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Diagnostic Voice Evaluation, 觀察呼吸發聲效率兩個指標 - Coggle Diagram
- Diagnostic Voice Evaluation
- Discover Etiologic, Physiologic, or Behavioral Factors
- Explore causes of voice disorders
- Describe deviant vocal symptoms
- Assess impact on respiration, phonation, resonance
- Develop a Systematic Management Plan
- Patient education and motivation
- Structured Diagnostic Workflow
- Perceptual Voice Assessment
- Voice Attributes Evaluated
- Strain 聲音緊繃 hyperfunction的情況
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- Tools for multidimensional auditory evaluation:
- GRBAS (Grade, Roughness, Breathiness, Asthenia, Strain)
- 4-point scale: Normal :zero:, Slight :one:, Moderate :two:, Extreme :three:
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- CAPE-V (Consensus Auditory-Perceptual Evaluation of Voice)
- :zero:- :100:公釐的視覺類比量表Visual Analog Scale, evaluates severity of key vocal attributes 針對每個嗓音特質標記持續性或間歇性
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- /a/ (lax) and /i/ (tense) for baseline phonatory analysis
- Standardized sentences, each targeting specific vocal behaviors
- Natural conversational context for holistic evaluation
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- Structured or informal interview formats
- Key data collection points:
- Referral source and reason
- Chronological history of vocal issues
- Medical background (e.g., surgeries, medications, habits)
- Social context affecting voice use
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- Build rapport, assess patient’s understanding of the condition了解發病成因 贏得個案信任
- Comprehensive otolaryngologic assessment
- Review voice problem history
- Examination of the head, neck, oral, and nasal cavities
- Visual examination of the larynx using:
- Tools: laryngeal mirror, head mirror
- Patient produces phoneme /i/ for optimal visualization
- Fiberoptic endoscope: flexible and rigid options
- Telescopy with 70° or 90° scopes for enhanced visuals
- Radiographs for structural insights
- Blood analysis for potential systemic issues
- Swallowing studies to assess related functional difficulties
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- Indicates possible vocal fold pathology;一般是等長 values >1.4 abnormal
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- Maximum Phonation Time (MPT):
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- Evaluates patient’s perceived impact of voice disorder:
- Voice Handicap Index (VHI): Functional, Physical, Emotional
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- VHI-10: Simplified 10-item variant for faster use
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- Final Impressions and Prognosis
- Summarize key etiologic factors:整合病理原因
- Primary contributors, secondary influencers寫出嗓音品質的原發性和次發性病因
- Based on patient’s physical/emotional state, adherence potential 評估改善嗓音的可能性，找到病人想做的和能做的事情
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- Roles in Diagnostic Voice Evaluation
- Diagnose laryngeal pathologies
- Determine medical/surgical treatments
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- Design and implement therapy
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- Vocal Coach & Other Professionals
- Optimize voice techniques
- Collaborate in management
- Patient Profiles and Referral Sources
- Teachers, singers, healthcare workers, factory workers
- Usage levels: elite performers to non-vocal professionals
- Primarily from otolaryngologists
- Case Study: Application of Process
- Teacher with hoarseness, bilateral vocal nodules, GERD
- Findings: moderate hoarseness, vocal strain, neck tension
- Therapy: vocal hygiene, hydration, GERD management, exercises
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