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STEMPLE HAPNER VOICE V O I C THERAPY E T H E R A C C S LINICAL ASE TUDIES P Y C L I F E N OURTH DITION I C A L C A S E S T U D I E S JOSEPH C. STEMPLE EF DO IU T IORT EDIE R. HAPNER NH www.pluralpublishing.com Voice Therapy Clinical Case Studies Fourth Edition Voice Therapy Clinical Case Studies Fourth Edition Joseph C. Stemple, PhD, CCC-SLP, ASHAF Edie R. Hapner, PhD, CCC-SLP 5521 Ruffin Road San Diego, CA 92123 e-mail: [email protected] Website: http://www.pluralpublishing.com Copyright © by Plural Publishing, Inc. 2014 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. Library of Congress Cataloging-in-Publication Data Voice therapy : clinical case studies / [edited by] Joseph C. Stemple, Edie R. Hapner. -- Fourth edition. p. ; cm. Includes bibliographical references and index. ISBN 978-1-59756-558-5 (alk. paper) — ISBN 1-59756-558-X (alk. paper) I. Stemple, Joseph C., editor of compilation. II. Hapner, Edie R., editor of compilation. [DNLM: 1. Voice Disorders — therapy — Case Reports. WV 500] RF510 616.85'5606 — dc23 2014000154 Contents Preface xiii Contributors xvii 1 Principles of Voice Therapy 1 Joseph C. Stemple Introduction 1 Historical Perspective 2 Hygienic Voice Therapy 3 Symptomatic Voice Therapy 4 Psychogenic Voice Therapy 5 Physiologic Voice Therapy 5 Eclectic Voice Therapy 6 Case Study: Patient A 6 Voice Care Professionals 10 References 10 2 Comments on Voice Evaluation 13 Joseph C. Stemple Introduction 13 Management Team 14 Medical Examination 15 Voice Pathology Evaluation 15 Instrumental Voice Assessment 23 Hearing Screening 23 Impressions 23 Prognosis 24 Recommendations 24 Summary 24 References 24 3 Primary and Secondary Muscle Tension Dysphonia 27 Introduction: Muscle Tension Dysphonia: An Overview 27 Nelson Roy Case Study 1. Behavioral Shaping in Primary MTD Masquerading 29 as Elective Mutism in a 10-Year-Old Boy R. E. Stone Jr and Kimberly Coker vi Voice Therapy: Clinical Case Studies Case Study 2. Management of Primary MTD in a 13-Year-Old Using 38 Falsetto Voice to Modify Phonation Joseph C. Stemple Case Study 3. Use of Laryngeal Massage and Resonant Therapy in 41 Primary MTD in an Adolescent Susan Baker Brehm Case Study 4. Flow Phonation in a Teenager with Primary Muscle 45 Tension Aphonia Jackie Gartner-Schmidt Case Study 5. Manual Circumlaryngeal Techniques in the Assessment 53 and Treatment of Primary MTD in a 55-Year-Old Woman Nelson Roy Case Study 6. Management of Primary MTD Initially Masquerading 60 as a Paralytic Dysphonia in a 39-Year-Old Woman Using an Enabling Approach Claudio Milstein Case Study 7. Use of Patient-Family Education and Behavior 66 Modification to Treat MTD Secondary to Vocal Nodules Leslie Glaze Case Study 8. Eclectic Voice Therapy for Secondary MTD in a 72 10-Year-Old With a Vocal Fold Cyst Carissa Portone-Maira Case Study 9. Using a Psychosocial Management Approach in the 78 Therapy of a Child With Midmembranous Lesions and Secondary MTD Moya Andrews Case Study 10. Treatment of Secondary MTD in a Child With Early 85 Bilateral Lesions: A Telehealth Approach Lisa N. Kelchner Case Study 11. Treating a Child With MTD Secondary to Vocal Nodules 91 Using Concepts From Adventures in Voice Rita Hersan Case Study 12. Pediatric Vocal Fold Nodules and Secondary MTD 100 Treated in Conjunction With a School-Based SLP Rebecca Hancock Case Study 13. Use of Vocal Function Exercises in the Treatment of an 106 Adult With Secondary MTD Joseph C. Stemple Case Study 14. Accent Method in the Treatment of Secondary MTD 116 Sara Harris Case Study 15. Voice Therapy Boot Camp in the Treatment of 125 Secondary MTD in an Adult Rita Patel Contents vii Case Study 16. Medical and Therapeutic Management of 131 Laryngopharyngeal Reflux With Resulting Secondary MTD Sandra A. Schwartz Case Study 17. Management of Secondary MTD Associated With 136 Vocal Process Granulomas Heather Starmer Case Study 18. Lessac-Madsen Resonant Voice Therapy in the 142 Treatment of Secondary MTD Diana M. Orbelo, Nicole Yee-Key Li, and Katherine Verdolini Abbott Case Study 19. Use of Ambulatory Biofeedback to Supplement 157 Traditional Voice Therapy for Treating Primary MTD in an Adult Female Tara Stadelman-Cohen, Jarrad Van Stan, and Robert E. Hillman Case Study 20. Use of Glottal Attack in the Treatment of Primary MTD 164 in an Adult Female Presenting With Persistent Falsetto Joseph C. Stemple Case Study 21. The Use