic Dysphonia 247 Joseph C. Stemple Case Study 5.2. Medical and Behavioral Management of Adductor 250 Spasmodic Dysphonia Edie R. Hapner and Michael M. Johns III Case Study 5.3. Combined Laryngeal Injection of Botulinum Toxin 256 and Voice Therapy for Treatment of Adductor Spasmodic Dysphonia Eileen Finnegan Case Study 5.4. The Use of Reduced Voicing Duration to Treat 263 Vocal Tremor Julie M. Barkmeier-Kraemer Case Study 5.5. Treatment for Vocal Tremor in a Classical Singer 274 Kristen Bond Case Study 5.6. Use of LSVT LOUD® (Lee Silverman Voice 281 Treatment) in the Care of a Patient with Parkinson Disease Lorraine Ramig and Cynthia Fox References 287 6 Disorders of the Upper Airway: Irritable Larynx Syndrome, 293 Chronic Cough, Paradoxical Vocal Fold Dysfunction, and Upper Airway Challenges Introduction to Irritable Larynx Syndrome 293 Linda Rammage Case Study 6.1. A Case of ILS Managed by a Comprehensive 295 Approach to Multiple Central Sensitivity Syndrome Triggers Linda Rammage Case Study 6.2. Combined Voice Therapy with the use of 304 Central Nervous System Inhibitors in the Successful Treatment of Chronic Cough Madeleine Pethan and Laureano Giraldez-Rodriguez Case Study 6.3. Therapy for Chronic Refractory Cough 311 Thomas Murry