Skip to main content
Erschienen in: Indian Journal of Otolaryngology and Head & Neck Surgery 2/2022

04.08.2020 | Original Article

Muscle Tension Dysphonia: Experience from a Conflict Zone

verfasst von: Ihsan Ali, Raj Tajamul Hussain, Fayaz Ahmad Wagay, Rauf Ahmad

Erschienen in: Indian Journal of Otolaryngology and Head & Neck Surgery | Sonderheft 2/2022

Einloggen, um Zugang zu erhalten

Abstract

We sought to explore the frequency of stress among OPD attending Kashmiri public diagnosed as muscle tension dysphonia (MTD) and determine the subjective consequences of voice therapy in management of muscle tension dysphonia. 72 subjects that attended to ENT and HNS OPD with change of voice were prospectively evaluated and also underwent an extensive otolaryngological examination. Patients identified as MTD were provided a questionnaire which was split into 3 parts: First part dealt with the identification of the subject (age, geography, gender, profession) and also provided evaluation of perceived anxiety using Perceived Stress Scale-10. In the next part the individuals needed to assess their vocal quality based on parameters of GRBAS 4-point score scale before and also after the treatment. In the final component the subjects also needed to answer the VHI-10 (Voice Handicap Index) and also the outcome was compared with those acquired at the assessment before the beginning of the treatment. The mean age of the cohort was 30.31 ± 07.43 (age range, 12–71) and every subject was an indigenous Kashmiri. As expected, vast majority of subjects were females (43 patients). In the pooled information set, women had numerically higher PSS-10 scores than males. For women, the typical stress score was M = 18.6 and for men the average stress score was M = 16.65. In a healthy population, the typical PSS stress score is described to be 13.7 (SD = 6.6) for women and 12.1 (SD = 5.9) for men. At the Wilcoxon test for paired data, we observed a significant difference between the VHI pretreatment (mean = 19.7) and VHI post-treatment, that's at time of the research (mean = 9.73; P = 0.017). The grade (G) was assessed in terms of improvement of the vocal quality as opposed with before treatment and also the individuals demonstrated a high level of satisfaction (mean = 0.65). When looking at roughness (R) as well as breathiness (B), the individuals remember that their speech is seldom rough (mean = 0.62) and also less breathy (median = 0.44). Patients likewise noted improvement in other variables of GRBAS scale. Stress is persistent, pervasive and nearly unavoidable in contemporary life. The decades old perplexing and mind baffling pandemonium hovering around the Kashmiri population has had a tremendous impression on the psychological development of people in this region. A careful conclusion is the fact that emotional stress might play a major role in the upkeep of MTD. MTD has to be approached in a multidisciplinary environment in which closer cooperation between a laryngologist, a speech language pathologist and also a psychologist is likely.
Literatur
1.
Zurück zum Zitat Vilkman E (2000) Voice problems at work: a challenge for occupational safety and health arrangement. Folia Phoniatr Logop 52:120–125CrossRefPubMed Vilkman E (2000) Voice problems at work: a challenge for occupational safety and health arrangement. Folia Phoniatr Logop 52:120–125CrossRefPubMed
2.
Zurück zum Zitat Koufman JA, Blalock PD (1991) Functional voice disorders. Otolaryngol Clin North Am 24:1059–1073CrossRefPubMed Koufman JA, Blalock PD (1991) Functional voice disorders. Otolaryngol Clin North Am 24:1059–1073CrossRefPubMed
3.
Zurück zum Zitat Morrison MD, Nichol H, Rammage LA (1986) Diagnostic criteria in functional dysphonia. Laryngoscope 94:1–8 Morrison MD, Nichol H, Rammage LA (1986) Diagnostic criteria in functional dysphonia. Laryngoscope 94:1–8
4.
Zurück zum Zitat Morrison MD, Rammage LA, Gilles ME, Pullan CB, Hamish N (1983) Muscular tension dysphonia. J OtolaryngoI 12:302–306 Morrison MD, Rammage LA, Gilles ME, Pullan CB, Hamish N (1983) Muscular tension dysphonia. J OtolaryngoI 12:302–306
5.
Zurück zum Zitat Morrison MD, Rammage L (1993) Muscle misuse voice disorders: description and classification. Acta Otolaryngol (Stockh) 113:428–434CrossRefPubMed Morrison MD, Rammage L (1993) Muscle misuse voice disorders: description and classification. Acta Otolaryngol (Stockh) 113:428–434CrossRefPubMed
6.
Zurück zum Zitat Koufman JA, Blalock PD (1982) Classification and approach to patients with functional voice disorders. Ann Otol Rhinol Laryngol 91:372–377CrossRefPubMed Koufman JA, Blalock PD (1982) Classification and approach to patients with functional voice disorders. Ann Otol Rhinol Laryngol 91:372–377CrossRefPubMed
7.
