• 대한후두음성언어의학회지
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• 제25권2호
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• pp.82-85
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• 2014

Functional dysphonia is a specific voice disorder refers to dysphonia without abnormal anatomical vocal fold findings at larynx. The proportions of this disorder are estimated up to 40% of dysphonia patients at ENT clinics. In this article, we will discuss about other functional dysphonia and neurological dysphonia except for muslce tension dysphonia and spasmodic dysphonia. For details, will describe about phonatory charateristics and treatment options about paradoxical vocal fold motion disorder, mutational dysphonia, essential vocal tremor, conversion dysphonia, and vocal tremor related with parkinson's disease.

• 대한후두음성언어의학회지
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• 제28권2호
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• pp.71-78
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• 2017

Voice disorder is classified into three categories, structural, neurogenic and functional dysphonia. Neurogenic dysphonia refers to a disruption in the nerves controlling the larynx. Common examples of this include complete or partial vocal cord paralysis, spasmodic dysphonia. Also it occurs as part of an underlying neurologic condition such as Parkinson's disease, myasthenia gravis, Lou Gehrig's disease or disorder of the central nervous system that causes involuntary movement of the vocal folds during voice production. Functional dysphonia is a voice disorder in the absence of structual or neurogenic laryngeal characteristics. A near consensus exist that Muscle tension dysphonia (MTD) is functional voice disorder wherein hyperfunctional laryngeal muscle activity whereas Spasmodic dysphonia (SD) is neurogenic, action-induced focal laryngeal dystonia including several subtype. Both Adductor type spasmodic dysphonia (AdSD) and MTD may be associated with excessive supraglottic contraction and compensation, resulting in a strained voice quality with spastic voice breaks. It makes these two disorders extremely difficult to differentiate based on clinical interpretation alone. Because treatment for AdSD and MTD are quite different, correct diagnosis is important. Clinician should be aware of the specific vocal characteristics of each disease to improve therapeutic outcome.

• 대한후두음성언어의학회지
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• 제25권2호
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• pp.75-78
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• 2014

기능성 음성장애는 후두에 구조적 혹은 신경학적 병변이 없이 음성발성에 장애가 있는 질환으로, 의학적인 부분만으로 설명하기가 어려운 장애 요소들을 내포하고 있기 때문에 진단에 많은 혼란이 있을 수 있는 논쟁의 여지가 많은 음성질환이다. 기능성 음성장애의 중요한 부분 중의 하나인 muscle tension dysphonia는 후두 근육과 후두 주변 근육의 지나친 긴장에 의해서 발생하는 음성장애로, 비록 후두 내/외근의 운동이 제대로 조절되지 않는 것이 muscle tension dysphonia의 가장 첫 번째 원인이라고 알려져 있고, 특정의 개인적인 인성의 특징(personality traits)들도 발생에 있어서 상당히 중요한 부분을 차지 하는 것으로 연구되고 있지만, 이들 근육이 도대체 어떻게 문제가 되는 지에 대해서는 사실 아직까지 완전하게 설명하기에는 곤란한 점이 많다. 또한 최근 들어서는 muscle tension dysphonia를 하나의 질환으로 보기보다는 기능성 음성장애의 문제점들을 설명하는 진단적 지표(diagnostic label)로 보는 경향이 많으며, 기능성 음성장애와 기질적 음성장애(organic voice disorder)를 아우르는 위치에 있는 것으로 해석하는 경향도 있다. 따라서 기능성 음성장애에 대한 분류나 발생기전에 대한 의견들은 아직까지 논란이 되는 부분들이 많은 상태이고, 기능성 음성장애를 더 잘 이해하고 이 질환을 성공적으로 치료해 나갈 수 있는 중요한 요인들을 찾아낼 수 있도록 더 많은 연구들이 이루어 져야 할 것으로 생각된다.

• 대한후두음성언어의학회지
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• 제30권1호
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• pp.12-14
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• 2019

Functional dysphonia (FD) is a disease entity which includes various voice disorders in the absence of structural or neurologic laryngeal pathology. Muscle tension dysphonia (MTD), psychogenic dysphonia are representative FD with completely different pathogenesis. Therefore there is no standard treatment modality for FD, the first step of treatment of FD is differentiating patient's voice symptoms from other organic voice disorders and other functional voice problems. MTD is a functional voice disorder caused by hyperfunction of intrinsic and extrinsic laryngeal musculature. Symptoms include increased vocal effort, roughness, fatigue and odynophonia. First line for MTD is indirect or direct voice therapy. Unfortunately, many patients with MTD improve with voice therapy alone. For these patients, various modalities tried; lidocaine application, surgical excision of the false vocal folds, and botulinum toxin injection, etc. Botulinum toxin injections are widely used in the field of otolaryngology, especially for spasmodic dysphonia. However, its use in FD or MTD has only been described in few case reports. The aim of this lecture is to evaluate the feasibility of botulinum toxin injection for FD, especially MTD.

