A classic work, now in its fourth edition, Clinical Voice Pathology is a distillation of the authors' many years of experience gained in a multitude of settings, across a huge range of disorders in populations through the life spectrum, and represents etiologies arising from medical, environmental, social, psychological, occupational, and even idiopathic threats to vocal health. Whether typical voice user, occupational voice user, elite vocal performer, head and neck cancer client, or anyone who has lost the ability to communicate competently and confidently due to detrimental voice change, each patient presents a unique diagnostic dilemma: how best to return the voice to optimal condition? In answering this question, the authors assert that voice pathologists must apply knowledge of anatomy and physiology, etiologic correlates, laryngeal pathologies, and differential diagnosis to conduct an accurate evaluation. Traditional clinical management requires well-developed skills in the interpersonal interview, behavioral observation and modification, and task selection and elicitation. The contemporary voice assessment no longer relies solely on audio-perceptual voice quality judgments, but also demands technical expertise in using voice laboratory instruments for acoustic analysis, aerodynamic measures, and laryngeal imaging to help inform the management plan. Finally, we can only succeed when we have educated our patients to understand and self-monitor voice production behaviors independently and accurately. Thus, this book organizes, explains, and illustrates the comprehensive hierarchy of knowledge necessary to manage voice disorders by: Opening with an entertaining history of voice disorders from its ancient foundations to the present, so clarifying the role of speech-language pathologists in the care of voice disordered patients, and introducing the interdisciplinary background that has proved essential in attaining success in voice therapy. Detailing the anatomy and physiology of voice production to provide an understanding of the structure and function of the laryngeal mechanism as an essential basis for evaluating phonatory function, examining the larynx and vocal folds, and recognizing the impact of abnormal changes or adaptations on voice production. Providing a thorough update on the etiologies of voice disorders (including misuse, medically-related factors, primary disorders, and personality-related influences) by discussing the common factors associated with the cause and maintenance of voice disorders in order to understand best options for treatment planning. Presenting the pathologies of the laryngeal mechanism, organized according to ASHA's Classification Manual for Voice Disorders-I in eight major groups: Structural pathologies; Inflammatory conditions; Trauma or injury; Systemic conditions affecting voice; Aerodigestive conditions affecting voice; Psychiatric or psychological disorders affecting voice; Neurologic voice disorders; Other disorders of voice. The text illustrates many of the pathologies with color plates. Discussing the objectives and procedures of a systematic diagnostic voice evaluation, introducing traditional evaluation techniques, including the patient interview, audio-perceptual judgments, patient self-assessment, determining the cause(s) and maintaining factor(s) of the voice disorder, and educating the patient about these findings to establish a collaborative management plan based on these clinical data. Reviewing the instrumental measures that comprise a comprehensive voice assessment, including the scientific principles that underlie their development, application, and interpretation. In addition to standard measures of acoustics, aerodynamics, electromyography, and stroboscopy, this edition explains the utility of high speed digital imaging and videokymography tools. The appendix includes instrumental measurement norms and a helpful glossary of terms. Exploring an array of voice therapy approaches following the orientations of hygienic, symptomatic, psychogenic, physiologic, and eclectic treatments. Using frequent case examples to illustrate major insights about voice treatment gathered from the authors' thirty-plus years of clinical experience, and orienting the reader to the theories, selection criteria, and clinical methods for specific voice management principles. Delivering a treatment framework that is appropriate for common, yet diverse complaints due to nodules, laryngopharyngeal reflux, paralysis, and vocal fold dysfunction, as well as infrequent disorders such as papilloma, mutational falsetto, and transgendered voice. Highlighting the current clinical evidence that either supports or refutes popular treatments used in voice therapy. Introducing the factors that influence clinical management approaches for the performing voice, such as personality, temperament, performance routines and schedule, and other special considerations needed for care and treatment, as well as defining the roles of a necessarily expanded interdisciplinary team, and identifying the affiliate organizations that represent and support voice performers. In addition to traditional voice therapy considerations, non-traditional alternative treatments that are popular with this population are also considered. Providing what is effectively a stand-alone manual on the management and rehabilitation of the laryngectomized patient, reflecting the current 'best practice' in voice rehabilitation or restoration in head and neck cancer patients, and outlining the complementary roles of the interdisciplinary treatment team as a means to understanding the multiple management goals: cure the disease, select optimal communication methods, ensure safe swallowing, and address any associated physical, social, and emotional changes that affect each patient Packed with a vast amount of entirely new artwork, redrawn and historical images, full color illustrations, replete with case examples, multimedia images of pathologies, and fully revised and updated, Clinical Voice Pathology maintains and improves on the standards set by its predecessors and is set to enjoy the same worldwide adulation. In the authors' words "Over the past four decades, our chosen specialty of clinical voice pathology has expanded greatly within the field of communication disorders. Nonetheless, this fourth edition of our text retains its original purpose: to provide students and clinicians with a strong foundation of basic voice science infused with a deep clinical understanding of the best methods for assessing and treating voice disorders. As we prepared this edition, we challenged ourselves to revise every chapter thoroughly, by referencing the latest relevant published research, infusing clinical treatment evidence, and sharing lessons learned from our ever-broadening experience, whenever possible. The effort was both illuminating and rewarding. Consequently, we hope that you, the reader, will find this text clear, informative, and a worthwhile addition to your professional library."