Cleveland Clinic Head and Neck Institute, Cleveland, Ohio, U.S.A.
Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio, U.S.A.
Laryngoscope. 2021 Jun;131(6):E1957-E1964. doi: 10.1002/lary.29358. Epub 2020 Dec 28.
Functional dysphonia (FD) is one of the possible presentations of chronic dysphonia. Defined as dysphonia without gross abnormality of the larynx, FD manifests as aberrant muscle contractions resulting in mild-to-severe dysphonia. Despite increasing clinical awareness, diagnosis, and treatment strategies for FD remain challenging.
Institutional review board.
A retrospective review of videostroboscopic examinations and EMR data from 109 patients treated for FD was performed. Videostroboscopy was analyzed by two independent reviewers and classified by laryngeal posturing and observer-rated quality of voice. Medical records were reviewed and patient characteristics, history of disease, and survey responses were collected. Statistics were calculated using JMP and SAS packages.
A total of 85.1% of subjects were female and the average voice handicap index (VHI30) score was 71.0/120. Average time to diagnosis of FD was 688 days and average time from diagnosis to treatment was 3.7 days. 44.0% of patients exhibited hyperadducted laryngeal posturing, 31.9% hypoadducted, and 24.2% showed a mixed posture. 98% of patient voices improved after treatment. 85% returned to normal voice and 10% maintained a mild residual dysphonia.
We describe here a large cohort of patients affected by FD, including clinical presentation and videostroboscopic findings. Our data show that most individuals with FD improve after specialized voice therapy once correctly diagnosed but that correct diagnosis and proper treatment was often significantly delayed.
4-Case-series Laryngoscope, 131:E1957-E1964, 2021.
功能性嗓音障碍（FD）是慢性嗓音障碍的一种可能表现。FD 定义为喉部无明显异常的嗓音障碍，表现为异常的肌肉收缩，导致轻度至重度嗓音障碍。尽管临床对 FD 的认识不断提高，但其诊断和治疗策略仍具有挑战性。
机构审查委员会。
对 109 例 FD 患者的频闪喉镜检查和 EMR 数据进行回顾性分析。由两名独立观察者对频闪喉镜进行分析，并根据喉部姿势和观察者评估的嗓音质量进行分类。回顾病历，收集患者特征、疾病史和调查应答。使用 JMP 和 SAS 包进行统计学计算。
共有 85.1%的患者为女性，平均嗓音障碍指数（VHI30）评分为 71.0/120。FD 的平均诊断时间为 688 天，从诊断到治疗的平均时间为 3.7 天。44.0%的患者表现为喉过度内收姿势，31.9%为喉过度外展，24.2%为混合姿势。98%的患者治疗后嗓音改善。85%恢复正常嗓音，10%保持轻度残留嗓音障碍。
我们在此描述了一组受 FD 影响的大量患者，包括临床表现和频闪喉镜检查结果。我们的数据表明，大多数 FD 患者在经过专门的嗓音治疗后会改善，但正确的诊断和适当的治疗往往被严重延迟。
4-病例系列研究喉镜，131：E1957-E1964，2021 年。
