Functional and organic dysphonia in voice professionals (lecture)
- Authors: Stepanova J.E.1
-
Affiliations:
- Saint Petersburg Research Institute of Ear, Throat, Nose and Speech
- Issue: Vol 25, No 9 (2023): Otorhinolaryngology and pulmonology
- Pages: 629-635
- Section: Articles
- URL: https://journal-vniispk.ru/2075-1753/article/view/253580
- DOI: https://doi.org/10.26442/20751753.2023.9.202387
- ID: 253580
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Abstract
An urgent task of otorhinolaryngology (phoniatry) is the diagnosis and treatment of disorders of voice function in voice professionals or persons of voice-speech professions. An undiagnosed laryngeal disease worsens the quality of life of patients, creates difficulties in communication and can even lead to professional unfitness, because the patient does not withstand the necessary vocal load. The leading role in the modern diagnosis of laryngeal diseases belongs to endoscopic research methods – video endoscopy and video endostroboscopy. All disorders of voice function are classified as functional and organic. Recent studies have shown that from 30.5 to 40% of voice professionals who have applied for phoniatric care suffer from functional disorders. Functional changes are understood to mean changes in which laryngoscopic examination does not always reveal any visible pathology. But with the help of special research methods, such as stroboscopy (videostroboscopy), spectral analysis of the voice, pathognomonic changes can be determined, and the patient presents characteristic complaints. More often than others, hypotonic and hypo-hypertonic dysphonia are diagnosed. Organic laryngeal diseases are characteristic of 69.5% of patients with dysphonia. They are represented by various nosological forms. Certain difficulties arise in the diagnosis of professional laryngitis and vascular pathology of the larynx. The lecture presents pathognomonic clinical changes of the larynx in voice professionals, knowledge of which is necessary for practical doctors to make a diagnosis.
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##article.viewOnOriginalSite##About the authors
Julia E. Stepanova
Saint Petersburg Research Institute of Ear, Throat, Nose and Speech
Author for correspondence.
Email: julia.stepanov@yandex.ru
ORCID iD: 0000-0003-1502-6337
D. Sci. (Med.), Assoc. Prof., Saint Petersburg Research Institute of Ear, Throat, Nose and Speech
Russian Federation, Saint PetersburgReferences
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Fig. 1. Functional dysphonia of the hypotonic type (phonation): oval fissure.
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Fig. 2. Functional dysphonia of the hypotonic type (phonation): triangular fissure.
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Fig. 3. Functional dysphonia of the hypotonic type (inhalation): gaping of the laryngeal ventricles, insufficient tension of the medial edge of the vocal folds.
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Fig. 4. Functional dysphonia of the hypotonic type (phonation): a symptom of “heterogeneity” of the vocal folds.
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Fig. 5. Functional dysphonia of the hypo-hypertonic type (phonation): oval phonation gap in the anterior third, triangular phonation gap in the posterior third, hyperfunction of the vestibular folds, closure of the vocal processes; The stalk of the epiglottis hangs over the anterior commissure.
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Fig. 6. Functional dysphonia of the hypo-hypertonic type (phonation): tight closure of the vocal folds, absence of the phonation gap, hyperfunction of the vestibular folds.
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Fig. 7. Acute occupational laryngitis (phonation): oval fissure, vascular injection of the laryngeal mucosa.
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Fig. 8. Chronic occupational laryngitis, remission (phonation): triangular fissure, mucous discharge on the vocal folds.
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Fig. 9. Capillary ectasia of the vocal folds with angiomatous dilatation, swelling of the medial edges of the vocal folds (inspiration).
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Fig. 10. Diffuse hemorrhage in the right vocal fold (phonation).
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Fig. 11. Diffuse hemorrhage in the left vocal fold, “blooming” (phonation).
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