Systematic review of the treatment of functional dysphonia and prevention of voice disorders

The mucus layer on the vocal folds was examined by videostrobolaryngoscopy in patients with laryngeal tension-fatigue syndrome, a chronic functional dysphonia due to vocal abuse and misuse. Besides the findings in previous reports (such as abnormal glottal closure, phase or amplitude asymmetry, and the irregular mucosal wave), the vocal folds during vibration had an uneven mucus surface. The occurrence of an uneven mucus layer on vocal folds was significantly greater in subjects with this voice disorder (83% or 250 of 301 patients in this series) than in those without voice disorders (18.5% or 5 of 27). The increase of mucus viscosity, mucus aggregation, and the formation of rough surfaces on the vocal folds alter the mechanical properties that contribute to vibration of the cover of the vocal folds, and thereby worsen the symptoms of dysphonia in patients with laryngeal tension-fatigue syndrome.

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Presbylarynx, Functional Voice Disorders, Muscle Tension Dysphonia

10.2310/ot.7065 ◽

2021 ◽

Author(s):

Elizabeth Erickson-DiRenzo ◽

Christine M. Kim ◽

C. Kwang Sung Sung

Keyword(s):

Muscle Tension ◽

Voice Disorders ◽

Neuromuscular Control ◽

Vocal Folds ◽

Voice Therapy ◽

Type I ◽

Muscle Tension Dysphonia ◽

Functional Dysphonia ◽

Age Related ◽

Type I Thyroplasty

Presbylarynx refers to age-related structural changes of the vocal folds that include muscle atrophy, reduced neuromuscular control, loss of superficial lamina propria layer, and reduced pliability. The changes result in thin and bowed vocal folds, increased vocal effort requirements, breathy voice, change in habitual pitch, and strain. The primary treatment options are voice therapy focused on strengthening breath support and the intrinsic muscles of the larynx, and optimization of resonance; injection augmentation of the vocal folds; and type I thyroplasty. Functional dysphonia is defined as change in voice quality in the absence of structural or neurological abnormalities of the larynx. Muscle tension dysphonia (MTD) is a subtype of functional voice disorders and involves laryngeal muscle tension imbalance due to excessive or dysregulated activation resulting often in strained or breathy voice. MTD can be divided into primary (psychological etiology or vocal misuse) and secondary (compensatory for organic laryngeal pathology). The mainstay of treatment for MTD is voice therapy, along with medical or surgical treatment of the underlying vocal pathology in secondary MTD. Mutational falsetto, or puberphonia, is a functional voice disorder where a high-pitched, pre-adolescent voice fails to transition to the lower pitch of adulthood. This review contains 5 figures, 7 tables, 4 videos and 10 references Key Words: Presbylarynx, Injection augmentation, Type I thyroplasty, Primary muscle tension dysphonia, Secondary muscle tension dysphonia, Muscle tension patterns, Manual circumlaryngeal therapy, Functional dysphonia, Mutational falsetto

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Prevalence of Voice Disorders in Singers: Systematic Review and Meta-Analysis

Journal of Voice ◽

10.1016/j.jvoice.2017.02.010 ◽

2017 ◽

Vol 31 (6) ◽

pp. 722-727 ◽

Cited By ~ 27

Author(s):

Pedro Melo Pestana ◽

Susana Vaz-Freitas ◽

Maria Conceição Manso

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Voice Disorders

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Personality and Voice Disorders

Journal of Speech Language and Hearing Research ◽

10.1044/jslhr.4303.749 ◽

2000 ◽

Vol 43 (3) ◽

pp. 749-768 ◽

Cited By ~ 64

Author(s):

Nelson Roy ◽

Diane M. Bless ◽

Dennis Heisey

Keyword(s):

Vocal Fold ◽

Voice Disorders ◽

Personality Factors ◽

Control Group ◽

Personality Variables ◽

Personality Differences ◽

Functional Dysphonia ◽

Vocal Nodules ◽

Personality Features ◽

And Control

To determine whether personality factors play causal, concomitant, or consequential roles in common voice disorders, a vocally normal control group and four groups with voice disorders—functional dysphonia (FD), vocal nodules (VN), spasmodic dysphonia (SD), and unilateral vocal fold paralysis (UVFP)—were compared on measures of personality and psychological adjustment. Superfactor group comparisons revealed that the majority of FD and VN subjects were classified as introverts and extraverts, respectively. Comparisons involving the SD, UVFP, and control subjects did not identify consistent personality differences. The disability hypothesis, which suggests that personality features and emotional maladjustment are solely a negative consequence of vocal disability, was not supported. Personality variables and their behavioral consequences may therefore contribute to FD and VN. Results are presented within the context of a dispositional theory offered by Roy and Bless (2000a).

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Prevalence of voice disorders in the elderly: a systematic review of population-based studies

European Archives of Oto-Rhino-Laryngology ◽

10.1007/s00405-014-3252-7 ◽

2014 ◽

Vol 272 (10) ◽

pp. 2601-2609 ◽

Cited By ~ 33

Author(s):

Leandro de Araújo Pernambuco ◽

Albert Espelt ◽

Patrícia Maria Mendes Balata ◽

Kenio Costa de Lima

Keyword(s):

Systematic Review ◽

Voice Disorders ◽

The Elderly ◽

Population Based

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Voice disorders in teachers and their associations with work-related factors: A systematic review

Journal of Communication Disorders ◽

10.1016/j.jcomdis.2013.01.001 ◽

2013 ◽

Vol 46 (2) ◽

pp. 143-155 ◽

Cited By ~ 83

Author(s):

Lady Catherine Cantor Cutiva ◽

Ineke Vogel ◽

Alex Burdorf

Keyword(s):

Systematic Review ◽

Voice Disorders ◽

Related Factors ◽

Work Related

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Personality Traits and Psychological Factors in Voice Pathology

Journal of Speech Language and Hearing Research ◽

10.1044/jslhr.4303.737 ◽

2000 ◽

Vol 43 (3) ◽

pp. 737-748 ◽

Cited By ~ 78

Author(s):

Nelson Roy ◽

Diane M. Bless

Keyword(s):

Behavioral Response ◽

Psychological Factors ◽

Voice Disorders ◽

Psychological Problems ◽

Spasmodic Dysphonia ◽

Functional Dysphonia ◽

Theoretical Synthesis ◽

Vocal Nodules ◽

Response Biases

It has been argued that personality, emotions, and psychological problems contribute to or are primary causes of voice disorders and that voice disorders in turn create psychological problems and personality effects. This article (a) briefly reviews the literature surrounding the role of psychological and personality processes in individuals with functional dysphonia (FD), vocal nodules (VN), and spasmodic dysphonia (SD); (b) provides an overview of recent concepts in personality and trait structure; and (c) summarizes the fundamental tenets of a theoretical synthesis proposed by Roy and Bless (2000) to explain the dispositional bases of FD and VN. This theory links FD and VN to the signal sensitivities and behavioral response biases of neurotic introverts and neurotic extraverts, respectively. In a companion article, the merits of the Roy and Bless theory are evaluated.

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