SITUATION:
During a radio interview the British pop star, Adele, “felt a pop” and experienced her vocal pitch drop into the bass range frequency, followed by a sudden and complete loss of voice. She stressed her vocal folds, and ruptured a blood vessel resulting in a hemorrhage of the vocal lining, called a hemorrhagic polyp. The edge in her style of singing is the likely contribution to the polyp, along with a combination of smoking (WebMD). In October, 2011Adele underwent surgery to treat the vocal fold polyp with hemorrhage (Fauquier ENT).
For this study I will use her case to study the effects of a laryngeal growth on the voice.
WHAT IS A VOCAL FOLD POLYP AND HEMORRHAGE?
Vocal fold polyps are a benign (non-cancerous) growth on either on one or both of the vocal folds, and a common disorder of the larynx. The polyps look like a swelling or bump (ASHA) on the junction of the anterior and middle third of the vocal folds where lesions are elevated, appearing red, white or translucent (Hideki et al., 2012). They appear similar to a blister (ASHA). Refer to Figure 1.
Figure 1: Picture of a vocal polyp as seen by the speech pathologist or ENT physician through video endoscopy. Persistent, unilateral, midmusculomembraneous, true vocal fold lesions with typical hemorrhagic, fibrotic, or translucent characteristics (Hideki et al., 2012).
HOW DO POLYPS DEVELOP?
I. Vocal abuse or misuse: The long term or repeated vocal abuse or misuse of the vocal cords though activities such as singing, coaching, yelling and talking loudly (ASHA). A rupture occurs in the vessels of the superficial layer of the lamina propria resulting in a hematoma (swelling of clotted blood within the tissue). Edema and inflammatory cell infiltration th...
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...multilayered ultrastructure of vocal folds by maintaining a functional and anatomical state that closely mirrors the normal glottis (Geyer et al., 2010). o Preservation of both healthy mucosa and intermediate and deep layers of lamina propria is important for voice restitution (Geyer et al., 2010)
WHAT TREATMENT RECOMMENDATION WOULD YOU MAKE FOR A FELLOW STUDENT WHO HAS A VOCAL FOLD POLYP?
The recommendation I would give to a friend would be specific to their needs.If my fellow student discovered they had a vocal polyp after a night of screaming from watching The Backstreet Boy’s concert, I would recommend them to voice therapy. My assumption is the vocal fold polyp would be small and have a high chance of shrinking or going on remission. Voice therapy takes longer and requires strict care, but is noninvasive. I would also imagine less costly than surgery.
one of her husbands has a different effect on her ability to find that voice.
Cholesteatoma is a growth of excess skin or a skin cyst (epithelial cyst) that contains desquamated keratin and grows in the middle ear and mastoid (Thio, Ahmed, & Bickerton, 2005). A cholesteatoma can grow and spread, destroying the ossicles, tympanic membrane and other parts of the ear. They appear on the pars flaccida and pars tensa sections of the tympanic membrane. A cholesteatoma can occur when a part of a perforated tympanic membrane is pushed back into the middle ear space, debris and skin cells can build up forming a growth. It can obstruct tympanic membrane movement and movement of the ossicles. As the layers grow, the amount of hearing loss can increase. A cholesteatoma can be congenital (present at birth) or be acquired as a result of another disease. They can also be formed as a result of a surgery, trauma, chronic ear infection, chronic otitis media, or tympanic membrane perforation. It can develop beyond the tympanic membrane and cause intracranial and extracranial complications. Due to this patients can experience permanent hearing loss as a result of an infection of the inner ear as well as other serious health concerns. These include dizziness, facial nerve weakness and infections of the skull (Hall, 2013). Patients may present chronically discharging ear, hearing loss, dizziness, otalgia (ear pain), and perforations (marginal or attic).
