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嗓音障碍:病因与诊断

Voice Disorders: Etiology and Diagnosis.

作者信息

Martins Regina Helena Garcia, do Amaral Henrique Abrantes, Tavares Elaine Lara Mendes, Martins Maira Garcia, Gonçalves Tatiana Maria, Dias Norimar Hernandes

机构信息

Ophthalmology, Otorhinolaryngology, Head and Neck Surgery Department, Botucatu Medical School, UNESP-Universidade Estadual Paulista, Botucatu, São Paulo, Brazil.

Botucatu Medical School, UNESP-Universidade Estadual Paulista, Botucatu, São Paulo, Brazil.

出版信息

J Voice. 2016 Nov;30(6):761.e1-761.e9. doi: 10.1016/j.jvoice.2015.09.017. Epub 2015 Nov 4.

Abstract

OBJECTIVES

Voice disorders affect adults and children and have different causes in different age groups. The aim of the study is to present the etiology and diagnosis dysphonia in a large population of patients with this voice disorder.for dysphonia of a large population of dysphonic patients.

METHODS

We evaluated 2019 patients with dysphonia who attended the Voice Disease ambulatories of a university hospital. Parameters assessed were age, gender, profession, associated symptoms, smoking, and videolaryngoscopy diagnoses.

RESULTS

Of the 2019 patients with dysphonia who were included in this study, 786 were male (38.93%) and 1233 were female (61.07). The age groups were as follows: 1-6 years (n = 100); 7-12 years (n = 187); 13-18 years (n = 92); 19-39 years (n = 494); 41-60 years (n = 811); and >60 years (n = 335). Symptoms associated with dysphonia were vocal overuse (n = 677), gastroesophageal symptoms (n = 535), and nasosinusal symptoms (n = 497). The predominant professions of the patients were domestic workers, students, and teachers. Smoking was reported by 13.6% patients. With regard to the etiology of dysphonia, in children (1-18 years old), nodules (n = 225; 59.3%), cysts (n = 39; 10.3%), and acute laryngitis (n = 26; 6.8%) prevailed. In adults (19-60 years old), functional dysphonia (n = 268; 20.5%), acid laryngitis (n = 164; 12.5%), and vocal polyps (n = 156; 12%) predominated. In patients older than 60 years, presbyphonia (n = 89; 26.5%), functional dysphonia (n = 59; 17.6%), and Reinke's edema (n = 48; 14%) predominated.

CONCLUSIONS

In this population of 2019 patients with dysphonia, adults and women were predominant. Dysphonia had different etiologies in the age groups studied. Nodules and cysts were predominant in children, functional dysphonia and reflux in adults, and presbyphonia and Reinke's edema in the elderly.

摘要

目的

嗓音障碍影响成人和儿童,且在不同年龄组中有不同病因。本研究的目的是呈现大量患有这种嗓音障碍的患者中发声困难的病因及诊断情况。

方法

我们评估了2019名到大学医院嗓音疾病门诊就诊的发声困难患者。评估的参数包括年龄、性别、职业、相关症状、吸烟情况以及视频喉镜诊断。

结果

本研究纳入的2019名发声困难患者中,男性786名(38.93%),女性1233名(61.07%)。年龄组如下:1 - 6岁(n = 100);7 - 12岁(n = 187);13 - 18岁(n = 92);19 - 39岁(n = 494);41 - 60岁(n = 811);60岁以上(n = 335)。与发声困难相关的症状有嗓音过度使用(n = 677)、胃食管症状(n = 535)和鼻鼻窦症状(n = 497)。患者的主要职业是家政工人、学生和教师。13.6%的患者报告有吸烟情况。关于发声困难的病因,在儿童(1 - 18岁)中,小结节(n = 225;59.3%)、囊肿(n = 39;10.3%)和急性喉炎(n = 26;6.8%)最为常见。在成年人(19 - 60岁)中,功能性发声困难(n = 268;20.5%)、酸性喉炎(n = 164;12.5%)和声带息肉(n = 156;12%)最为常见。在60岁以上的患者中,老年嗓音障碍(n = 89;26.5%)、功能性发声困难(n = 59;17.6%)和任克氏水肿(n = 48;14%)最为常见。

结论

在这2019名发声困难患者群体中,成年人和女性占多数。在研究的年龄组中,发声困难有不同的病因。儿童中以小结节和囊肿为主,成年人中以功能性发声困难和反流为主,老年人中以老年嗓音障碍和任克氏水肿为主。

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