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Aerodigestive Disorders of the Pharynx and Larynx: Causes, Symptoms, and Treatments, Study notes of Voice

An overview of various aerodigestive disorders affecting the pharynx and larynx, including chronic cough, dystonia, epiglottitis, fungal infections, laryngeal stenosis, laryngospasm, and muscle tension dysphonia. Each disorder is described in terms of its causes, symptoms, and potential treatments. The document also covers less common conditions such as laryngeal clefts, laryngeal webs, and velopharyngeal dysfunction.

Typology: Study notes

2021/2022

Uploaded on 09/27/2022

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Aerodigestive Disorders of the Airway (Pharynx and Larynx)
Condition or disease
Description
Results in
Chronic cough
Cough lasting more than 8
weeks in adults and more than
4 weeks in children
May be termed “somatic
cough syndrome” in the
absence of a known cause or
“tic cough” when
accompanied by core clinical
features of tics, including
suppressibility, distractibility,
suggestibility, variability, and
presence of a warning
sensation
Coughing; voice problems
from irritation of the vocal
folds
Dystussia
Disordered cough—inability to
cough effectively due to
weakened vocal folds or
reduced muscle coordination
or sensation
Reduced airway protection
Epiglottitis
Inflammation of the epiglottis
and surrounding tissue
Difficulty breathing
Fungal infections of the larynx
(e.g., blastomycosis,
histoplasmosis, candidiasis)
Fungal infections commonly
seen in immunocompromised
patients
Voice problems and
odynophagia (painful
swallowing)
Irritable larynx
Laryngeal hypersensitivity to
stimuli such as strong smells,
cold air, or talking
Cough or throat clearing
Laryngeal clefts
Abnormal opening between
the larynx and the esophagus
Type I—gap between the
larynx and the esophagus
is above the true vocal
folds
Type II—gap extends into
the lower laryngeal
Aspiration (material
entering the airway)
pf3
pf4

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Aerodigestive Disorders of the Airway (Pharynx and Larynx) Condition or disease Description Results in Chronic cough Cough lasting more than 8 weeks in adults and more than 4 weeks in children May be termed “somatic cough syndrome” in the absence of a known cause or “tic cough” when accompanied by core clinical features of tics, including suppressibility, distractibility, suggestibility, variability, and presence of a warning sensation Coughing; voice problems from irritation of the vocal folds Dystussia Disordered cough—inability to cough effectively due to weakened vocal folds or reduced muscle coordination or sensation Reduced airway protection Epiglottitis Inflammation of the epiglottis and surrounding tissue Difficulty breathing Fungal infections of the larynx (e.g., blastomycosis, histoplasmosis, candidiasis) Fungal infections commonly seen in immunocompromised patients Voice problems and odynophagia (painful swallowing) Irritable larynx Laryngeal hypersensitivity to stimuli such as strong smells, cold air, or talking Cough or throat clearing Laryngeal clefts Abnormal opening between the larynx and the esophagus

  • Type I—gap between the larynx and the esophagus is above the true vocal folds
  • Type II—gap extends into the lower laryngeal Aspiration (material entering the airway)

cartilage below the true vocal folds

  • Type III—gap extends past the larynx into the trachea
  • Type IV—gap extends further into the trachea or all the way to the bottom of the trachea Laryngeal stenosis (supraglottic, glottic, or subglottic) Narrowing of the airway, from partial or circumferential narrowing Difficulty breathing Laryngeal webs Fibrotic membrane, ranging from thin to thick, extending across the laryngeal lumen close to the level of the true vocal folds Difficulty breathing, roughness, or aphonia (loss of voice) Laryngeal or pharyngeal paralysis/paresis (unilateral or bilateral) Disruption in innervation to one or both of the arytenoid cartilages of the larynx Airway obstruction or reduced airway protection during swallowing (based on positioning of the vocal fold) Laryngomalacia (moderate to severe) Soft, immature cartilage of the upper larynx collapses during inhalation Airway obstruction and inhalatory stridor (wheezing sound) Laryngopharyngeal reflux Reflux of gastric content into the larynx and the pharynx, causing irritation of the laryngeal tissue May be termed “esophagopharyngeal reflux” if there is regurgitation of esophageal contents into the laryngopharynx Voice problems and swallowing discomfort Laryngospasm Spasm or contraction of the true vocal folds Temporary difficulty breathing

Martinucci, I., de Bortoli, N., Savarino, E., Nacci, A., Romeo, S. O., Bellini, M., Savarino, V., Bruno, F., & Marchi, S. (2013). Optimal treatment of laryngopharyngeal reflux disease. Therapeutic Advances in Chronic Disease, 4(6), 287 – 301. Matsuo, K., & Palmer, J. B. (2008). Anatomy and physiology of feeding and swallowing: Normal and abnormal. Physical Medicine and Rehabilitation Clinics of North America, 19 (4), 691 – 707. Morris, M. J., Allan, P. F., & Perkins, P. J. (2006). Vocal cord dysfunction: Etiologies and treatment. Clinical Pulmonary Medicine, 13(2), 73 – 86. Petty, B. E., & Dailey, S. H. (2009). The collaborative medical and behavioral management of chronic cough. Perspectives on Voice and Voice Disorders, 19(2), 49 – 57. Reitz, J. R., Gorman, S., & Kegyes, J. (2014). Behavioral management of paradoxical vocal fold motion. Perspectives on Voice and Voice Disorders, 24(2), 64 – 70. Vertigan, A. E. (2017). Somatic cough syndrome or psychogenic cough—what is the difference? Journal of Thoracic Disease, 9(3), 831 – 838.