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Miranda is a 34-year-old woman with a 3-month history of dysphonia, which began after an upper respiratory infection (URI)

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Miranda is a 34-year-old woman with a 3-month history of dysphonia, which began after an upper respiratory infection (URI). Her chief voice complaints are harsh and strained voice quality, high speaking pitch, and vocal fatigue by the end of the day. She saw an otolaryngologist (ENT), who diagnosed her with muscle tension dysphonia and laryngopharyngeal reflux disease (LPRD). She has been prescribed proton pump inhibitors. Miranda reports being depressed because of the changes in her social life due to her dysphonia.

1. The ENT’s report of the stroboscopic laryngeal exam noted “moderate laryngeal constriction.” Based on this information, which structures are most likely involved?

A. The petiole of the epiglottis

B. The arytenoids

C. The ventricular folds

D. All of the above

2. This type of dysphonia is known as

A. Secondary-based muscle tension dysphonia

B. Primary-based muscle tension dysphonia

C. Puberphonia

D. Functional aphonia

3. Videolaryngostroboscopy also probably showed

A. Swelling and redness of the vocal folds and arytenoid mucosa

B. Vocal fold atrophy

C. Polyps

D. Paresis

4. Which perceptual observations would be made about this patient’s voice on a standardized voice protocol?

A. Her voice remains consistent across speaking tasks.

B. Her voice changes considerably across speaking tasks.

C. Her voice is normal for certain speaking tasks.

D. Her voice is hypernasal.

5. Which of the following treatment options would serve this patient well?

A. Pharmacologic and behavioral

B. Voice rest

C. Whisper

D. Glottal stops