Characterization of Functional Dysphonia: Pre- and Post-Treatment Findings

Area of Science:

• Otolaryngology
• Speech-Language Pathology

Background:

• Functional dysphonia (FD) is a challenging diagnosis characterized by aberrant muscle contractions causing voice impairment without visible laryngeal abnormalities.
• Despite increasing clinical recognition, effective diagnosis and treatment strategies for FD remain areas of concern.

Purpose of the Study:

• To analyze the clinical presentation, videostroboscopic findings, and treatment outcomes in a large cohort of patients diagnosed with functional dysphonia.
• To highlight delays in diagnosis and treatment for FD and their impact on patient recovery.

Main Methods:

• Retrospective review of videostroboscopic examinations and electronic medical records for 109 patients treated for FD.
• Independent analysis of videostroboscopy by two reviewers, classifying laryngeal posturing and voice quality.
• Collection of patient demographics, medical history, and survey responses.

Main Results:

• The cohort comprised 85.1% females, with an average Voice Handicap Index (VHI30) score of 71.0/120.
• Average time to diagnosis was 688 days; average time from diagnosis to treatment was 3.7 days.
• Laryngeal posturing varied: 44.0% hyperadducted, 31.9% hypoadducted, and 24.2% mixed. 98% of patients improved post-treatment, with 85% achieving normal voice.

Conclusions:

• Functional dysphonia patients demonstrate significant improvement with specialized voice therapy post-diagnosis.
• There are substantial delays in the diagnosis and initiation of treatment for functional dysphonia, impacting patient outcomes.