Zurück zum Zitat Aronson AB (1990) Clinical voice disorders: an interdisciplinary approach, 3rd edn. Thieme, New York, NY Aronson AB (1990) Clinical voice disorders: an interdisciplinary approach, 3rd edn. Thieme, New York, NY
8.
Zurück zum Zitat Rammage LA, Nichol H, Morrison MD (1987) The psychopathology of voice disorders. Hum Commun Canada 11:21 Rammage LA, Nichol H, Morrison MD (1987) The psychopathology of voice disorders. Hum Commun Canada 11:21
9.
Zurück zum Zitat Seifert E, Kollbrunner J (2005) Stress and distress in non-organic voice disorders. Swiss Med Wkly. 57:584–594 Seifert E, Kollbrunner J (2005) Stress and distress in non-organic voice disorders. Swiss Med Wkly. 57:584–594
10.
Zurück zum Zitat Greene M, Mathieson L (1989) The voice and its disorders, 5th edn. Whurr, London, England Greene M, Mathieson L (1989) The voice and its disorders, 5th edn. Whurr, London, England
11.
Zurück zum Zitat Schalén L, Andersson K, Eliasson I (1992) Diagnosis of psychogenic dysphonia. Acta Otolaryngol Suppl 492:110–112CrossRefPubMed Schalén L, Andersson K, Eliasson I (1992) Diagnosis of psychogenic dysphonia. Acta Otolaryngol Suppl 492:110–112CrossRefPubMed
12.
Zurück zum Zitat Andersson K, Schaltn L (1998) Etiology and treatment of psychogenic voice disorder: results of a follow-up study of thirty patients. J Voice 12:96–106CrossRefPubMed Andersson K, Schaltn L (1998) Etiology and treatment of psychogenic voice disorder: results of a follow-up study of thirty patients. J Voice 12:96–106CrossRefPubMed
13.
Zurück zum Zitat Baker J (2002) Psychogenic voice disorders—heroes or hysterics. A brief overview with questions and discussion. Logoped Phoniatr Vocol. 27:84–91.6CrossRefPubMed Baker J (2002) Psychogenic voice disorders—heroes or hysterics. A brief overview with questions and discussion. Logoped Phoniatr Vocol. 27:84–91.6CrossRefPubMed
14.
Zurück zum Zitat Carding PN, Horsley IA, Doherty GJ (1999) A study of the effectiveness of voice therapy in the treatment of 45 patients with nonorganic dysphonia. J Voice 13(1):72–104CrossRefPubMed Carding PN, Horsley IA, Doherty GJ (1999) A study of the effectiveness of voice therapy in the treatment of 45 patients with nonorganic dysphonia. J Voice 13(1):72–104CrossRefPubMed
15.
Zurück zum Zitat MacKensie K, Millar A, Deary IJ, Wilson JA (1999) Does voice therapy work? A randomized controlled trial of the efficacy of voice therapy for dysphonia. Clin Otolaryngol Allied Sci 14(4):377CrossRef MacKensie K, Millar A, Deary IJ, Wilson JA (1999) Does voice therapy work? A randomized controlled trial of the efficacy of voice therapy for dysphonia. Clin Otolaryngol Allied Sci 14(4):377CrossRef
16.
Zurück zum Zitat Van Lierde KM, Claeys S, De Bodt M, van Cauwenberg P (2007) Long-term outcome of hyperfunctionnal voice disorder based on a multiparameter approach. J Voice 21(2):179–188CrossRefPubMed Van Lierde KM, Claeys S, De Bodt M, van Cauwenberg P (2007) Long-term outcome of hyperfunctionnal voice disorder based on a multiparameter approach. J Voice 21(2):179–188CrossRefPubMed
17.
Zurück zum Zitat Speyer R, Wieneke GH, van Wijck-Warnaar I, Dejonckere PH (2003) Effects of voice therapy on the voice range profiles of dysphonic patients. J Voice 17(4):544–566CrossRefPubMed Speyer R, Wieneke GH, van Wijck-Warnaar I, Dejonckere PH (2003) Effects of voice therapy on the voice range profiles of dysphonic patients. J Voice 17(4):544–566CrossRefPubMed
18.
Zurück zum Zitat Mathieson L (1989) Voice treatment: the wider perspective. Speech Therapy Prac 5(5):6–8 Mathieson L (1989) Voice treatment: the wider perspective. Speech Therapy Prac 5(5):6–8
20.
Zurück zum Zitat Ramig LO, Verdolini K (1998) Treatment efficacy: voice disorders. J Speech Lang Hear Res 41:S101–S116CrossRefPubMed Ramig LO, Verdolini K (1998) Treatment efficacy: voice disorders. J Speech Lang Hear Res 41:S101–S116CrossRefPubMed
21.
22.
Zurück zum Zitat Roy N, Bless DM, Heisey D (2000) Personality and voice disorders: a superfactor trait analysis. J Speech Lang Hear Res 43:749–768CrossRefPubMed Roy N, Bless DM, Heisey D (2000) Personality and voice disorders: a superfactor trait analysis. J Speech Lang Hear Res 43:749–768CrossRefPubMed
23.
Zurück zum Zitat Butcher P, Elias A, Raven R, Yeatman J, Littlejohns D (1987) Psychogenic voice disorder unresponsive to speech therapy: psychological characteristics and cognitive behavior therapy. Br J Disord Commun 22:81–92CrossRefPubMed Butcher P, Elias A, Raven R, Yeatman J, Littlejohns D (1987) Psychogenic voice disorder unresponsive to speech therapy: psychological characteristics and cognitive behavior therapy. Br J Disord Commun 22:81–92CrossRefPubMed
24.
