• Title/Summary/Keyword: 기능성 발성장애

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Differential Diagnosis between Neurogenic and Functional Dysphonia (신경성 발성장애와 기능성 발성장애의 감별 진단)

  • Kim, So Yean;Lee, Sang Hyuk
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.28 no.2
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    • pp.71-78
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    • 2017
  • Voice disorder is classified into three categories, structural, neurogenic and functional dysphonia. Neurogenic dysphonia refers to a disruption in the nerves controlling the larynx. Common examples of this include complete or partial vocal cord paralysis, spasmodic dysphonia. Also it occurs as part of an underlying neurologic condition such as Parkinson's disease, myasthenia gravis, Lou Gehrig's disease or disorder of the central nervous system that causes involuntary movement of the vocal folds during voice production. Functional dysphonia is a voice disorder in the absence of structual or neurogenic laryngeal characteristics. A near consensus exist that Muscle tension dysphonia (MTD) is functional voice disorder wherein hyperfunctional laryngeal muscle activity whereas Spasmodic dysphonia (SD) is neurogenic, action-induced focal laryngeal dystonia including several subtype. Both Adductor type spasmodic dysphonia (AdSD) and MTD may be associated with excessive supraglottic contraction and compensation, resulting in a strained voice quality with spastic voice breaks. It makes these two disorders extremely difficult to differentiate based on clinical interpretation alone. Because treatment for AdSD and MTD are quite different, correct diagnosis is important. Clinician should be aware of the specific vocal characteristics of each disease to improve therapeutic outcome.

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음성치료에 반응이 없는 기능성 발성장애 환자의 보툴리눔독소 치료

  • 김형태;조승호;김민식;박영학;선동일;유우정
    • Proceedings of the KSLP Conference
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    • 1998.11a
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    • pp.190-190
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    • 1998
  • 배경 : 기능성발성장애는 해부생리학적으로 정상적인 발성기관을 갖고 있으나 잘못된 사용에서 기인하며, 기질적 이상의 결과로서 후두 생물역학의 변화에 따른 잘못된 보상기전에 의해서 일어나게 된다. 흔히 기능성발성장애는 음성치료로서 치료가 가능하나 음성치료에 반응하지 않는 경우 치료에 많은 어려움이 따른다. (중략)

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Pathophysiology of Functional Dysphonia (기능성 음성장애의 병태생리)

  • Jin, Sung Min
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.25 no.2
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    • pp.75-78
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    • 2014
  • Functional dysphonia refers to a voice disturbance that occurs in the absence of structural or neurologic laryngeal pathological characteristics. Poorly regulated activity of the intrinsic and extrinsic laryngeal muscles is cited as the proximal cause of functional dysphonia (FD). Recently, the term functional dysphonia has been replaced in some clinical circles by diagnostic label muscle tension dysphonia (MTD), which serves to highlight excess, dysregulated, or imbalanced activity of the intrinsic and extrinsic laryngeal muscles as proximal cause of the observed dysphonia. And recent research evidence points to specific personality traits as important contributors to its development and maintenance. However, the origin of this dysregulated laryngeal muscle activity has not been fully elucidated. Further research is needed to better understand the pathogenesis of functional dysphonia, and factors contributing to its successful management.

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Other Functional and Neurological Dysphonia (기타 기능성 발성장애 및 신경성 발성장애)

  • Lee, Seung Won
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.25 no.2
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    • pp.82-85
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    • 2014
  • Functional dysphonia is a specific voice disorder refers to dysphonia without abnormal anatomical vocal fold findings at larynx. The proportions of this disorder are estimated up to 40% of dysphonia patients at ENT clinics. In this article, we will discuss about other functional dysphonia and neurological dysphonia except for muslce tension dysphonia and spasmodic dysphonia. For details, will describe about phonatory charateristics and treatment options about paradoxical vocal fold motion disorder, mutational dysphonia, essential vocal tremor, conversion dysphonia, and vocal tremor related with parkinson's disease.

