Praxis SLP Licensure Exam

After open heart surgery, a patient presents with hypo phonic, breathy voice. What condition is most likely to be discovered upon endoscopy?

1. Vocal fold polyps

2. Presbylaryngeus

3. Vocal fold paralysis

4. Arytenoid granuloma

The correct answer is: Vocal fold paralysis

In the scenario described, the patient's hypophonic, breathy voice following open heart surgery suggests a significant impact on the vocal folds' function. Vocal fold paralysis is characterized by a loss of muscle control, leading to a weakened or ineffective closure of the vocal folds, which results in a breathy voice quality. This condition commonly arises due to trauma or damage to the recurrent laryngeal nerve during surgical procedures in the neck or thoracic area, such as open heart surgery. Upon endoscopy, one would expect to see one or both vocal folds positioned away from the midline, lacking the typical medial contact necessary for phonation. This means that rather than lightly touching each other to produce a clear sound, the folds would be unable to come together adequately, confirming the presence of paralysis. While other conditions like vocal fold polyps, presbylaryngeus, and arytenoid granuloma can also affect voice quality, they typically present with different characteristics upon examination. Polyps are usually associated with a more hoarse voice rather than breathy and would appear as lumpy growths on the vocal folds. Presbylaryngeus relates to age-related changes in the larynx affecting vibratory characteristics over time, but it doesn't usually present ac