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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.
Abductory spasmodic dysphonia
(AB-SD): A benign neurological voice disorder caused
by laryngeal dystonia.
Abductory SD interferes with smooth flow of the voice as follows:
During running speech, the voice intermittently drops out
to a whisper. AB-SD is also called intermittent whisper phonation,
and comprises about 10% of all cases of spasmodic
dysphonia. See also tonic
variant spasmodic dysphonia.
Achalasia: Failure
of a ring of muscle, such as the lower
esophageal sphincter (LES), to relax appropriately.
This muscular non-relaxation creates a functional obstruction,
interfering with normal passage of food into the stomach.
This term is most commonly used in relation to the LES, but
may also be used in reference to the upper
esophageal sphincter (UES) or even anus.
Acid reflux: The
backwards flow (reflux) of acid from stomach upwards into
the esophagus and even
farther up, to the level of the laryngopharynx.
Symptoms may be esophageal, laryngopharyngeal, or both. Esophageal
symptoms include heartburn, indigestion, acid belching. Laryngopharynx
symptoms tend to include dry throat, husky (especially morning)
voice, frequent morning throat clearing, excessive mucus,
mildly sore throat.
Acoustic analysis of voice:
The measurement and /or graphing of acoustic (sound) information
such as fundamental frequency,
formant pattern and
energies, decibel level (roughly, the loudness), signal-to-noise
ratio, jitter, shimmer,
and the like from the voice. At present it is difficult to
find unique diagnostic information from any set of acoustic
measures. Hence, acoustic analysis is arguably justified for
now in the realm of voice research and when used as a feedback
tool in the therapy room. Although this may change in the
future, at present acoustic analysis is superfluous to the
diagnostic process, and specifically to the integrative
diagnostic model or method.
Addition of loudness:
Refers to the ability to increase the loudness of the voice.
An individual may be either apparently or due to physical
limitation unable to add loudness because of vocal
fold paralysis, a nonorganic
disorder, or vocal fold bowing
– although the phenomenology
observed when three individuals representing these three diagnoses
try to add loudness differs markedly.
Adductory spasmodic dysphonia
(AD-SD): A benign neurological voice disorder caused
by laryngeal dystonia.
Typically, during running speech, the voice is interrupted
by sudden choking off of the voice, and there may be an underlying
more continuous "tight" sound to the voice as well.
Also called strain-strangle phonation. AD-SD comprises about
90% of cases of spasmodic
dysphonia. Also exists in the less common
tonic variant spasmodic dysphonia.
Aerodynamic analysis of
voice: Refers to instrument analysis of the power
supply for voice pulmonary air. Can include spirometry,
which assesses various capacities and capabilities of the
respiratory system, apart from phonation.
Also allows determination of the pressure and flow through
the vocal folds during phonation.
BVI clinicians believe that aerodynamic analysis of voice
has yet to earn a place as part of the routine diagnostic
workup. See integrative diagnostic model,
as well as BIV’s diagnostic
model/method for voice disorders. Aerodynamic analysis
of voice, however, may be of interest for voice research and
when the equipment is used as a biofeedback tool in the therapy
room.
*Air-wasting dysphonia:
A kind of hoarseness that refers to the breathiness (see Breathy
dysphonia) that one is hearing. Typically, the length
of time a person can sustain voice without taking a new breath
(maximum phonation time, or
MPT) is decreased. The voice may be described as whispery
or foggy or fuzzy. Among other things, possible causes include
vocal fold paralysis
or paresis, vocal fold bowing
and atrophy, or functional (especially non-organic)
voice problems.
Amyloid: A waxy,
translucent protein substance deposited into tissue in response
either to unknown local factors, or as a manifestation of
systemic disease, such as multiple myeloma. Treatment is generally
directed at improving function, for example via local (laser)
excision.
Ankylosis: Immobility and fusion of a joint due to disease, injury, or a surgical procedure. Ankylosis of the cricoarytenoid joint may be seen after traumatic dislocation, or in rare instances of the disease rheumatoid arthritis.
Aspiration: The sucking into the airways of foreign material, when one breathes in. Aspirated material may be saliva, ingested liquid or food, or refluxed gastric contents.
*Atypical spasmodic dysphonia:
A benign neurological voice disorder caused by
laryngeal dystonia. Atypical cases of SD may be challenging
to diagnose, even by clinicians with some experience with
the disorder. Examples of reasons that this may be so: In
the atypical case, contrary to what is usually seen, singing
may be more affected than talking; falsetto/head voice
may be more affected than chest voice, and so forth. There
may also be no phonatory arrests
in the less common tonic variant
spasmodic dysphonia.
Auditory perceptual evaluation
of voice: Auditory perception in essence is the sense
of hearing applied to assessment of the voice. In some locations
this refers primarily to characteristics of the patient’s
spontaneous speaking voice, and sometimes very basic additional
elicitations. In clinics where
the integrative diagnostic model
has been mastered, the clinician’s auditory perception
has been informed by extensive knowledge and experience of
normal and abnormal vocal capabilities
and vocal limitations. This
knowledge, along with his or her own voice used for modeling
and elicitation, are the tools
used during vocal capability battery administration. It is
auditory perceptual evaluation
of elicited vocalizations at the extremes
of normal capability that provide powerful diagnostic information
about the voice, as distinct from the larynx.
*Average/anchor frequency:
The term used at BVI to designate the pitch
(and by extension, fundamental frequency)
that an individual is using during spontaneous, running speech,
as determined via auditory
perception. We use both "average" and "anchor"
together, because some persons speak in a perceptually monotone
voice, at which point we consider the pitch extracted via
auditory perception to be virtually synonymous with "average"
fundamental frequency (Fo).
(Proven to be the case in informal study comparing Fo extracted
by auditory perception vs. by machine measures.) Other individuals
speak with a great deal of pitch inflection. In this latter
case we listen for the lowest common pitch to which the voice
seems to be "anchored." When highly inflected speakers
become generally fatigued or "depressed," they tend
to default to this pitch, which then becomes more of an "average"
pitch for them. Of course, using machine measures of fundamental
frequency (primarily using equipment for acoustic
analysis), a formal average fundamental frequency can be determined.
The ability to determine average / anchor pitch via auditory
perception during the vocal capability battery can be learned
by clinicians with good pitch perception.
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