Creighton Francis X, Hapner Edie, Klein Adam, Rosen Ami, Jinnah Hyder A, Johns Michael M
Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts.
Department of Otolaryngology-Head and Neck Surgery, Emory Voice Center, Emory University School of Medicine, Atlanta, Georgia.
J Voice. 2015 Sep;29(5):592-4. doi: 10.1016/j.jvoice.2013.10.022. Epub 2015 Apr 11.
Spasmodic dysphonia (SD) is a rare but often debilitating disease. Due to lack of awareness among practitioners and lack of well-defined diagnostic criteria, it can be difficult for patients with SD to receive a diagnosis and subsequent treatment. There is currently no literature documenting the efficacy of the medical community in recognizing and diagnosing this disorder. We aimed to quantify the patients' experiences with obtaining a diagnosis of SD.
One hundred seven consecutive patients with SD completed questionnaires about their experiences with SD. Patients were recruited either during outpatient laryngology visits or during participation in a National Institutes of Health funded study investigating SD.
It took patients an average of 4.43 years (53.21 months) to be diagnosed with SD after first going to a physician with vocal symptoms. Patients had to see an average of 3.95 physicians to receive a diagnosis of SD. Patients (31.4%) had been prescribed medications other than botulinum toxin to treat their symptoms. Patients (30%) attempted alternative therapies for treatment of SD, such as chiropractor or dietary modification.
Despite advances in diagnostic modalities in medicine, the diagnosis of SD still remains elusive. Objective criteria for the diagnosis of SD and increased clinician education are warranted to address this diagnostic delay.
痉挛性发声障碍（SD）是一种罕见但常使人衰弱的疾病。由于从业者认识不足且缺乏明确的诊断标准，SD患者可能难以获得诊断及后续治疗。目前尚无文献记录医学界在识别和诊断这种疾病方面的成效。我们旨在量化患者获得SD诊断的经历。
107例连续性SD患者完成了关于其SD经历的问卷调查。患者通过门诊喉科就诊或参与美国国立卫生研究院资助的SD研究招募。
患者首次因嗓音症状就医后，平均需要4.43年（53.21个月）才能被诊断为SD。患者平均需要看3.95名医生才能获得SD诊断。31.4%的患者曾被开具除肉毒杆菌毒素以外的药物来治疗症状。30%的患者尝试过替代疗法来治疗SD，如脊椎按摩或饮食调整。
尽管医学诊断方式有所进步，但SD的诊断仍然难以捉摸。有必要制定SD的客观诊断标准并加强临床医生培训，以解决这一诊断延迟问题。