Zurück zum Zitat Günther V, Mayr-Grafl A, Miller C, Kinzl H (1996) A comparative study of psychological aspects of recurring and non-recurring functional aphonias. Eur Arch Otorhinolaryngol 253:240–244CrossRefPubMed Günther V, Mayr-Grafl A, Miller C, Kinzl H (1996) A comparative study of psychological aspects of recurring and non-recurring functional aphonias. Eur Arch Otorhinolaryngol 253:240–244CrossRefPubMed
25.
Zurück zum Zitat Roy, Bless DM, Heisey D, Ford CN (1997) Manual circumlaryngeal therapy for functional dysphonia: an evaluation of short- and long-term treatment outcomes. J Voice 11:321–331CrossRefPubMed Roy, Bless DM, Heisey D, Ford CN (1997) Manual circumlaryngeal therapy for functional dysphonia: an evaluation of short- and long-term treatment outcomes. J Voice 11:321–331CrossRefPubMed
26.
Zurück zum Zitat Behlau M, Azevedo R, Pontes P, Brasil O (2001) Disfonias funcionais. In: Belhau MA (ed) voz. O livro do especialista. Rio de Janeiro, Revinter, pp 247–294 Behlau M, Azevedo R, Pontes P, Brasil O (2001) Disfonias funcionais. In: Belhau MA (ed) voz. O livro do especialista. Rio de Janeiro, Revinter, pp 247–294
27.
Zurück zum Zitat Cohen S, Williamson GM (1988) Perceived stress in a probability sample of the United States. In: Spacapan S, Oskamp S (eds) The social psychology of health. Sage, Newbury Park, CA, pp 31–67 Cohen S, Williamson GM (1988) Perceived stress in a probability sample of the United States. In: Spacapan S, Oskamp S (eds) The social psychology of health. Sage, Newbury Park, CA, pp 31–67
28.
Zurück zum Zitat Karam EG (1999) Women and the Lebanon wars: depression and post-traumatic stress disorder. In: Shehadeh L (ed) Women and War in Lebanon. University Press of Florida, Miami Karam EG (1999) Women and the Lebanon wars: depression and post-traumatic stress disorder. In: Shehadeh L (ed) Women and War in Lebanon. University Press of Florida, Miami
29.
Zurück zum Zitat Bennett O, Bexley J, Warnock K (eds) (1995) Arms to protect, arms to fight: women speak out about conflict. Panos, London Bennett O, Bexley J, Warnock K (eds) (1995) Arms to protect, arms to fight: women speak out about conflict. Panos, London
30.
Zurück zum Zitat UN (1995) Platform for action. Author, New York UN (1995) Platform for action. Author, New York
31.
Zurück zum Zitat Sudhir PM, Chandra PS, Shivashankar N, Yamini BK (2009) Comprehen-sive management of psychogenic dysphonia: a case illustration. J Commun Disord 42(305–12):16 Sudhir PM, Chandra PS, Shivashankar N, Yamini BK (2009) Comprehen-sive management of psychogenic dysphonia: a case illustration. J Commun Disord 42(305–12):16
32.
Zurück zum Zitat Baker J (2002) Persistent dysphonia in two performers affecting the singing and projected speaking voice: a report on a collaborative approach to management. Logoped Phoniatr Vocol 27:179–187CrossRefPubMed Baker J (2002) Persistent dysphonia in two performers affecting the singing and projected speaking voice: a report on a collaborative approach to management. Logoped Phoniatr Vocol 27:179–187CrossRefPubMed
33.
Zurück zum Zitat Morsomme D, de la Bardonnie MF, Verduyckt I, Jamart J, Remacle M (2010) Subjective evaluation of the long-term efficacy of speech therapy on dysfunctional dysphonia. J Voice 24(2):178–182CrossRefPubMed Morsomme D, de la Bardonnie MF, Verduyckt I, Jamart J, Remacle M (2010) Subjective evaluation of the long-term efficacy of speech therapy on dysfunctional dysphonia. J Voice 24(2):178–182CrossRefPubMed
34.
Zurück zum Zitat Rosen CA, Murry Th, Zinn A, Zullo Th, Sonbollian M (2000) Voice Handicap Index change following treatment of voice disorders. J Voice 14(4):619–623CrossRefPubMed Rosen CA, Murry Th, Zinn A, Zullo Th, Sonbollian M (2000) Voice Handicap Index change following treatment of voice disorders. J Voice 14(4):619–623CrossRefPubMed
35.
Zurück zum Zitat Speyer R, Wieneke GH, Dejonckere PH (2003) Self-assessment for chronic dysphonia. Clin Otolaryngol 29:66–74CrossRef Speyer R, Wieneke GH, Dejonckere PH (2003) Self-assessment for chronic dysphonia. Clin Otolaryngol 29:66–74CrossRef
36.
Zurück zum Zitat Speyer R, Wieneke GH, Dejonckere PH (2004) Documentation of progress in voice therapy: perceptual, acoustic, and laryngostroboscopic findings pretherapy and posttherapy. J Voice 18(3):325–340CrossRefPubMed Speyer R, Wieneke GH, Dejonckere PH (2004) Documentation of progress in voice therapy: perceptual, acoustic, and laryngostroboscopic findings pretherapy and posttherapy. J Voice 18(3):325–340CrossRefPubMed
Metadaten
Titel
Muscle Tension Dysphonia: Experience from a Conflict Zone
verfasst von
Ihsan Ali
Raj Tajamul Hussain
Fayaz Ahmad Wagay
Rauf Ahmad
Publikationsdatum
04.08.2020
Verlag
Springer India
Erschienen in
Indian Journal of Otolaryngology and Head & Neck Surgery / Ausgabe Sonderheft 2/2022
Print ISSN: 2231-3796
Elektronische ISSN: 0973-7707
DOI
https://doi.org/10.1007/s12070-020-02007-4

