痉挛性发声障碍的病因及发病机制探讨

目的 回顾性分析痉挛性发声障碍(SD)患者的人口学特点、发生背景、嗓音障碍特点及不同治疗方法的效果,探讨痉挛性发声障碍的病因及发病机制.方法 受试者为68例痉挛性发声障碍患者,病程5个月～8年,男6例,女62例;调查患者的职业、受教育程度、家庭或(和)工作状况、嗓音障碍出现的背景、病程、嗓音障碍的表现形式等.录音文字为...

The etiology and pathogenesis of spasmodic dysphonia

Objective To retrospectively analyze the demographic characteristics, occurrence background, characteristics of voice disorders, and effects of different treatment methods in patients with adduction spasmodic dysphonia(SD), as well as to explore the etiology and pathogenesis of SD. Methods Sixty eight SD patients aged 5 months to 8 years were enrolled, including 62 women and 6 men. We investigated the patient's occupation, education, family or/and work status, background, onset mode and course of disease, manifestation of voice disorder, and others. The recorded text was a short poem and long vowel ［a:］. It was produced in three different ways: normal speech, whispering, and high-pitched voice. The anatomical morphology of the bilateral vocal cords was normal on electronic laryngoscopy. According to the patient's age, degree of voice disorder, course of disease, and willingness to choose the treatment: injection of Botox, voice training and/or self-regulating relaxation therapy, music therapy, and anti-anxiety drugs. Results The age range of the SD patients was 30-49 years, and the number of females was significantly higher than that of males, with a sex ratio of 1:10.3. Voice disorders occurred in 29 cases of important difficult periods, 15 cases of mental trauma, 5 cases of adverse events, and 19 cases of no clear psychological background. Therapeutic effect: Among the 22 patients who received botulinum toxin treatment 1-5 times, 1 case was cured, 14 cases were relieved, and 7 cases were invalid; 4 cases were treated with music therapy, of which 1 case was cured and 3 cases were relieved; 23 cases were treated with vocal training, of which 8 cases were relieved and 15 cases were invalid; 12 cases were treated with oral anti-anxiety drugs, of which 2 cases were relieved and 10 cases were invalid; and 7 cases were treated with self-relaxation training, of which 4 cases were cured and 3 cases were invalid. Conclusion The diversity of therapeutic methods resulted in different therapeutic effects, suggesting a multidimensional etiology and the complexity of the pathogenesis of SD. Unhealthy living events or long-term mental stress are highly correlated with the occurrence of SD, suggesting that it is an important factor affecting SD patients.