摘要
本科自民國82年9月至83年11月於每週音聲特別門診收集功能性音聲異常的病患共84例，其中肌肉緊張性發聲困難55例 (65.5%)，聲帶結節17例 (20.2%)，聲帶瘜肉12例 (14.3%)。自此統計中可發現肌肉緊張性發聲困難佔了很大的比例。這些尚未在聲帶出現病變的音聲病患常被診斷為慢性咽炎或慢性喉炎，而不能得到適當的治療。針對此一問題，本科利用3種喉外症狀與4種喉內局部所見比較肌肉緊張性發聲困難的病患及非音聲病患，俾便發現可供應用之資訊。喉外症狀包括：1) 頸部緊繃有壓痛感，2) 發聲效率低(glottal inefficiency)及3)舌骨與喉部上提(elevation of the hyoid bone and larynx)。4種喉內所見是利用纖維內視鏡及喉頻閃光原內視鏡觀察是否有聲門閉合不全、假聲帶內轉( false vocal cord closure)、聲門上部分狹窄及聲門上完全緊縮等情形。結果在20例對照組中，只有1例發現聲門上部分狹窄，其餘皆無3種喉外症狀及4種喉內發現。如此明顯的差異，對於尚未在聲帶出現病變的病患，即使沒有纖維內視鏡及喉頻閃光源內視鏡的設備，我們也可以利用3種喉外症狀配合病患的病史及職業，簡單的診斷出肌肉緊張性發聲困難。
並列摘要
Eighty-four patients who attended our special clinic for functional voice disorder from September 1993 to November 1994, constituted this study population. Of them, there were 55(65.5%) muscular tension dysphonia, 17(20.2%) vocal nodules, and 12(14.3%) vocal polyp. Muscular tension dysphonia represented the majority, but these patients have usually been misdiagnosed with chronic pharyngitis or chronic laryngitis, and thus inappropriate treatment ensued. To match this, 20 patients without voice problems were randomly selected from outpatient dinic as control group. Three extralaryngeal clinical symptoms (neck tightness with tenderness, glottal inefficiency, and elevation of the hyoid bone and larynx) and 4 intralaryngeal local findings (open posterior glottic chink, false cord closure, supraglottic contraction, and supraglottic closure) under fiberscopy and stroboscopy were used as criteria to compare muscular tension dysphonia patients with control group. In the patients with muscular tension dysphonia, most (51/55, 92.7%) had one or more of the extralaryngeal clinical symptoms and majority (41/55, 74.5%) had one of the intralaryngeal findings. In contrast to this, only one case of supraglottic contraction was found in the control group. Before lesions in the true cords develop, even without the aid of the fiberscope and stroboscope, simply by the 3 extralaryngeal clinical symptoms, past history, and present occupation, we can make an early and accurate diagnosis of muscular tension dysphonia.