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Surgical Treatment for Dysphonia

Code: 101723 ECTS Credits: 6
2025/2026
Degree Type Year
Logopedia OP 4

Contact

Name:
Juan Lorente Guerrero
Email:
juan.lorente@uab.cat

Teachers

Juan Fernando Fuentes Cabrera
Silvia Naches Solsona

Teaching groups languages

You can view this information at the end of this document.


Prerequisites

Official prerequisites are not required.

It is desirable for the student to have general knowledge in the anatomy and physiology of the organs that compose the phonatory system: mouth, nose, pharynx, larynx, trachea, bronchi, lungs and diaphragm.  Anatomical and physiological knowledge of the nervous system is also important, as it is the system that integrates the sensitive information and executes the motor responses of the phonatory system.

It is also necessary to know the relations of the phonatory system and the nervous system in the production of  language, speech and voice.

On the other hand, it is necessary that the student has knowledge  about the typical alterations of the voice: dysphonies, dysglossies, rhinolalia, etc. They must know how to differentiate the different pathologies well in order to understand the medical and surgical treatment of them.

The subject Medical-surgical treatment of dysphonies is an optional subject that is taught in fourth year of the second semester of the Degree of Speech Therapy.

Language is an exclusively human and highly complex function that allows us to manifest our personality and express our feelings, so often say that the voice is the letter of presentation of the

However, some voice disorders, such as chronic dysphonia, may trigger in patients significant emotional imbalances such as depression and social isolation, etc.

The ENT specialists understand that a good portion of the injuries that have to be treated through phonosurgery, have originated and developed due to poor use of  mechanisms of voice production.

If  we remove the injury, but we do not correct these triggering or promoting mechanisms, we will not have treated the condition properly.

The ENT specialist is responsible for diagnosing the etiology of the dysphonia and indicating the treatment needs. These can be: pharmacological, surgical and rehabilitative/logopedic treatment, or a mixed treatment. Thesurgeon indicates the beginning of the rehabilitation based on the surgical evolution of the patient in addition to his general state. Once  the diagnosis and the corresponding treatment have been carried out, the need for the speech therapy and the  exact treatment needed, as well as the guidelines and the type of exercises required is a  competence of the own speech therapist.


Objectives and Contextualisation

 OBJECTIVES OF THEORETICAL CLASSES
1.    While attending this course, the student can begin the rehabilitation of the voice, while his knowledge deepens.  This will allow them to develop protocols of action in speech therapy.
2.    To give the student knowledge to work in multidisciplinary teams, exchanging information with the other ENT professionals involved in the diagnosis, treatment and evolution of the patient. Emphasis is placed on risk factors, especially the signs and symptoms that should make us suspect that we are in front of a tumor recurrence. Thus, a speech therapist must know how to interpret a medical report
3.     Learn now how to discriminate the needs of speech therapy, plan it and put it into practice, without forgetting the needs and preferences of the patient for one type or another of treatment. Speech therapy has gone from being barely used option to becoming an indispensable part of the recovery process

In  the  subject Surgical treatment of dysphonia students will learn to relate the knowledge already acquired in the subject of anatomy and physiology, as well laryngeal and resonant cavity diseases. They will practice assessment and intervention,  and will learn to discriminate between normal and pathological voices, as well as the surgical and medical procedures available to ENT specialists for the treatment such diseases. The students will also be able to develop protocols of speech therapy.


Learning Outcomes

  1. CM21 (Competence) Interpret the results of ENT examination techniques and integrate these data with speech therapy evaluation techniques.
  2. KM54 (Knowledge) Describe the consequences of laryngectomies and dysphonia on people's communication.
  3. KM55 (Knowledge) Identify the characteristics of language in people with cochlear implants, dysphonia, and laryngectomies.
  4. KM56 (Knowledge) Identify from cases what information should be offered to the person and/or family members so that they can make their own decisions.
  5. KM57 (Knowledge) Explain the intervention techniques available according to the characteristics of each case.

