Exploring the Characteristics of Functional Dysphonia by Multimodal Methods

Area of Science:

• Laryngology and Speech Pathology
• Psychosomatic Medicine
• Respiratory Physiology

Background:

• Functional dysphonia (FD) is a voice disorder with unclear etiology.
• Understanding FD's multifactorial nature is crucial for effective treatment.

Purpose of the Study:

• To comprehensively characterize functional dysphonia using a multimodal approach.
• To identify objective and subjective markers differentiating FD patients from healthy controls.

Main Methods:

• 47 FD patients and 22 controls underwent voice assessment, VHI-30, acoustic analysis, psychological evaluation, surface electromyography (sEMG), and respiratory studies.
• sEMG assessed laryngeal and neck muscle activity.
• Nasal airflow and thoracoabdominal movements were analyzed to evaluate breathing patterns.

Main Results:

• FD is primarily triggered by mood changes, with subjective voice handicap exceeding objective measures.
• Laryngoscopy revealed no gross organic lesions but showed glottic insufficiency and supraglottic compensation.
• FD patients exhibited increased sternocleidomastoid, infra/suprahyoid, and cricothyroid muscle activity with prephonation recruitment and postphonation persistence.
• Breathing patterns in FD were characterized by shortened inspiratory time, increased chest breathing, reduced abdominal contribution, and increased respiratory rate during speech tasks.

Conclusions:

• Functional dysphonia predominantly affects middle-aged women and is linked to psychological factors.
• Objective findings include increased muscle tension, altered laryngeal function (glottic insufficiency, supraglottic compensation), and dysfunctional breathing patterns.
• Therapeutic strategies for FD should address both the psychological triggers and the identified physiological characteristics.