Question
I am a SLP in a public school and a 6th grade girl just came to me about her voice change since her tonsillectomy recently. Not sure how long it's been since the surgery, but I'm guessing not long. Is there a certain amount of time that this can occur and
Answer
Few issues to consider with the 6th grade female after tonsillectomy:
her 'voice' change is actually resonance changes not vocal fold changes so no vocal hygiene is necessary.
if the adenoids were removed as well as the palatine tonsiles, then there could be some velopharyngeal incompetence and hypernasality. If this is the case, palatal strengthening exercises (puff up cheeks, plosive phonemes, etc) would be useful to help the palate adjust to the new depth of the nasopharynx.
If it truly sounds like a voice disorders (ie hoarseness), the resonance issues from the tonsils could have been masking the voice disorders previously and traditional voice therapy would be useful.
Recommended approach:
assess hypernasality with mirror test if no equipment available,
voice evaluation to determine if it is a true voice disorder,
facilitative strategies for voice and hypernasality to identify perceptual qualities that are acceptable,
referral to ENT to evaluate VPI and voice if unable to facilitate acceptable voice/resonance
Lori Lombard, PhD is an associate professor at Indiana University of Pennsylvania specializing in voice and laryngectomy rehab. Previously, seven years experience at the University of Pittsburgh Medical Center.
Lori Lombard, Ph.D
Related Courses
1https://www.speechpathology.com/slp-ceus/course/20q-induced-laryngeal-obstruction-overview-1076120Q: Induced Laryngeal Obstruction - An Overview for Speech-Language PathologistsThe nature of induced laryngeal obstruction, including comorbidities and causes, and the speech-language pathologist’s role in evaluation and treatment of this disorder are described in this course. Current diagnostic and treatment practices and research updates pertaining to the condition are discussed.textual, visual129USDSubscriptionUnlimited COURSE Access for $129/yearOnlineOnlySpeechPathology.comwww.speechpathology.com20Q: Induced Laryngeal Obstruction - An Overview for Speech-Language PathologistsThe nature of induced laryngeal obstruction, including comorbidities and causes, and the speech-language pathologist’s role in evaluation and treatment of this disorder are described in this course. Current diagnostic and treatment practices and research updates pertaining to the condition are discussed.10761OnlinePT60M
The nature of induced laryngeal obstruction, including comorbidities and causes, and the speech-language pathologist’s role in evaluation and treatment of this disorder are described in this course. Current diagnostic and treatment practices and research updates pertaining to the condition are discussed.
2https://www.speechpathology.com/slp-ceus/course/vocal-fold-paralysis-11280Vocal Fold ParalysisSpeech pathologists may encounter patients with vocal fold paralysis in various clinical, hospital, and rehabilitation settings. This course provides an overview of the etiology, evaluation, prognosis, and management options, including voice therapy techniques.auditory, textual, visual129USDSubscriptionUnlimited COURSE Access for $129/yearOnlineOnlySpeechPathology.comwww.speechpathology.comVocal Fold ParalysisSpeech pathologists may encounter patients with vocal fold paralysis in various clinical, hospital, and rehabilitation settings. This course provides an overview of the etiology, evaluation, prognosis, and management options, including voice therapy techniques.11280OnlinePT60M
Speech pathologists may encounter patients with vocal fold paralysis in various clinical, hospital, and rehabilitation settings. This course provides an overview of the etiology, evaluation, prognosis, and management options, including voice therapy techniques.
3https://www.speechpathology.com/slp-ceus/course/chronic-cough-evaluation-10793Chronic Cough: EvaluationThis is Part 1 of a 2-part series. Chronic cough affects millions of people per year, and SLPs can be an integral part of evaluation and management of this disorder. Characteristics of chronic cough and its impact on quality of life are discussed in this course. In addition, SLP evaluation of chronic cough to identify candidates for voice therapy management is described in the context of medical evaluation and management.auditory, textual, visual129USDSubscriptionUnlimited COURSE Access for $129/yearOnlineOnlySpeechPathology.comwww.speechpathology.comChronic Cough: EvaluationThis is Part 1 of a 2-part series. Chronic cough affects millions of people per year, and SLPs can be an integral part of evaluation and management of this disorder. Characteristics of chronic cough and its impact on quality of life are discussed in this course. In addition, SLP evaluation of chronic cough to identify candidates for voice therapy management is described in the context of medical evaluation and management.10793OnlinePT60M
This is Part 1 of a 2-part series. Chronic cough affects millions of people per year, and SLPs can be an integral part of evaluation and management of this disorder. Characteristics of chronic cough and its impact on quality of life are discussed in this course. In addition, SLP evaluation of chronic cough to identify candidates for voice therapy management is described in the context of medical evaluation and management.
4https://www.speechpathology.com/slp-ceus/course/laryngectomy-basics-introduction-to-voice-10299Laryngectomy Basics: An Introduction to Voice and Pulmonary ChangesBasic clinical management skills related to pulmonary function and communication after a total laryngectomy are described in this course. Information about medical/surgical treatments, anatomic and physiologic changes, communication options, and pulmonary rehabilitation management is provided.auditory, textual, visual129USDSubscriptionUnlimited COURSE Access for $129/yearOnlineOnlySpeechPathology.comwww.speechpathology.comLaryngectomy Basics: An Introduction to Voice and Pulmonary ChangesBasic clinical management skills related to pulmonary function and communication after a total laryngectomy are described in this course. Information about medical/surgical treatments, anatomic and physiologic changes, communication options, and pulmonary rehabilitation management is provided.10299OnlinePT60M
Basic clinical management skills related to pulmonary function and communication after a total laryngectomy are described in this course. Information about medical/surgical treatments, anatomic and physiologic changes, communication options, and pulmonary rehabilitation management is provided.
5https://www.speechpathology.com/slp-ceus/course/respiratory-muscle-strength-training-and-9282Respiratory Muscle Strength Training and Speech-Language Pathologists: Part 1This is Part 1 of a two-part series. This course will provide an overview of respiration and why respiratory muscle strength training is important. Appropriate diagnoses for patient referral, including COVID-19, will be examined, as well as evidence for use of respiratory muscle strength training. (Part 2 - Course 9283)auditory, textual, visual129USDSubscriptionUnlimited COURSE Access for $129/yearOnlineOnlySpeechPathology.comwww.speechpathology.comRespiratory Muscle Strength Training and Speech-Language Pathologists: Part 1This is Part 1 of a two-part series. This course will provide an overview of respiration and why respiratory muscle strength training is important. Appropriate diagnoses for patient referral, including COVID-19, will be examined, as well as evidence for use of respiratory muscle strength training. (Part 2 - Course 9283)9282OnlinePT60M
This is Part 1 of a two-part series. This course will provide an overview of respiration and why respiratory muscle strength training is important. Appropriate diagnoses for patient referral, including COVID-19, will be examined, as well as evidence for use of respiratory muscle strength training. (Part 2 - Course 9283)