Content

  1. Oral communication Physiology.   General aspects of the spoken voice.
  2. Clinical exploration of the voice.  Management  of professional voice (singer´s voice)
  3. Verbal communication disorders. Dysphonia: etiology, physiopathology, diagnostic procedures, differential diagnoses,  therapeutic methods.  Occupational disability derived from dysphonia.
  4. Vocal education for voice professionals.   Treatment of acute dysphonia in the professional setting.
  5. Functional disorders of the larynx:  respiratory and protective. Treatment
  6. Vocal rehabilitation. Vocal hygiene. Quality of life in voice disorders.
  7. Medical treatment of voice disorders: toxics, drugs, allergies, upper and lower respiratory infections, muscular tension syndrome. Medical treatment-related voice disorders. Voice rest.
  8. Medical treatment of inflammatory and endocrine dysphonia.
  9. Pharyngeal and laryngeal manifestations of gastric reflux disease.  Medical and surgical treatment.
  10. Medical and surgical treatment of laryngeal malformations.  Medical, surgical and behavioral treatment of pediatric dysphonia: indications, complications and results.
  11. Neurological dysphonia. Spasmodic dysphonia. Bilateral vocal cord paralysis. Botulinum toxin injection in spasmodic dysphonia. Electrical stimulation of laryngeal muscles.
  12. Diagnosis and treatment of external and internal laryngeal trauma and its sequels. Diagnosis and treatment of peripheral laryngeal paralysis. Timing of intervention and repair techniques.
  13. Phonosurgery. History, principles and development.  Indications, initial assessment and preoperative planning, surgical techniques, complications and results.  Preoperative and postoperative (role of the phoniatrist ).
  14. Surgery of benign and functional laryngeal lesions. Vocal nodules and polyps, papilloma, Reinke’s edema, granulomas, membranes, cysts and other benign neoplasms.
  15. Malignant laryngeal lesions. Treatment indications (radiotherapy, chemotherapy and surgery), surgical techniques (chordectomy, partial laryngectomy, total laryngectomy, neck dissection),complications and results.  Tracheostomy.  Pharyngeal and esophageal repair. 
  16. Rehabilitation and follow up of laryngectomy patients.  Voice assessment after laryngeal carcinoma surgery. Voice rehabilitation after laryngeal carcinoma treatment. Psychosocial and quality of life impact of laryngeal cancer diagnosis and treatment.
  17. Surgical rehabilitation techniques after total laryngectomy. Phonatory trachesophageal punctures.  Procedure, indications, complications and results. Tracheoesophageal speech prostheses
  18. Structural laryngeal surgery. Indications, techniques; thyroplasty , arytenoid abduction, combined procedures. Complications and results.
  19. Assessment and surgical treatment of laryngeal injuries. Vocal cord scars, laryngotracheal stenosis. Timing of surgical intervention, repair techniques, splints and grafts, additional treatment.
  20. Laser in phonosurgery. Procedure, indications, complications and results.
  21. Medical-surgical treatment of swallowing disorders: indications, complications and results. Tracheostomy and swallowing issues.
  22. Medical and surgical treatment of diseases that cause oropharyngeal dysphagia or aspiration. Enteral nutrition, gastrostomy.

Activities and Methodology

Title Hours ECTS Learning Outcomes
Type: Directed      
Hospital practices 12 0.48 CM21, KM55, KM56, CM21
Theoretical sessions 24 0.96 KM54, KM55, KM57, KM54
Type: Supervised      
Tutoring session for coursework 2 0.08 CM21, CM21
Type: Autonomous      
Bibliographic search 22 0.88 CM21, KM56, KM57, CM21
Coursework development 25 1 CM21, KM54, KM55, KM56, KM57, CM21
Preparation of the clinical case oral presentation 20 0.8 CM21, CM21
Studying 43 1.72 KM54, KM55, KM56, KM57, KM54

Program sessions

Expositions of content from the program with iconographic material stimulating the discussion of the subject.

Hospital Practices

The hospital practice  will be carried out in the outpatient consult of the Otorhinolaryngology Department of the Vall d'Hebron University Hospital.

Students will be integrated into a healthcare team in outpatient consult: they will observe how complementary diagnostic explorations (endoscopes, stroboscopes, etc) are performed, as well as  the evolution and observation of the anatomical and functional alterations after treatment.

Students who wish to go to the operating room to observe the various steps of the  vocal microsurgery  (preparation for surgery, instrumental and techniques, etc.) are encouraged to do so.

All students in the class  will be divided into 6 groups. Each group will attend 2 days, previously assigned, to the hospital from 9 to 15 hours. No changes can be made.

 Presentation of a clinical case

Completion of a practical work on a clinical case provided by the teacher. The student will have to elaborate a bibliographic review on the subject, given in writing to the professor and defended in public, during the assessment weeks.

The active participation of students through questions, opinions and personal contributions will be encouraged at all times, both about acquired knowledge of each topic as well as from bibliographic research.

Annotation: Within the schedule set by the centre or degree programme, 15 minutes of one class will be reserved for students to evaluate their lecturers and their courses or modules through questionnaires.


Assessment

Continous Assessment Activities

Title Weighting Hours ECTS Learning Outcomes
EV1. Attendance at hospital practices, and brief report of the observed cases 20% 0 0 CM21, KM55, KM56
EV2. Work report, oral presentation and defense of the clinical case 70% 2 0.08 CM21, KM54, KM56, KM57
EV3. Attendance and involvement in class 10% 0 0 KM54, KM57

The competences of this course will be evaluated:

Theoretical content:

A multiple-choice exam (EV3), questions with 5 answers, of which only one is correct.  The exam will include at least two questions by topic, although this number can be increased depending on the theoretical content and the relevance of these at the time of consolidating the theoretical bases of the subject. There’s a penalty for guessing, three wrong answers erase one good answer. Only one option is lacorrect. The minimum grade to pass the subject is 5. This represents 40% of the grade of the subject. It is mandatory to attend 80% of the theoretical classes.

