痉挛性发音障碍的喉功能特点

目的 为了探讨痉挛性发音障碍的喉功能特点及其发音障碍的表现形式。方法 对24例痉挛性发音障碍患者（男4例，女18例）的发病诱因、发音障碍特征、喉镜所见、喉肌电及喉空气动力学改变进行了分析。结果 痉挛性发音障碍主要表现为音韵及声音的流畅性障碍，主观听觉上以紧张性发音障碍为特点；喉镜检查可看到痉挛性发音时声带过度内收，室带不同程度的内收超越，重者声带强烈内收，会厌、室带以及整个喉呈闭锁状态；典型的喉肌电图所见为束发性放电；喉呼气流率明显减少。结论 痉挛性发音障碍伴随着紧张性发音的同时声带或整个喉强烈内收痉挛，同时伴有呼气流率下降，典型病例可看到喉肌电的改变。

Laryngeal Function Features of Spasmodic Dysphonia

Objective To investigate laryngeal function features and manifestation of dysphonia of spasmodic dysphonia. Methods Induction factors, features of dysphonia, laryngoscopic findings, electromyography and aerodynamics changes in 24 patients with spasmodic dysphonia (6 male patients, 18 female patients) were analysed. Results Spasmodic dysphonia mainly demonstrated disturbance of voice rhyme and fluency revealed as tonic dysphonia when perceptual evaluated. Laryngoscope examination demonstrated overadduction of vocal folds during spasmodic phonation and different levels of adduction surpass of ventricular fold. For some severe cases, the vocal folds adducted strongly, the epiglottis, the ventricular folds, and even the whole larynx presented lock-in state. Typical presentation of laryngeal electromyography was bundle discharge and laryngeal expiratory flow decreased apparently. Conclusion Spasmodic dysphonia demonstrates tonic dysphonia, as well as overadduction and spasm of the whole larynx, decreasing of expiratory flow and electromyography change for typical cases.