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. 2021 Apr;130(4):389-394.
doi: 10.1177/0003489420956379. Epub 2020 Sep 10.

Patient-Reported Factors Associated with the Onset of Hyperfunctional Voice Disorders

Samantha Kridgen  1   2 , Robert E Hillman  1   2   3 , Tara Stadelman-Cohen  1   2 , Steven Zeitels  1   3 , James A Burns  1   3 , Tiffiny Hron  1   3 , Carol Krusemark  1   2 , Jason Muise  1   2 , Jarrad H Van Stan  1   2   3
Affiliations

Patient-Reported Factors Associated with the Onset of Hyperfunctional Voice Disorders

Samantha Kridgen et al. Ann Otol Rhinol Laryngol. 2021 Apr.

Abstract

Objectives: Prevention, diagnosis, and treatment of hyperfunctional voice disorders would be improved by better understanding their etiological contributing factors. Therefore, this study estimated the prevalence of etiological factors using self-reported data about disorder onset from a large cohort of patients with Phonotraumatic Vocal Hyperfunction (PVH) and Non-Phonotraumatic Vocal Hyperfunction (NPVH).

Methods: Retrospective chart review extracted the self-reported rate (gradual, sudden) and events associated (voice use, anxiety/stress, upper respiratory infection [URI]) with disorder onset from 1,577 patients with PVH and 979 patients with NPVH.

Results: Both patient groups reported a gradual onset more than a sudden onset. Voice use was the most frequently reported event for PVH and the NPVH group self-reported all three events at equal frequency. The largest PVH subgroups were associated with voice use while the NPVH subgroups were associated with only voice use, only URI, or only anxiety/stress.

Conclusion: The results support the general clinical view that PVH is most strongly related to the gradual accumulated effects of phonotrauma, while NPVH has a more heterogeneous etiology. The identified PVH and NPVH subgroups may have clinical relevance and future work could investigate differences in treatment and outcomes among these subgroups.

Keywords: muscle tension dysphonia; vocal fold nodules; vocal hyperfunction; voice disorders.

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Conflict of interest statement

Conflict of interest statement: Drs. Robert Hillman and Steven Zeitels have a financial interest in InnoVoyce LLC, a company focused on developing and commercializing technologies for the prevention, diagnosis and treatment of voice-related disorders. Dr. Hillman’s and Dr. Zeitels’ interests were reviewed and are managed by Massachusetts General Hospital and Partners HealthCare in accordance with their conflict of interest policies.

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