Dysphonia Following Anoxic Brain Injury

by Kristen

I work in a SNF and have a patient who suffers from dysphonia following an anoxic brain injury. The brain injury happened at least 2 years ago and the patient has been nonverbal since then. The patients cognitive status is functional, and he scored highly on a receptive language assessment I completed with him. It is unclear how much therapy he received due to poor history. Initially I was unsure about the extent of the damage to the vocal cords, but found that the patient could not produce any quality sound and could not participate in the s-z ratio assessment. I suspected vocal fold paralysis and requested an ENT consult to explore more. The consult reported that the vocal cords “weren’t paralyzed, but sluggish in movement.” This baffles me as the patient is unable to produce any quality voice at all, despite several maneuvers to help him to do so. I am at a loss with what to do with this patient, and all my research has led me into a corner. Does anyone have anymore input or experience with something like this? Is AAC the best option or is there something I’m missing. Any advice would be greatly appreciated.

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Bridget is an ASHA certified, practicing speech-language pathologist. She is passionate about providing parents with information on child speech and language development as well as provide functional, easy activities to do at home! Parents have the power to make a real difference. Follow Bridget at Facebook and Pinterest for more fun!

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