内転型痙攣性発声障害様症状を呈する心因性発声障害―１症例の報告と専門医による音声評価―

DOI 被引用文献2件 参考文献34件

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タイトル別名
  • Spasmodic-Like Psychogenic Dysphonia (SPD)-A Case Report with Expert Assessment of Voice-
  • —A Case Report with Expert Assessment of Voice—
  • ―1症例の報告と専門医による音声評価―

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抄録

A case of spasmodic-like psychogenic dysphonia (SPD) is presented. Voice examination during speech revealed pressed or strained voice quality, voice stoppages which are often described as characteristic signs of adductor spasmodic dysphonia (ADSD) . Fiberoptic laryngoscopy during phonation revealed sphincteric constriction of the larynx. Five expert otolaryngologists made perceptual assessment of the audio-recorded voice samples. All five experts agreed that the dysphonia of the patient most likely had ADSD as long as voice characteristics. The authors suspected the dysphonia of the patient to be psychogenic, mainly based on the findings in an interview, such as the fact that vocal symptoms occurred coincidentally with psychogenic dyspnea. The vocal symptoms improved to normal by voice therapy almost identical to that used to treat psychogenic aphonia. The diagnosis of psychogenic dysphonia in this case was confirmed by symptom reversibility in response to the voice therapy. These circumstances suggest a strong probability that SPD will be misdiagnosed as ADSD. An in-depth interview, comprehensive voice assessment, laryngoscopy, and diagnostic voice therapy are thus recommended in the diagnostic process of SPD and ADSD.

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