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Clinical Characteristics of Functional Dysphonia (기능성 발성장애의 임상적 특성)

  • Suh, Woo-Jung;Hong, Young-Hye;Choi, Jong-Min;Jung, Eun-Jung;Sung, Myung-Whun;Kim, Kwang-Hyun;Kwon, Tack-Kyun
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.17 no.2
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    • pp.127-132
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    • 2006
  • Background and Objectives : Functional dysphonia is a voice disturbance in the absence of structural or neurologic laryngeal pathology characterized by voluntary misuse of laryngeal muscles. The present report reviews clinical characteristics of 25 patients with functional dysphonia. Materials and Method : We analyzed medical records, perceptual and acoustic analysis of voice samples, aerodynamic studies and laryngoscopy. Results : There was no sex or age predilection. Eighty four percent of patients presented sudden onset of symptoms and 76% had specific events at the onset. Most patients showed breathy or strained voice and various degree of vocal fold insufficiency with supraglottic compensatory contractions. Acoustic analysis revealed non-diagnostic, but mean flow rate was lower than normal in all cases. All patients responded to voice therapy except for 4 patients who were tort to follow up. Mean number of voice therapy sessions required to get responses is 1.9 sessions. Conclusion : We concluded that patients with functional dysphonia responded very well to short-term voice therapy and should be included in differential diagnosis in patients with dysphonia cannot be explained by structural or neurologic etiology.

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Tube phonation in water for patients with hyperfunctional voice disorders: The effect of tube diameter and water immersion depth on bubble height and maximum phonation time (과기능적 음성장애 환자의 물저항발성: 튜브 직경과 물 깊이가 물거품 높이 및 최대발성지속시간에 미치는 영향)

  • Min Gyeong Kim;Seong Hee Choi;Jong-In Youn
    • Phonetics and Speech Sciences
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    • v.15 no.2
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    • pp.31-40
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    • 2023
  • Tube phonation in water has been widely used for voice training among semi-occluded vocal tract (SOVT) exercises in which the patient bubbles with phonation keeping the tube submerged in water. This study aims to investigate the effect of tube diameter and water depth on bubble height and maximum phonation time (MPT) for patients with hyperfunctional voice disorders. Seventeen patients with hyperfunctional voice disorders were asked to bubble with sustained /u/ at the different inner diameters of tube (5, 7, and 10 mm), water depth (4, 7, and 10 cm). A water resistance phonation biofeedback system using a water height sensor was used for recording bubble height and MPT. The bubble height was significantly changed by the tube diameter while MPT was significantly changed with the tube diameter and water depth. Although the wider tube presented significantly lower bubble height for a given depth, relatively consistent bubble height was maintained. Depending on the water depth, the bubble height did not significantly differ for a given tube diameter. In addtion, MPT significantly decreased with water depth and a wider tube led significantly shorter MPT. A water level-driven water resistance biofeedback system provided useful information on bubble characteristics and vocal fold vibration depending on tube diameter and water depth. It can be useful to monitor the breath support during water resistance phonation for patients with hyperfunctional voice disorders.

Clinical Application of Botulinum Toxin to Functional Dysphonia (기능성 음성장애에서 보툴리늄 독소의 임상적 적용)

  • Kim, Han Su
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.30 no.1
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    • pp.12-14
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    • 2019
  • Functional dysphonia (FD) is a disease entity which includes various voice disorders in the absence of structural or neurologic laryngeal pathology. Muscle tension dysphonia (MTD), psychogenic dysphonia are representative FD with completely different pathogenesis. Therefore there is no standard treatment modality for FD, the first step of treatment of FD is differentiating patient's voice symptoms from other organic voice disorders and other functional voice problems. MTD is a functional voice disorder caused by hyperfunction of intrinsic and extrinsic laryngeal musculature. Symptoms include increased vocal effort, roughness, fatigue and odynophonia. First line for MTD is indirect or direct voice therapy. Unfortunately, many patients with MTD improve with voice therapy alone. For these patients, various modalities tried; lidocaine application, surgical excision of the false vocal folds, and botulinum toxin injection, etc. Botulinum toxin injections are widely used in the field of otolaryngology, especially for spasmodic dysphonia. However, its use in FD or MTD has only been described in few case reports. The aim of this lecture is to evaluate the feasibility of botulinum toxin injection for FD, especially MTD.

Controversies in Management of Functional Dysphonia (기능성 음성 장애 치료의 고려사항)

  • Kim, Han Su
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.25 no.2
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    • pp.86-89
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    • 2014
  • Functional dysphonia (FD) is a voice disorder in the absence of structural or neurologic laryngeal pathology. FD is not a single disease but a disease entity. Therefore several voice disorders, which have completely different pathogenesis, are included in this category. The first step of treatment of FD is differentiating patient's voice symptoms from other organic voice disorders and other functional voice problems. Several different treatment modalities are included in the managements of FD. Voice therapy is in charge of the main role in treatment of FD. Medical treatment is also necessary when patient has general problems which would affect voice production. Vocal folds mucosal lesions can cause FD even the lesion is minor. In this case proper surgical intervention helps to improve the symptom of FD. Psychiatric consultation should be considered when the patient has psychological problems.

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