痉挛性发声障碍和声带震颤症状的识别:专家与非专家评判的比较
Identification of symptoms for spasmodic dysphonia and vocal tremor: a comparison of expert and nonexpert judges.
作者信息
Barkmeier J M, Case J L, Ludlow C L
机构信息
Department of Speech and Hearing Sciences, University of Arizona, Tucson 85721, USA.
出版信息
J Commun Disord. 2001 Jan-Apr;34(1-2):21-37. doi: 10.1016/s0021-9924(00)00039-3.
UNLABELLED
Spasmodic dysphonia is a rare voice disorder that is most successfully treated by injection of botulinum toxin (i.e., BOTOX) into the affected laryngeal muscles. BOTOX is currently available for use by professionals outside of metropolitan voice centers who may be unfamiliar with this rare disorder. Patients may seek assessment and treatment locally from clinicians who are unfamiliar with the speech symptoms for adductor-type (ADSD) or abductor-type (ABSD) spasmodic dysphonia. Although these disorders have been described in the literature, the symptoms have not been well defined and may appear similar to those of vocal tremor or muscle tension dysphonia (MTD). Thus, patients with spasmodic dysphonia might not be easily identified by local clinicians for treatment. The purpose of the current study was to determine whether voice clinicians with infrequent exposure to patients with spasmodic dysphonia could learn to identify speech symptoms for ADSD and ABSD comparable to voice clinicians with extensive experience with these disorders. The ratings of five nonexpert judges were compared to the ratings obtained from three expert judges. The results of this study demonstrated that nonexpert judges could be trained to identify the speech symptoms associated with ADSD, ABSD, and vocal tremor. While the nonexpert judges tended towards false positive judgements for the speech symptoms of interest, the overall speech symptom profiles for each type of voice disorder appeared comparable to those obtained from the expert judges. The symptom identificationscales used, therefore, have potential for use by clinicians unfamiliar with these disorders for correctly identifying persons with symptoms of ADSD and ABSD.
EDUCATIONAL OBJECTIVES
Readers will be able to (1) define the predominant speech symptoms reflective of the voice disorder categories of ABSD, ADSD, and vocal tremor; and (2) describe the methods utilized in a new perceptual training protocol for teaching clinicians how to identify predominant speech symptoms associated with the voice disorder categories of ABSD, ADSD, and vocal tremor.
未标注
痉挛性发声障碍是一种罕见的嗓音疾病,向受影响的喉部肌肉注射肉毒杆菌毒素(即保妥适)是最有效的治疗方法。目前,保妥适可供大都市嗓音中心以外的专业人员使用,这些人员可能不熟悉这种罕见疾病。患者可能会在当地寻求评估和治疗,而那里的临床医生可能不熟悉内收型(ADSD)或外展型(ABSD)痉挛性发声障碍的言语症状。尽管这些疾病在文献中已有描述,但其症状尚未得到明确界定,可能与声带震颤或肌肉紧张性发声障碍(MTD)的症状相似。因此,痉挛性发声障碍患者可能不易被当地临床医生识别以便进行治疗。本研究的目的是确定很少接触痉挛性发声障碍患者的嗓音临床医生是否能够学会识别ADSD和ABSD的言语症状,其识别能力能否与对这些疾病有丰富经验的嗓音临床医生相媲美。将五位非专家评委的评分与三位专家评委的评分进行了比较。本研究结果表明,非专家评委可以通过培训来识别与ADSD、ABSD和声带震颤相关的言语症状。虽然非专家评委对感兴趣的言语症状倾向于做出假阳性判断,但每种嗓音障碍类型的总体言语症状特征似乎与专家评委的结果相当。因此,所使用的症状识别量表有可能供不熟悉这些疾病的临床医生用于正确识别有ADSD和ABSD症状的患者。
教育目标
读者将能够(1)定义反映ABSD、ADSD和声带震颤等嗓音障碍类别的主要言语症状;(2)描述一种新的感知训练方案中所采用的方法,该方案用于教导临床医生如何识别与ABSD、ADSD和声带震颤等嗓音障碍类别相关的主要言语症状。