Weitere Artikel der Sonderheft 2/2022

Indian Journal of Otolaryngology and Head & Neck Surgery 2/2022 Zur Ausgabe

Darf man die Behandlung eines Neonazis ablehnen?

08.05.2024 Gesellschaft Nachrichten

In einer Leseranfrage in der Zeitschrift Journal of the American Academy of Dermatology möchte ein anonymer Dermatologe bzw. eine anonyme Dermatologin wissen, ob er oder sie einen Patienten behandeln muss, der eine rassistische Tätowierung trägt.

Ein Drittel der jungen Ärztinnen und Ärzte erwägt abzuwandern

07.05.2024 Klinik aktuell Nachrichten

Extreme Arbeitsverdichtung und kaum Supervision: Dr. Andrea Martini, Sprecherin des Bündnisses Junge Ärztinnen und Ärzte (BJÄ) über den Frust des ärztlichen Nachwuchses und die Vorteile des Rucksack-Modells.

Nur selten Nachblutungen nach Abszesstonsillektomie

03.05.2024 Tonsillektomie Nachrichten

In einer Metaanalyse von 18 Studien war die Rate von Nachblutungen nach einer Abszesstonsillektomie mit weniger als 7% recht niedrig. Nur rund 2% der Behandelten mussten nachoperiert werden. Die Therapie scheint damit recht sicher zu sein.

Rezidivierender Peritonsillarabszess nach Oralsex

02.05.2024 Peritonsillarabszess Kasuistik

Die erotischen Dimensionen von Peritonsillarabszessen scheinen eng begrenzt zu sein. Das heißt aber nicht, solche Abszesse und Erotik hätten nichts miteinander gemein, wie ein Fallbericht verdeutlicht.

Update HNO

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.