Provoked Laryngeal Dysfunction

Haapanen, Marja‐Leena

doi:10.1159/000266061

Cited by 6 publications

(3 citation statements)

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“…In cases with defined allergens it is possible to use the specific agents for stimulus and it is also possible to make up an appropriate placebo (2,5). However, in our study, without a specific allergen as the stimulating substance, there is no obvious choice of placebo.…”

Section: Saline As a Control Substancementioning

confidence: 90%

“…Haapanen (2) proposed that an off-warding reaction, induced by supraglottal stimulation and defending larynx and lungs, would create a "pharyngeal dysphonia" by activating the supraglottal laryngeal sphincter. Our results from videolaryngostroboscopy, performed using the rigid laryngoscope, failed to reveal any systematic alteration in laryngeal or supralaryngeal motility aspects in patients after any challenge.…”

Section: Possible Mechanisms Of Dysphonia In Our Patientsmentioning

confidence: 99%

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Hoarseness as a Sign of Possible Nonspecific Mucosal Hyperreactivity in Vocal Tract

2009

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The aim of the present paper was to evaluate the possible impact of methacholine challenge on the voice and vocal tract in ten patients reporting hoarseness due to presumable hyperreactivity to some environmental factors. Ten age-and gender-matched healthy subjects served as controls. Methacholine was used for hypersensitivity challenge and saline solution (0.9% NaCl) as control substance. Subjects were examined on two separate challenge occasions testing either methacholine in increasing doses (3, 6, 12 mg) or NaCl. Voice recordings, videolaryngoscopy, and measurement of nasal secretion were performed before and after each sniffing session. Subjective complaints were documented. Data were statistically analyzed with three-way analysis of variance (ANOVA) and group comparisons performed. Perceptual analysis of voice recordings showed an increase of the grade of voice disorder in patients after exposure to both substances. Moreover, one of the patients became aphonic and another severely dysphonic after NaCl. No voice quality changes were detected in controls. The videolaryngoscopy findings divergent from normal did not increase in any group. Nasal secretion was significantly higher after sniffing of methacholine than NaCl in both groups. The frequency of subjective complaints was equal in both groups after both substances. However, there was a qualitative difference in the character of the symptoms: the patients complained of throat, vocal and nasal symptoms while the controls complained exclusively of nasal symptoms.The study supports the view that vocal dysfunction after exposure to non-specific environmental irritating factors may be triggered mainly by emotional mechanisms such as off-warding reaction or dissociative disorder. BACKGROUND AND AIM

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