The plan is to build a strong conceptual framework about the umbrella diagnosis of dystonia and then to zero in on this neurological disorder as it affects the larynx and causes the clinical syndrome of spasmodic dysphonia and/or breathing difficulty. This course is offered for 0.3 ASHA CEUs (Intermediate level, Professional area).

You can find more information, as well as the registration form, in this downloadable brochure:

Brochure for 2013 BVI Speech Pathology Seminar

The early bird registration deadline is March 22; the regular registration deadline is April 5. Hope to see you there!

Update: Due to a mailing issue, early bird registration has been extended to April 5.

A: The human papilloma virus (HPV) comes in 150 or more subtypes.  Think of it like the many models of automobiles that all fall under the designation “Ford.”  Subtypes found most often in the respiratory and genital tracts are 6 and 11.  HPV infection is associated with some degree of risk of stimulating, or converting to, a carcinoma.  Hence the higher risk of cervical cancer in women with HPV infection.  Some subtypes are considered to have a low risk of viral carcinogenesis; others have a high risk.  At BVI, the majority of our many adult patients have 6 or 11, both of which are low-risk subtypes.  We also have one or two who have both 6 and 11.  Then we have a handful of patients with intermediate or high risk for cancer.  A few of these high-risk subtypes have in fact caused cancers in our population of ~150 adult patients  with RRP.  Thankfully, all have responded well to treatment and none to my memory have died from their cancer.

A:  Human papilloma virus infection can consist of as many as 150 different subtypes.  Some are related to skin infection (causing warts).  Some are more common in genital or respiratory sites.  Genital lesions are typically called condylomata, or genital warts.  In the airway, the lesions are typically called papillomas.  Commonest subtypes in the airway are types 6 and 11.  These two subtypes comprise the vast majority of our patients at BVI.  We have patients who have also tested positive for types 16, 18, 45, 55, and a few others.

A:  The underlying disorder is HPV (human papilloma virus) infection of the airway, especially the larynx.  The virus “sets up house” chronically inside airway and stimulates a kind of proliferation called papillomas, or papillomatosis.  Because these lesions tend to recur after surgical removal, the clinical syndrome has become referred to as recurrent respiratory papillomatosis (RRP).

A: It is possible to have an MI (heart attack) without any chest pain.  In the same way, it is possible to have acid reflux up the esophagus without any heartburn.  Beyond this, even if acid comes up into the throat at night, this may not waken you unless it is major.  Think of gentle-to-moderate rain in the night as an analogy.  If you do have the nighttime reflux, however, you may notice symptoms such as a dry or scratchy/sore throat, increased mucus production with throat clearing, a deep morning voice requiring more warmup if you must sing early in the day.  The potential for “silent” reflux explains why physicians may suggest a treatment trial even when you have no awareness of actual acid either during the day, or at night.