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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
2
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)
5
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