Seikel, J. A., King, D. W., & Drumright, D. G. (2010). 12. Anatomy & physiology for speech,
Many may wonder if nodules are cancerous, the answer is that they're not. They are just simply growths that affect the voice. Treating these nodules is simply stated. A specialist will first tell a person with a nodule to completely rest their voice. Rest is just the first step and will not get rid of them by that alone. If you are a speaker then speech therapy is recommended and if you're a singer than receive singing exercises from professional help. Surgery is that last result and is very uncommon. It is rarely necessary and is only for nodules that are extremely large or if six weeks of training and help left with no result at all. It is mainly an issue for children who are of the age of 10 or under. There are known to be some logical reasons why surgery is rarely recommended for them. Usually if a child has a nodule removed, it will most likely re-occur or come back and there would have been no point of removing it in the first place. Another thing is that children abuse their voice much more often than adults. This is just because they scream and carry on more often than adults ever would which results in possibilities of seeing the nodules resolve around the time the children hit puberty. For girls who are in their teens and becoming something like a cheerleader who constantly has to yell, future problems can occur. Schools rarely recommend speech therapy because most often it doesn't help.
Pau, H., r.w. Clarke. (2004). Advances in the genetic manipulations in the treatment of hearing disorders. Clinical Otolaryngology (29), Page 574
"Speech Development." Cleft Palate Foundation. Cleft Palate Foundation, 25 Oct 2007. Web. 10 Mar 2014.
A relatively low risk and quick surgery; however, after the surgery Stella’s vocal cords began to swell and she was having trouble breathing one day while playing. Her owners realized it and rushed her to the veterinarian. The doctor had to perform an emergency surgery that involved cutting out the swollen tissue which required a large incision along her neck leaving an ugly scar. This surgery was much more expensive than the original devocalization or hiring a dog trainer and could eventually require another removal of swollen tissues (Devocalized: Stella’s
The pharynx is a large cavity behind the mouth and between the nasal cavity and larynx. The pharynx serves, as an air and food passage but cannot be used for both purposes at the same time, otherwise choking would result. The air is also warmed and moistened further as it passes through the pharynx. The larynx is a short passage connecting the pharynx to the trachea and contains vocal chords. The larynx has a rigid wall and is composed mainly of muscle and cartilage, which help prevent collapse and obstruction of the airway.
Her phonetic inventory is well developed. She has no troubles creating the age-appropriate speech sounds. The child is just above normal because she can produce more adult-like sounds than her peers. She has control over her articulators and she knows how to manipulate her oral cavity to produce the correct sounds.
According to Chapman et al., (2000), the loss of hearing appears to be a chronic issue through...
Reverberation artifact of the lung occurs as ultrasound waves spring amid the transducer and the pleura. The pleura is shown as a hyperdense white line (black arrow). The reverberation lines (white arrows) embody repetition of the pleural line. ...
The ear is looked upon as a miniature receiver, amplifier and signal-processing system. The structure of the outer ear catching sound waves as they move into the external auditory canal. The sound waves then hit the eardrum and the pressure of the air causes the drum to vibrate back and forth. When the eardrum vibrates its neighbour the malleus then vibrates too. The vibrations are then transmitted from the malleus to the incus and then to the stapes. Together the three bones increase the pressure which in turn pushes the membrane of the oval window in and out. This movement sets up fluid pressure waves in the perilymph of the cochlea. The bulging of the oval window then pushes on the perilymph of the scala vestibuli. From here the pressure waves are transmitted from the scala vestibuli to the scala tympani and then eventually finds its way to the round window. This causes the round window to bulge outward into the middle ear. The scala vestibuli and scala tympani walls are now deformed with the pressure waves and the vestibular membrane is also pushed back and forth creating pressure waves in the endolymph inside the cochlear duct. These waves then causes the membrane to vibrate, which in turn cause the hairs cells of the spiral organ to move against the tectorial membrane. The bending of the stereo cilia produces receptor potentials that in the end lead to the generation of nerve impulses.
While this early evidence was not empirical, anatomists have since found that all humans display two tiny pits, with duct openings, on both sides of the septum just behind the opening of the nose (3). The duct leads into a tubular lumen lacking a thick, distinct sensory epithelium. ...
disease is coughing, rapid breathing, discharge from the nose and eyes, swelling near the neck
Extra Ear – ¼ Scale, the Tissue Culture & Art in Collaboration with Stelarc, retrieved September 13th, 2004, from http://www.tca.uwa.edu.au/extra/extra_ear.html