Hospital practices:  Attendance and student participation and involvement  will be assessed, presentation and defense of the clinical case together with the written case (EV2) will COUNT FOR 40% OF THE FINAL GRADE

 The attendance to all the practices (EV1) will be MANDATORY AND  WILL COUNT FOR  20%  of the final grade  and each student will give a summary about the clinical cases seen in consultations.

All assessments are individual. The clincal case will be delivered on-line.

 A minimum note will be established for each assessment module from which the student will be able to pass the subject

 Final note:

 

Passing the subject: when the student has a finalgrade of 5or more points, it is essential to have attended the 80% of the theoretical classes and have attained a final test score of at least 5.

No unique final synthesis test for students who enrole for the second time or more is anticipated.

 

General assessment guidelines: https://www.uab.cat/web/estudiar/graus/graus/avaluacions-1345722525858.htm


Bibliography

Basic References:

Ramírez C. Manual de Otorrinolaringología, Ed. McGrawHill. Madrid 2007

Bleeckk. Disfagia: Evaluación y reeducación de los trastornos de la deglución. Ed. McGrawHill 2004.

Jaume G, Tomas M. Manejo de la disfagia y aspiración. Ed. Ergon 2007

Casado J. C. Pérez A. Trastornos de la voz: Del diagnostico al tratamiento. Ed. Aljibe. Malaga 200

Practica para la elaboracion de informes logopedicos. Mendizábal, N. - Santiago, R. - Jimeno, N. - García, N. - Díaz-Emparanza, M .Editorial: Medica Panamericana . 2013

Patología de la voz. I Cobeta, F. Nuñez, S Fernández. Ponencia Oficila de la SEORL PCF Ed. Marge Médica Books 2014

 

Further readings:

  1. Courtat P., Peytral C, Elbaz P. Exploraciones funcionales en ORL. Ed. Massón. Barcelona 1994
  2. Cobeta, I. - Nuñez, F. - Fernández, S. Patologia de la Voz. Editorial: Marge Books 2014
  3. Hirano, H. Clinical examination of voice. Springer. Berlín 1981.
  4. Sataloff R.T. Profesional voice. Raven Press. New York 1991.
  5. Le Huche F, Allali A. La voz Tomo (1, 2, 3, 4). Ed. Massón. Barcelona 2004
  6. Ramírez C. Manual de Otorrinolaringología, Ed. McGrawHill. Madrid 2007
  7. Educación de la voz. Anatomía, patologías y tratamiento. Ed Ideaspropias. 2004.
  8. Núñez F., Maldonado, Suárez C. Cuidados y rehabilitación del paciente traqueotomizado. Servicio de publicaciones Universidad de Oviedo. 2000
  9. Puyuelo M. Casos Clínicos en logopedia. Ed. Massón 1997
  10. Novo JJ, Videgain J, Videgain G. et al. Tratamiento conservador en el carcinoma de laringe. Ponencia oficialdel XV Congreso de la Socieda Vasca de ORL. Ed. Universidad del País Vasco. Bilbao 2001.
  11. Casado J. C. La evaluación clínica de la voz. Fundamentos médicos y logopédicos. Ed. Aljibe. Málaga 2002.
  12. Menaldi J. La Voz Patológica. Ed. Panamericana 2002
  13. Suárez A. Martínez J.D., Moreno J.M, García  ME. Trastornos de la voz. Estudio de casos. Ed. EOS 2003.
  14. Bleeckk. Disfagia: Evaluación y reeducación de los trastornos de la deglución. Ed. McGrawHill 2004.
  15. Jaume G, Tomas M. Manejo de la disfagia y aspiración. Ed. Ergon 2007
  16. Navarro S., Navarro F., Romero P. Voz: Trastornos y rehabilitación. Ed. CEP 2007
  17. Casado J. C. Pérez A. Trastornos de la voz: Del diagnostico al tratamiento. Ed. Aljibe. Malaga 200
  18. Calais-Germain, B. - Germain, F. Anatomia para la voz. entender y mejorar la dinamica del aparato vocal. Editorial: La liebre de marxo 2014.
  19. PRACTICA PARA LA ELABORACION DE INFORMES LOGOPEDICOS. Mendizábal, N. - Santiago, R. - Jimeno, N. - García, N. - Díaz-Emparanza, M .Editorial:  Medica Panamericana . 2013
  20. Patología de la voz. I Cobeta, F. Nuñez, S Fernández. Ponencia Oficila de la SEORL PCF Ed. Marge Méica Books 2014

Software

No special software needed


Groups and Languages

Please note that this information is provisional until 30 November 2025. You can check it through this link. To consult the language you will need to enter the CODE of the subject.

Name Group Language Semester Turn
(PLAB) Practical laboratories 111 Catalan second semester morning-mixed
(PLAB) Practical laboratories 112 Catalan second semester morning-mixed
(TE) Theory 1 Catalan second semester morning-mixed