Functional dysphonia (FD) is a condition in which structurally completely normal vocal cords cannot perform the proper sound production function. In other words, normal can be defined as inappropriate or incorrect use of the vocal organ. In order to make this diagnosis, the patient must be evaluated by a clinic experienced in voice diseases in the light of all necessary examinations. This patient group constitutes 10-40% of voice patients (1). Although the signs and symptoms of FD can vary widely, it can be seen in most patients following a previous upper respiratory tract infection. It is seen more frequently in women than men. It is usually temporary and treatment response is variable.
Different features of the voice may be negatively affected in FD. There may be deterioration in the intensity, pitch or general quality of the voice, and in rare cases, the patient may not be able to produce any sound at all (Functional aphonia). Psychological factors and stress may cause the onset or increase of FD symptoms.
There are many definitions used instead of the FD definition or for similar clinical conditions. These include psychogenic, convertive, hysterical, hyperfunctional, muscle tension and misuse hoarseness (2-6).
It is thought that inappropriate contractions of the small muscles in the larynx (larynx, larynx) play a role in functional dysphonia. . It has been stated in various studies that one or more of the following mechanisms may play a role in causing these contractions (1):
1. Technically incorrect use of voice due to the need to use excessive voice (2-4)
2. Learned vocal harmony required after upper respiratory tract infection (5)
3. Increased larynx and pharynx (throat, pharynx) muscle tension secondary to voice problems due to laryngopharyngeal reflux (7,8)
4. Overcorrection of voice problems secondary to small vocal cord pathologies (such as nodules, polyps) or insufficiencies (9)
5. Excessive tension in the larynx region due to personality traits or psychological reasons (10,11)
FD diagnosis It can be determined as a result of a complete ear, nose, throat and head and neck examination of the individual, examination of the larynx with both traditional and current (endoscopic, videolaryngostroboscopic) methods and, if necessary, other examinations to be performed in the voice laboratory (such as voice analysis, diagnostic voice therapy, laryngeal electromyography). .
Untreated FD not only negatively affects the individual's quality of life, but also may lead to organic pathologies (such as vocal cord nodule) if it continues.
FD treatment consists of different medications used when necessary. In addition, voice therapy methods aim to teach the individual correct voice behavior and apply it in daily life. Methods that the patient can apply on his own, such as adequate fluid intake, humidifying the air in the breathing environment, avoiding smoking, reducing general stress, speaking in an appropriate voice and with breathing support, and avoiding the habit of frequently clearing the throat, are also very important for the success of the treatment (12). Making these precautions a habit is also very useful to avoid encountering FD problems again.
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