of a Multi-Approach Therapy in a Female 166 Professional Voice Speaker Presenting With a Primary MTD Marked With Habitual Falsetto Phonation Mara Behlau and Glaucya Madazio Case Study 22. Use of Hard Glottal Attack as Laryngeal Manipulation 174 to Modify Mutational Voice in a 16-Year-Old Male Lisa Fry References 179 4 Management of Glottal Incompetence 189 Introduction 189 Case Study 1. Treatment Strategies Used for Unilateral Vocal Fold 190 Paralysis in a Case With a Complex Medical History Stephen C. McFarlane and Shelley Von Berg Case Study 2. Use of Physiologic Therapy Approaches to Treat 198 Unilateral Vocal Fold Paralysis Following Complications From a Total Thyroidectomy Mara Behlau, Gisele Oliveria, and Osíris do Brasil Case Study 3. Treatment of Glottal Incompetence With Secondary 206 Muscle Tension Dysphonia in a Patient With Unilateral Vocal Fold Paralysis Maria Dietrich Case Study 4. Use of Semi-Occluded Vocal Tract Methods and 212 Resonant Voice Therapy to Treat Unilateral Vocal Fold Paralysis Julie Barkmeier-Kraemer viii Voice Therapy: Clinical Case Studies Case Study 5. Use of Expiratory Muscle Strength Training in a Case of 222 Unilateral Vocal Fold Paralysis 4 Years Post Chemotherapy/Radiation Bari Hoffman Ruddy, Christine M. Sapienza, Erin Silverman, and Henry Ho Case Study 6. Brief Discussion and Case Presentation of Treatment for 226 Superior Laryngeal Nerve Paralysis Using Medical, Surgical, and Behavioral Interventions Bruce J. Poburka Case Study 7. Use of Phonation Resistance Training Exercises (PhoRTE) 233 in a Part-Time Cooking Instructor With Presbyphonia Aaron Ziegler and Edie R. Hapner Case Study 8. Use of Vocal Function Exercises in an Elderly Man With 240 Presbyphonia Stephen Gorman Case Study 9. Treatment of Glottal Incompetence Caused by Sulcus 245 Vocalis: Evidence of a Team Approach for Vocal Rehabilitation Amanda I. Gillespie and Clark A. Rosen Case Study 10. Improvement of Vocal Fold Closure in a Patient With 250 Voice Fatigue Joseph C. Stemple Case Study 11. An Eclectic Approach in the Management of an 255 Individual With Vocal Fatigue Chaya Nanjundeswaran References 262 5 Dystonia, Essential Tremor, and Other Neurogenic Disorders 269 Spasmodic Dysphonia 269 Case Study 1. Functional Voice Therapy for Spasmodic Dysphonia 271 Joseph C. Stemple Case Study 2. Medical and Behavioral Management of Adductor 273 Spasmodic Dysphonia Edie R. Hapner and Michael M. Johns Case Study 3. Combined Laryngeal Injection of Botulinum Toxin and 281 Voice Therapy for Treatment of Adductor Spasmodic Dysphonia Eileen M. Finnegan Case Study 4. Use of Reduced Voicing Duration to Treat Vocal Tremor 287 Julie Barkmeier-Kraemer Case Study 5. Use of LSVT® LOUD (Lee Silverman Voice Treatment) 298 in the Care of a Patient With Parkinson Disease Lorraine Ramig and Cynthia Fox Case Study 6. Use of Telehealth Technology to Provide Voice Therapy 303 Lyn Tindall Covert References 307 Contents ix 6 Irritable Larynx Syndrome, Paradoxical Vocal Fold 311 Dysfunction, and Chronic Cough Introduction to Irritable Larynx Syndrome 311 Linda Rammage Case Study 1. A Case of ILS Managed by a Comprehensive Approach 313 to Multiple Central Sensitivity Syndrome Triggers Linda Rammage Case Study 2. Multimodality Behavioral Treatment of Long-Standing 324 Chronic Cough in an Adult Marc Haxer Case Study 3. Failed Voice Therapy With Successful Use of Central 328 Nervous System Inhibitors in Chronic Cough Madeleine Pethan and Laureano Giraldez-Rodriguez Paradoxical Vocal Fold Motion: An Introduction 335 Mary J. Sandage Case Study 4. Treatment of PVCD in a Collegiate Swimmer 338 Mary J. Sandage Case Study 5. Management of PVCD: An Adolescent Athlete With 345 Exercise-Induced Dyspnea Michael D. Trudeau, Jennifer Thompson, and Christin Ray Case Study 6. Treatment of Paradoxical Vocal Fold Motion Disorder 348 in a 9-Year-Old Athlete Maia Braden Case Study 7. Paradoxical Vocal Fold Movement (PVFM): A Case of 355 the Young Athlete With Associated Psychosocial Contributions Mary V. Andrianopoulos References 368 7 Management of the Professional, Avocational, and 375 Occupational Voice Introduction 376 Marina Gilman Case Study 1. Management of Vocal Fold Nodules in a Female 379 Prepubescent Singer Patricia Doyle and Starr Cookman Case Study 2. The Developing Performer 389 Barbara Jacobson Case Study 3. 19-Year-Old Talented Male Singer, Presenting With 394 Soft Bilateral Vocal Fold Lesions Marina Gilman