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SPPA 6400 Voice Disorders Tasko

Laryngoscopic Features

Goal

� Illustrate range and variety of disordered laryngeal movement patterns within MTD

How?

� Based on Rammage & Morrison (2001)

� Dysregulated muscle activity = myriad of glottic/supraglottic contraction patterns

SPPA 6400 Voice Disorders Tasko

MTD Type 1: Laryngeal Isometric

(+/- benign mucosal disease)

� Principle feature:

posterior glottic chink

� Presumed due to ↑ PCA

activity

� Suggested association

with benign mucosal

lesions

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SPPA 6400 Voice Disorders Tasko

MTD Type 2a – Supraglottic Lateral Compression

� Lateral compression

principally at the glottis

� May be some ventricular

compression

� ↑ closed phase

� ↓ vibratory amplitude

SPPA 6400 Voice Disorders Tasko

MTD Type 2b – Supraglottic Lateral Compression

� Ventricular folds are

approximated

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SPPA 6400 Voice Disorders Tasko

MTD Type 3: Anterior-posterior supraglottic

compression

� ↓ distance between

anterior and posterior

glottis

� Arytenoids “pull” toward

epiglottis

� Associated with “Bogart-

Bacall” syndrome

SPPA 6400 Voice Disorders Tasko

MTD Type 4 – Non-adducted hyperfunction

(- supraglottic compression)

� Incomplete glottal closure

with normal mobility

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SPPA 6400 Voice Disorders Tasko

MTD Type 4 – Non-adducted hyperfunction

(+ supraglottic compression)

� Incomplete glottal closure

with normal mobility

� Concomitant compression

of the ventricular folds

SPPA 6400 Voice Disorders Tasko

MTD Type 5 – Bowed vocal folds

� “Spindle”-shape glottis

� Also associated with

� aging (presbylaryngis or

presbyphonia)

� Neurologic conditions

(Parkinson’s Disease)

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SPPA 6400 Voice Disorders Tasko

Laryngeal dyscoordination (dynamic)

� Static images do not capture transient or phasic

changes in laryngeal function

� Presumed to be competition between agonist-

antagonist muscle function