Morrison M
Division of Otolaryngology, University of British Columbia, Vancouver Hospital and Health Sciences Centre, Canada.
J Voice. 1997 Mar;11(1):108-14. doi: 10.1016/s0892-1997(97)80031-8.
The diagnosis of the patient with a muscle misuse voice disorder can be a complex process. The dysphonia is usually caused by problems stemming from a number of interacting factors that may include habitual vocal technique and postural use, vocal behavior, emotion, manifestations of gastroesophageal reflux, neuromuscular abnormalities, and associated organic mucosal disease. Sorting out the relative importance of the various factors is the first step towards planning an effective treatment program. This article addresses the difficulties caused by trying to classify dysphonia too rigidly, and presents a strategy for collecting the necessary information in a manner that facilitates the development of effective tools for clinical decision making. For each dysphonic patient, a pattern of causation will emerge in a way that helps the clinician to disentangle the interrelated factors.
诊断患有肌肉误用性嗓音障碍的患者可能是一个复杂的过程。发音障碍通常由多种相互作用的因素引起，这些因素可能包括习惯性发声技巧和姿势运用、发声行为、情绪、胃食管反流的表现、神经肌肉异常以及相关的器质性黏膜疾病。梳理出各种因素的相对重要性是制定有效治疗方案的第一步。本文阐述了试图过于严格地对发音障碍进行分类所带来的困难，并提出了一种收集必要信息的策略，这种方式有助于开发有效的临床决策工具。对于每一位发音障碍患者，一种因果模式将会呈现出来，帮助临床医生理清相互关联的因素。
