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J Korean Soc Laryngol Phoniatr Logop > Volume 28(2); 2017 > Article
Journal of The Korean Society of Laryngology, Phoniatrics and Logopedics 2017;28(2): 71-78.
doi: https://doi.org/10.22469/jkslp.2017.28.2.71
신경성 발성장애와 기능성 발성장애의 감별 진단
김소연, 이상혁
성균관대학교 의과대학 강북삼성병원 이비인후과학교실
Differential Diagnosis between Neurogenic and Functional Dysphonia
So Yean Kim, Sang Hyuk Lee
Department of Otorhinolaryngology-Head and Neck Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
Correspondence  Sang Hyuk Lee ,Tel: (02) 2001-2264, Fax: (02) 2001-2273, Email: entlsh@hanmail.net
Received: 25 April 2017; Revised: April 30, 2017   Accepted: 9 May 2017.  Published online: 31 December 2017.
Voice disorder is classified into three categories, structural, neurogenic and functional dysphonia. Neurogenic dysphonia refers to a disruption in the nerves controlling the larynx. Common examples of this include complete or partial vocal cord paralysis, spasmodic dysphonia. Also it occurs as part of an underlying neurologic condition such as Parkinson's disease, myasthenia gravis, Lou Gehrig’s disease or disorder of the central nervous system that causes involuntary movement of the vocal folds during voice production. Functional dysphonia is a voice disorder in the absence of structual or neurogenic laryngeal characteristics. A near consensus exist that Muscle tension dysphonia (MTD) is functional voice disorder wherein hyperfunctional laryngeal muscle activity whereas Spasmodic dysphonia (SD) is neurogenic, action-induced focal laryngeal dystonia including several subtype. Both Adductor type spasmodic dysphonia (AdSD) and MTD may be associated with excessive supraglottic contraction and compensation, resulting in a strained voice quality with spastic voice breaks. It makes these two disorders extremely difficult to differentiate based on clinical interpretation alone. Because treatment for AdSD and MTD are quite different, correct diagnosis is important. Clinician should be aware of the specific vocal characteristics of each disease to improve therapeutic outcome.
KEY WORDS: Functional dysphoniaNeurogenic dysphoniaMuscle tension dysphoniaSpasmodic dysphoniaDifferential diagnosis.
중심 단어: 기능성 음성장애신경성 발성장애근긴장성 발성장애연축성 발성장애감별 진단.
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