Laryngeal Function and Voice Disorders: Basic Science to Clinical Practice

Review by L Flood
Middlesborough, UK

Voice work, long the poor relation in otolaryngology, has proved a popular topic for book publishers of late. The challenge is to provide some novelty and appeal to the trainee, as much as to the subspecialist senior surgeon and those clever folk, the speech and language pathologists.

I usually start my review by reading the Foreword and Preface, to determine the target audience, the content, and any claim to ‘something different’. The author of this Foreword is to be congratulated on producing a superbly insightful description of this book. It left me thinking I could almost copy it word for word (indeed, at times, I will) as I cannot improve on it, frankly.

Well, it tells us that there are nine chapters, all presented in a very distinctive and consistent format. Each opens with a summary, learning objectives and introduction, followed by the body of the chapter, a clinical case vignette (these are well thought out), text questions with detailed answers, references, and suggested future reading. Actually, this is almost word for word plagiarism, I do admit.

The opening chapter is on the basic sciences of the anatomy and physiology of the voice. The anatomical diagrams are particularly clear and attractive, and the physiology is ‘made simple’ (no easy task). Then comes a ‘Survey of Voice Disorders’, obviously the longest chapter, exploring everything that can go wrong. It is illustrated with high-quality endoscopic photographs (most from earlier Thieme publications, however) and many a detailed table. This chapter contains 125 references, most very recent indeed.

Four chapters then cover the diagnostic work, from history taking, through acoustic and aerodynamic analysis of vocal function, to endoscopy and stroboscopy. Some chapters are clearly aimed at the speech and language pathologist and the US one at that. It is intriguing to note how their role varies with individual state legislation, but equally how often questions of competency are answered as ‘possibly’ rather than yes or no. That was a clever feature. Endoscopy prompts many more nice laryngeal images, but true nostalgia is evoked by seeing the examining doctor wearing a head mirror and a white coat (the former sadly unknown to most and the latter banned in UK practice).

Chapter 7 is entitled ‘Medical Treatment of Voice Disorders’, but starts by repeating the earlier diagnostic work and quickly takes us onto surgery. There is brief coverage of phonomicrosurgery, laryngeal framework surgery, and injection augmentation and Botox. Chapter 8 is devoted to the physiotherapy role of the speech and language pathologist, and is particularly good in terms of professional voice users, transgender issues and voice disorders in childhood. The final chapter covers voice rehabilitation after laryngeal cancer and gives an excellent review of the various tracheoesophageal valves.

As always, the purchaser gets access to the online version, also via MedOne. What makes this book stand out is the chapter structure, described earlier. Self-assessment questions and answers are commonly employed, but here they are a major feature, which turns this into a far from passive read. There is content here for the otolaryngology trainee, the consultant with a special interest, and, obviously, the speech and language pathologist. I initially skipped over the sophisticated scientific analysis of voice, thinking it of speech and language pathologist relevance only, but, on reflection, we all should have some insight into the work of our colleagues. That Foreword says ‘It is an invaluable addition to the literature and should be in the library of every voice care professional’. It is indeed and it should indeed. I cannot improve on that (which made for an easy review for once).

Amazon Link: Laryngeal Function and Voice Disorders: Basic Science to Clinical Practice
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