• 대한후두음성언어의학회지
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• 제21권1호
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• pp.17-21
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• 2010

Dysphonia is a medical terminology for voice disorders characterized by hoarseness, harshness, weakness, or even loss of voice ; any impairment in ability to produce voice sounds using the vocal organs, larynx, The causes of dysphonia can be classified into two groups, organic and functional. Functional dysphonia includes spasmodic dysphonia, muscle tension dysphonia, mutational dysphonia and conversion dysphonia, etc, The findings of laryngoscopy in these dysphonia are almost normal. Therefore, physicians should diagnosis these diseases from careful history taking and abundant understandings about the phonation pattern, Organic dysphonia is caused by anatomical problems in the larynx, especially on the vocal fold, Some lesions, however, are not easily found because these lesions are too small, or located on the lower lip of vibrating vocal fold. Laryngopharyngeal reflux induced laryngitis, vascular lesions, sulcus vocalis, vocal atropy including presbylaryngis, and mucosal tears are common lesions easily missed in laryngoscopy, Therefore, a high index of suspicion is necessary to avoid missing vocal fold mucosal lesions, and the strobovideolaryngoscopy is indispensable in making the diagnosis,

• 대한후두음성언어의학회지
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• 제17권2호
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• pp.127-132
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• 2006

Background and Objectives : Functional dysphonia is a voice disturbance in the absence of structural or neurologic laryngeal pathology characterized by voluntary misuse of laryngeal muscles. The present report reviews clinical characteristics of 25 patients with functional dysphonia. Materials and Method : We analyzed medical records, perceptual and acoustic analysis of voice samples, aerodynamic studies and laryngoscopy. Results : There was no sex or age predilection. Eighty four percent of patients presented sudden onset of symptoms and 76% had specific events at the onset. Most patients showed breathy or strained voice and various degree of vocal fold insufficiency with supraglottic compensatory contractions. Acoustic analysis revealed non-diagnostic, but mean flow rate was lower than normal in all cases. All patients responded to voice therapy except for 4 patients who were tort to follow up. Mean number of voice therapy sessions required to get responses is 1.9 sessions. Conclusion : We concluded that patients with functional dysphonia responded very well to short-term voice therapy and should be included in differential diagnosis in patients with dysphonia cannot be explained by structural or neurologic etiology.

• 대한후두음성언어의학회지
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• 제25권2호
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• pp.86-89
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• 2014

Functional dysphonia (FD) is a voice disorder in the absence of structural or neurologic laryngeal pathology. FD is not a single disease but a disease entity. Therefore several voice disorders, which have completely different pathogenesis, are included in this category. The first step of treatment of FD is differentiating patient's voice symptoms from other organic voice disorders and other functional voice problems. Several different treatment modalities are included in the managements of FD. Voice therapy is in charge of the main role in treatment of FD. Medical treatment is also necessary when patient has general problems which would affect voice production. Vocal folds mucosal lesions can cause FD even the lesion is minor. In this case proper surgical intervention helps to improve the symptom of FD. Psychiatric consultation should be considered when the patient has psychological problems.

• 말소리와 음성과학
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• 제3권2호
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• pp.99-105
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• 2011

The treatment for patients with mutational dysphonia typically is useful with vegetative phonation, but has not yet been studied. This study attempts to identify the effect of $SKTCLP^{(R)}$ using throat clearing and laughing in patients with mutational dysphonia. The study, which was designed by the author, included 26 patients aged from 14 to 32 years (mean: 18.7 years) who had been diagnosed with mutational dysphonia between January 2007 and June 2010. Voice therapy for these patients included $SKTCLP^{(R)}$, ranging from two to seven sessions (mean: 3.8 sessions). Results were evaluated by videostroboscopy, perceptual evaluation of GRBAS scale, aerodynamic test, and acoustic analysis before and after therapy. Most patients could phonate with low pitch from the beginning and sustain with normal pitch sound in the last session. We had found that glottic gap reduced after therapy and anterior-posterior compression of superior laryngeal part at the first time, and these patients had complete closure of the glottis after treatment. The results of acoustic and aerodynamic measures after treatment indicated significant decreases in Fo, Jitter, Shimmer, SFF, and SPI, and increases in MPT, Psub, and vocal efficiency (p<.05). $SKTCLP^{(R)}$ may be a useful treatment method in managing mutational dysphonia. We can suggest this technique may be useful in improving the voice quality of other functional dysphonia having glottal chink or functional aphonia.

• 대한후두음성언어의학회지
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• 제10권1호
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• pp.17-23
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• 1999

Vocal hyperfunction is considered to be the most significant characteristic in larynx disorders which is found among many patients presenting hoarseness Primarily as chief complaint. In Pusan National University Hospital, we executed the voice therapy to 28 patients being 17 female and 11 male patients who visited the Voice ＆ Speech Therapy Clinic, due to the voice disorder, and then compared and analysed the voice before and after its therapy using acoustic and aerodynamic test. The obtained results were as follows. In the analysis by the local findings, it was improved to 88% in the patients of vocal nodule, 75% in mutational falsetto, 75% in the functional dysphonia, 75% in the vocal cord palsy, 50% in the vocal polyp and 50% in dysphonia plica ventricularis. For the acoustic analysis, Fo, litter, Shimmer and NHR were measured. In the patients of mutational falsetto, Fo, Jitter and NHR were shown to be improved significantly and in the patients of vocal nodule, Shimmer was shown to be improved significantly. In the patients of vocal polyp, Fo was significantly improved. In the patients of vocal cord palsy in litter and NHH were significantly improved. In the patients of dysphonia plica ventricularis, Shimmer and NHR were significantly improved and the patients of functional dysphonia were more improved in Fo, litter and Shimmer. For the aerodynamic analysis, MPT was measured. In particular, it was shown to be improved significantly in the patients of vocal nodule, improved in the vocal polyp, vocal cord palsy, functional dysphonia patients.

• 대한후두음성언어의학회지
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• 제27권2호
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• pp.91-94
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• 2016

Voice is a physical phenomenon, generated by vocal fold and expiratory airflow. Dysphonia should come from abnormal vocal fold and airflow. Occassionally larynx looks normal in show, but it is actually not. There should be undetected structural or functional abnormalities. So when ENT doctors face dysphonia patients who looks normal larynx, should make a diagnosis through close observation. In this review article we present some dysphonia diseases which looks normal larynx. For example vocal fatigue, vocal fold paresis, posterior glottic diastasis, muscle tension dysphonia and psychogenic dysphonia.