Table Of ContentVoice Disorders
and their Management
Voice Disorders
and their Managetnent
Second edition
Edited by
MARGARET FAWCUS
Senior Lecturer, Department of Clinical Communication Studies,
City University, London
Springer-Science+Business Media, B.Y.
First edition 1986 Croom Helm Ltd
Reprinted 1987
Second edition 1991
Typeset in 1O/12pt Times by Excel Typesetters Co.
© 1986, 1991 Margaret Fawcus
Originally published by Chapman & Hall in 1991.
Apart from any fair dealing for the purposes of research or private study,
or criticism or review, as permitted under the UK Copyright Designs and
Patents Act, 1988, this publication may not be reproduced, stored, or
transmitted, in any form or by any means, without the prior permission in
writing of the publishers, or in the case of reprographic reproduction only
in accordance with the terms of the licences issued by the Copyright
Licensing Agency in the UK, or in accordance with the terms of licences
issued by the appropriate Reproduction Rights Organization outside the
UK. Enquiries concerning reproduction outside the terms stated here
should be sent to the publishers at the London address printed on this
page.
The publisher makes no representation, express or implied, with regard
to the accuracy of the information contained in this book and cannot
accept any legal responsibility or liability for any errors or omissions that
may be made.
A catalogue record for this book is available from the British Library
Library of Congress Cataloging-in-Publication data
Voice disorders and their management/edited by Margaret Fawcus.
p. cm.
Includes bibliographical references and index.
1. Voice disorders. I. Fawcus, Margaret.
RFSlO.V66 1991
616.8S'S-dc20 91-8870
CIP
Printed on permanent acid-free text paper, manufactured in accordance
with the proposed ANSIINISO Z 39.48-199X and ANSI Z 39.48-1984
ISBN 978-0-412-36480-8 ISBN 978-1-4899-2861-0 (eBook)
DOI 10.1007/978-1-4899-2861-0
Contents
Contributors vii
Preface to the second edition ix
Introduction to the first edition xi
l. The physiology of phonation 1
Robert Fawcus
2. The causes and classification of voice disorders 20
Margaret Fawcus
3. Assessment of the dysphonic patient 39
Margaret Gordon
4. Visual feedback in the management of dysphonia 73
Allen Hirson and Robert Fawcus
5. Laryngeal disorders in children 101
Andrew Johns
6. Therapy and management of the dysphonic child 112
Elaine Hodkinson
7. Laryngeal disorders in adults 124
Andrew Johns
8. Hyperfunctional voice: The misuse and abuse syndrome 139
Margaret Fawcus
9. When is a voice disorder psychogenic? Some considerations 176
for diagnosis and management
Margaret Freeman
VI Contents
10. Voice in people with cerebral palsy 202
Kay Coombes
11. Voice problems in the dysarthric patient 238
Sheila Scott and Brian Williams
12. Vocal cord paralyses 259
Malcolm D. Stockley
13. Adductor spastic dysphonia: Diagnosis and management 272
Margaret Stoicheff
14. The voice of the deaf 283
Sheila Wirz
15. Mutational disorders of voice 304
Robert Fawcus
16. The voice of the transsexual 314
Judith Chaloner
17. Post-radiotherapy voice 333
Margaret Stoicheff
18. Phonosurgery 337
Marc Bouchayer and Guy Cornut
19. An interdisciplinary voice clinic 356
Tom Harris, Sara Collins and David D. Clarke
20. The voice clinic in a general hospital 376
Eryl Evans
Index 387
Contributors
Marc Bouchayer ENT Surgeon, Polyclinique de Minguettes,
69694 Venissieux, France
Judith Chaloner Speech Therapy Department, West Middlesex
University Hospital, Isleworth, Middlesex
David Clarke Lecturer, Department of Psychology,
Nottingham University, Nottingham
Sara Collins Senior Speech Therapist, Queen Mary's
Hospital, Sidcup, Kent
Kay Coombes Research Speech Therapist, Community
Paediatric Research Department of Child
Health, Charing Cross and Westminster
Medical School, London
Guy Cornut Phoniatrician, 90 rue Boileau, 69006 Lyon,
France
Eryl Evans Chief Speech Therapist, Singleton Hospital,
Sketty, Swansea
Margaret Fawcus Senior Lecturer, Department of Clinical
Communication Studies, City University,
Northampton Square, London
Robert Fawcus Professor and Head of Department,
Department of Clinical Communication
Studies, City University, Northampton Square,
London
viii Contributors
A1argaretFreer.nan Chief Speech Therapist, Sheffield Health
Authority, Foxwood, Ridgeway Road,
Sheffield
A1argaret Gordon Area Speech Therapist, The Victoria Infirmary,
Langside, Glasgow
Tor.n Harris Consultant ENT Surgeon, Queen Mary's
Hospital, Sidcup, Kent
Allen Hirson Lecturer, Department of Clinical
Communication Studies, City University,
Northampton Square, London
Elaine Hodkinson Chief Speech Therapist, St Ann's Hospital,
London
Andrew fohns Consultant ENT Surgeon, The Kent Aural and
Ophthalmic Hospital, Maidstone, Kent
Sheila Scott Chief Speech Therapist, Schaw Medical Centre,
Glasgow
A1alcolr.n Stockley Chair, Department of Speech Therapy, Central
School of Speech and Drama, Embassy
Theatre, Swiss Cottage, London
A1argaret StoicheJJ Professor, Graduate Department of Speech
Pathology, University of Toronto, Toronto,
Canada
Brian Williar.ns Consultant in Administrative Charge, Division
of Geriatric Medicine, Gartnavel General
Hospital, Glasgow
Sheila Wirz Senior Lecturer in Speech Pathology, National
Hospitals College of Speech Sciences,
Wakefield Street, London
Preface to the second edition
Since this book was first published, four years ago, there has been a
considerable upsurge of interest in the field of both normal and abnormal
voice production. Tangible evidence of this lies in the publication of the
Journal of Voice in the United States, and in the UK the formation of the
British Voice Association. This organization has attracted an increasing
membership from professionals involved in all aspects of voice care and
use - actors and singers, laryngologists and speech therapists, teachers
and phoneticians. The Association holds regular study days, holds an
annual two-day symposium, and publishes a Newsletter which attracts
entries from this broad spectrum of professionals.
We have also seen an increase in the number of specialist voice clinics,
and in the two final chapters in this book a contrast is presented between
such a specialist setting and the more typical clinic that operates in the
majority of general hospitals. This last chapter now contains a breakdown
of voice referrals over an eight-year period, which must represent a
unique published study in this country.
There still remains, however, little research into the management of
voice disorders. There is clearly a need for more efficacy studies into
specific treatment methods, and the single case-study designs developed
in the field of aphasia would seem to be appropriate here.
Recent studies, notably in Japan and the United States, have con
tinued to shed light on vocal fold structure and movement and the
co-ordinated mechanisms of respiration and phonation. We have now
included a chapter on the physiology of phonation, which looks at these
developments and the extent to which they increase our understanding of
voice production.
We have also included a chapter on technological support in the
management of dysphonia, reflecting the increasing sophistication of the
x Preface to the second edition
instrumentation available for presenting objective data on normal and
abnormal voice use.
Developments in the field of phonosurgery over the past few years
have certainly justified the inclusion of a chapter on this increasingly
specialist area of ENT management.
The majority of the original chapters have either been rewritten or
updated, and we hope that this volume will continue to be a useful source
of reference for all those involved, in one way or another, with voice
care.
Margaret Fawcus
