Topic 6: Dysphonia

A new 26-year-old female kindergarten teacher who just graduated from university is complaining about her voice problem. She said that she suffers from voice loss from time to time and the condition seems to be worse during the semester. She complains that she has intermittent voice loss, accompanied by very hoarse voice quality. The condition seems to be worse during weekdays. There are times when she is not able to raise her pitch and finds her pitch low when speaking to the class in the classroom. She loves her job a lot and she does not want to miss any day of school. This is why she goes to work even when she experiences voice problem. On average, she teaches 6 classes per day in front of a class of 50 students. She does not smoke, but she admits that she drinks cocktails or liquor several nights a week due to work pressure.

During a doctor’s visit, her physician suspects that she may have growth on her vocal folds and is then referred to an ENT doctor. After viewing the structure using a device inserted in her throat, the ENT confirms that she has bilateral vocal nodules, and her voice problem is considered mild to moderate. The doctor recommends that she should receive a surgery immediately.

In your presentation, make sure you include the following components:

  • What is vocal nodule? What are the risk factors of vocal nodules? What are the onset and course of development of vocal nodules?
  • How does vocal nodule affect one’s voice? What is the recommended treatment for vocal nodules?
  • How is dysphonia assessed? Instrumental and perceptual? What do we mean by a “mild-to-moderate” voice disorder?
  • What is the device the ENT doctor used to view the throat? What are the advantages and disadvantages of doing that?
  • As the speech therapist of the teacher, what is your recommendation? Do you think she should immediately undergo a surgery to remove the nodules? What are the possible consequences of vocal surgery?
  • What is vocal hygiene? What should you tell the teacher to avoid this from happening again?