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Glossary
Note: Within a definition, words in italics are defined elsewhere in the glossary. Words beginning with * were coined or brought into the language of voice disorders by Dr. Bastian, or to our knowledge are used primarily by BVI physicians and Bastian-trained fellows. Please note that we may be adding terms to this list from time to time. Copyright © 2008 Bastian Voice Institute.
Diagnostic model:
The codified tools and sequence used during diagnosis of a
disorder. In the realm of voice disorders in particular, different
clinics may use different models for diagnosis. For purposes
of discussion, at BVI we distinguish somewhat artificially
between the traditional diagnostic
model, the technology-driven
or reductionistic diagnostic model, and what is preferred
at BVI, the integrative diagnostic
model.
Diagnostic process:
See diagnostic model.
Differential diagnosis:
Refers to the short list of possible diagnoses based upon
the findings of the initial consultation. Sometimes the diagnosis
can be narrowed down to only one possibility; in other cases,
additional tests are done to distinguish between competing
diagnoses. Sometimes the most likely diagnosis of those in
the differential diagnosis becomes the working
diagnosis and trial treatment for this leading diagnosis is
begun.
Di-indolemethane (DIM):
This is a phytochemical derived from cruciferous vegetables
such as cabbage, broccoli, Brussels sprouts, cauliflower,
collards, and kale. Promotes estrogen metabolism to a form
that has been shown to be anti-proliferative. Used in treating
recurrent respiratory papillomatosis
(RRP). See also I3C.
Dilatation (or Dilation):
This means to stretch an opening to a larger size. For example,
one of the options when managing an individual with a stenosis
(narrowing) in the trachea or windpipe may be to dilate or
stretch that area, to see if durable enlargement of the airway
can be achieved, or whether a different approach such as tracheal
resection should be tried.
Diplophonia:
Double pitch phonation. Often
seen with vocal fold paralysis,
and in submucosal disorders such as epidermoid
cyst and glottic sulcus.
Except for a type of luffing
diplophonia that may be functionally produced, diplophonia
tends to be a pathologic vocal phenomenon.
Dysphagia: Abnormal swallowing,
or inability to swallow. This can result from such diverse
causes as surgery on the larynx or neck, stroke, the aging
process, tumor, injury to the neck, or radiation, among other
things.
Dysphonia:
Abnormal production of vocal sound; more commonly used as
a synonym for hoarseness. Dysphonia may be the result of injury
to the mucosa of the vocal
folds; or it may be neurogenic, the result of a benign or
malignant tumor; or it may be nonorganic.
Dystonia:
A benign neurological disorder in which twisting and repetitive
or sustained but unwanted muscle contraction occurs in a body
part. Dystonia can affect a specific muscle causing focal
dystonia, a region of the body (regional dystonia), or even
the body as a whole (generalized dystonia). Common focal dystonias
include laryngeal (spasmodic dysphonia);
ocular (blepharospasm); neck or cervical (torticollis and
related neck disorders); and limb dystonia (writer’s
cramp). Treatment for focal dystonias is most commonly via
Botox™ injection into
affected muscles, and occasionally by selective denervation.
More regional and generalized dystonias may respond to a variety
of systemic medications such as clonazepam and others.
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