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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.
*Talkativeness scale:
At BVI, we use a 7-point equally appearing interval scale
upon which patient and family rate degree of talkativeness.
1 signifies an individual who is unusually quiet and uncommunicative;
4 represents an averagely talkative person; 7 describes someone
who is unusually extroverted and even a “life of the
party” type. Notably, persons with mucosal
injuries are almost invariably 6 or 7 unless the occupational
demands on the voice are truly extreme.
"Technology-driven
diagnostic model": Used somewhat interchangeably
with the reductionistic diagnostic
model. The idea of this model appears to be that
technology is generally the answer to difficult diagnostic
dilemmas. The hope is also looking to make voice diagnosis
more “scientific” or “objective.”
Inherent to the technology-driven model is the idea that the
disorder will be better understood if only we can make enough
measures of various sorts. By extension, if we don’t
understand a voice disorder completely by the end of a large
battery of measurements, we need more measures. While BVI
clinicians make use of state-of-the-art technology, the integrative
diagnostic model is preferred . See also [BVI’s
diagnostic model/method for voice disorders].
Telangiectasia:
See post-radiation telangiectasia.
Thin liquids:
The prototype is water. Other examples include black coffee,
apple juice. There is little consistency or viscosity to thin
liquids, making them difficult to manage when there is an
issue with bolus control or inability to close the larynx
fully when swallowing, as with unilateral vocal
fold paralysis.
*Tonic variant spasmodic
dysphonia: In contrast to classic
variant spasmodic dysphonia, this variant produces
either a sustained strained-sounding voice (adductory
SD) or a voice that is more or less continuously,
rather than intermittently, breathy (abductory
SD). Tonic variant SD goes undiagnosed or misdiagnosed
far more frequently than does the classic
variant.
Topical anesthesia:
Refers to the loss of sensation confined to mucosal
surfaces (as when pontocaine, benzocaine, or lidocaine is
applied to the surface).
Trach:
A colloquial term used by clinicians to refer to a tracheotomy
tube.
Trachea: In layman’s
terminology, the windpipe. The trachea begins on its upper
end just below the larynx and extends inferiorly into the
chest to where it splits into the right and left mainstem
bronchi, which deliver inspired air to the right and left
lungs, respectively.
Tracheal resection
and reanastomosis: A surgical procedure for tracheal
stenosis in which the damaged,
narrowed segment of the trachea is removed and the healthy
remaining trachea is sutured back together.
Tracheotomy-dependence:
The state of having no choice but to breathe through a tracheotomy
tube, because of an obstruction of the normal “pathway”
for breathing, through nose and/or mouth, through the larynx,
and only then into the trachea. Tracheotomy dependence may
occur because part or all of the larynx has been removed,
e.g., for cancer, or because of severe scarring or inflammation.
Tracheotomy tube:
A device that is surgically placed into the trachea low in
the neck, with its tip well inside the trachea
and its other end anchored to a faceplate that sits on the
surface of the neck. A tracheotomy tube allows an individual
to breathe directly from the neck opening into the trachea
as an alternative to normal breathing through the nose and/or
mouth.
*Traditional diagnostic
model (for voice disorders): The method of diagnosis
used up to recent decades, and still by far the most prevalent
model worldwide. Here, the clinician collects a patient history
and then proceeds directly to mirror examination, or possibly
one using the fiberscope. Unfortunately, many diagnoses may
be missed due to missing information. See also [internal link:
BVI’s diagnostic model/method for voice disorders].
Transnasal esophagoscopy
(TNE): A diagnostic procedure that involves passing
a slender, flexible video-endoscope through a topically
anesthetized nasal passage into the back of the nose,
down past the larynx, and through the whole length of the
esophagus. Formerly, esophagoscopes
were much larger in diameter than the newer scope. This makes
passage of the scope relatively pain-free so that topical
anesthesia is all that is required. Occasionally,
anxious patients are slightly sedated for the procedure; more
commonly, sedation is not needed and in this latter instance
the patient may not only drive to the examination, but drive
back to work or home afterwards.
Transverse cordotomy:
A surgical procedure on the posterior part of the vocal fold,
first described to our knowledge by Dr. Haskins Kashima of
Johns Hopkins University many years ago. The procedure is
done for bilateral vocal fold paralysis or for glottic stenosis
caused by injury and resultant scarring of the vocal
folds together. Typically, an individual undergoes
this procedure because of tracheotomy-dependence
or because of marked exercise intolerance.
The procedure is performed endoscopically, using the laser
to make an incision across the posterior end of the most damaged
or least functioning vocal fold. Inherent to this problem,
and to this solution, is the idea that one trades away a little
bit of voice to gain a little bit better airway.
Tremor:
See vocal tremor.
Trial therapy:
The use of a variety of brief therapy approaches during the
initial diagnostic encounter to assess the vocal
phenomenology that results, and also to see what
changes of voice production appear to be possible for the
patient, versus which ones seem not to be, due to physical
limitation or nonorganic interference.
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