Center for Laryngeal Surgery and Voice Rehabilitation, Massachusetts General Hospital, Boston, MA, USA.
MGH Institute of Health Professions, Boston, MA, USA.
Ann Otol Rhinol Laryngol. 2021 Apr;130(4):389-394. doi: 10.1177/0003489420956379. Epub 2020 Sep 10.
Prevention, diagnosis, and treatment of hyperfunctional voice disorders would be improved by better understanding their etiological contributing factors. Therefore, this study estimated the prevalence of etiological factors using self-reported data about disorder onset from a large cohort of patients with Phonotraumatic Vocal Hyperfunction (PVH) and Non-Phonotraumatic Vocal Hyperfunction (NPVH).
Retrospective chart review extracted the self-reported rate (gradual, sudden) and events associated (voice use, anxiety/stress, upper respiratory infection [URI]) with disorder onset from 1,577 patients with PVH and 979 patients with NPVH.
Both patient groups reported a gradual onset more than a sudden onset. Voice use was the most frequently reported event for PVH and the NPVH group self-reported all three events at equal frequency. The largest PVH subgroups were associated with voice use while the NPVH subgroups were associated with only voice use, only URI, or only anxiety/stress.
The results support the general clinical view that PVH is most strongly related to the gradual accumulated effects of phonotrauma, while NPVH has a more heterogeneous etiology. The identified PVH and NPVH subgroups may have clinical relevance and future work could investigate differences in treatment and outcomes among these subgroups.
通过更好地了解其病因学的促成因素,可提高对机能亢进性嗓音障碍的预防、诊断和治疗。因此,本研究使用大量患有 Phonotraumatic Vocal Hyperfunction(PVH)和 Non-Phonotraumatic Vocal Hyperfunction(NPVH)患者的关于发病的自我报告数据,来估计病因因素的患病率。
回顾性图表回顾从 1577 名 PVH 和 979 名 NPVH 患者中提取了与发病相关的自我报告的发病(渐进性、突发性)和事件(声音使用、焦虑/压力、上呼吸道感染[URI])的发生率。
两个患者组均报告发病呈渐进性多于突发性。声音使用是 PVH 组和 NPVH 组最常报告的事件,两组自我报告的所有三个事件的发生率相同。最大的 PVH 亚组与声音使用有关,而 NPVH 亚组仅与声音使用、URI 或焦虑/压力有关。
结果支持一般的临床观点,即 PVH 与语音创伤的逐渐累积效应关系最密切,而 NPVH 的病因更为复杂。确定的 PVH 和 NPVH 亚组可能具有临床相关性,未来的研究可以调查这些亚组之间在治疗和结果方面的差异。