Franco Ramon A, Andrus Jennifer G
Division of Laryngology, Massachusetts Eye & Ear Infirmary, Department of Otology and Laryngology, Harvard Medical School, 243 Charles Street, Boston, MA 02114, USA.
Otolaryngol Clin North Am. 2007 Oct;40(5):1025-61, vii. doi: 10.1016/j.otc.2007.05.008.
Common problems among all patients seen by the laryngologist are also common among professional voice users. These include laryngopharyngeal reflux, muscle tension dysphonia, fibrovascular vocal fold lesions (eg, nodules and polyps), cysts, vocal fold scarring, changes in vocal fold mobility, and age-related changes. Microvascular lesions and their associated sequelae of vocal fold hemorrhage and laryngitis due to voice overuse are more common among professional voice users. Much more common among professional voice users is the negative impact that voice problems have on their ability to work, on their overall sense of well-being, and sometimes on their very sense of self. This article reviews the diagnosis and treatment options for these and other problems among professional voice users, describing the relevant roles of medical treatment, voice therapy, and surgery. The common scenario of multiple concomitant entities contributing to a symptom complex is underscored. Emphasis is placed on gaining insight into the "whole" patient so that individualized management plans can be developed. Videos of select diagnoses accompany this content online.
喉科医生诊治的所有患者中常见的问题,在职业用嗓者中也很常见。这些问题包括喉咽反流、肌肉紧张性发声障碍、纤维血管性声带病变(如小结和息肉)、囊肿、声带瘢痕形成、声带活动度改变以及与年龄相关的变化。微血管病变及其相关的声带出血后遗症和因过度用嗓导致的喉炎,在职业用嗓者中更为常见。职业用嗓者中更为常见的是嗓音问题对其工作能力、整体幸福感,有时甚至对其自我认知产生的负面影响。本文回顾了职业用嗓者这些及其他问题的诊断和治疗选择,描述了药物治疗、嗓音治疗和手术的相关作用。强调了多种并存因素导致症状复合体的常见情况。重点在于深入了解“整体”患者,以便制定个性化的管理计划。本文相关内容在网上配有精选诊断的视频。