Ogawa Makoto, Yoshida Misao, Watanabe Ken, Yoshii Tadashi, Sugiyama Yoshio, Sasaki Ryoji, Watanabe Yusuke, Kubo Takeshi
Department of Otorhinolaryngology, Kinki Central Hospital, Itami, Tokyo.
Nihon Jibiinkoka Gakkai Kaiho. 2005 Jul;108(7):734-41. doi: 10.3950/jibiinkoka.108.734.
Muscle tension dysphonia (MTD) is a voice disorder associated with abnormal laryngeal posture or glottic configuration induced by excessive contraction of the laryngeal muscles, and supraglottic contraction is one of the characteristic findings in MTD. In recent study we investigated the changes in laryngeal findings and voice quality and the association between them in the course of voice therapy for MTD with supraglottic contraction. The effects of voice therapy on the laryngeal and the vocal findings were assessed by two rating methods: the MTD score and the conventional GRBAS scores and both scores were gradually improved. Of the two components of supraglottic contraction, false vocal cord compression was more curable than anterior-posterior compression at the aryepiglottic level. Little correlation was found between the scores at the first examination, but significant associations (p < 0.05) were found between the differences of MTD score and G/R/S scores but not B/A scores before and after the series of voice therapy. These results suggest that supraglottic contraction is a crucial factor worsening voice quality and that MTD score is useful to assess the efficacy of voice therapy for MTD.
肌肉紧张性发音障碍(MTD)是一种与喉部姿势异常或声门结构异常相关的嗓音障碍,由喉部肌肉过度收缩引起,声门上收缩是MTD的特征性表现之一。在最近的研究中,我们调查了伴有声门上收缩的MTD患者在嗓音治疗过程中喉部表现和嗓音质量的变化以及它们之间的关联。通过两种评分方法评估嗓音治疗对喉部和嗓音表现的影响:MTD评分和传统的GRBAS评分,且两种评分均逐渐改善。在声门上收缩的两个组成部分中,假声带压缩比杓会厌襞水平的前后压缩更易治愈。首次检查时的评分之间几乎没有相关性,但在一系列嗓音治疗前后,MTD评分与G/R/S评分的差异之间存在显著关联(p < 0.05),而与B/A评分之间无显著关联。这些结果表明,声门上收缩是嗓音质量恶化的关键因素,且MTD评分有助于评估MTD嗓音治疗的疗效。