Koufman and Blalock classified functional voice disorders based on clinical features. The authors are from Wake Forest University in Winston-Salem, North Carolina.
(3) voice quality
(4) exam (indirect laryngoscopy, other)
Hysterical Aphonia or Dysphonia
often precipitating event, no history of laryngitis
onset after acute episode of laryngitis; variable evidence of "secondary gain"
aphonia or whisper; pitch-locked if any voice; stable (does not fluctuate)
breathy, raspy, diplophonia; pitch-locked; stable (does not fluctuate)
usually normal, occasional plica ventricularis
life-long of sudden
overuse; pitching the voice too low; tensing muscles in larynx and neck
abnormally high-pitched; pitch-locked; stable (does not fluctuate)
variable dysphonia; hard glottal attack; not pitch-locked; intermittent or may fluctuate; throat pain
normal or vocal nodules or polyps or ulcers or granulomas
• The authors also referred to the voice abuse category as the Tension-Fatigue Syndrome (TFS).
vocal abuse following surgery
dysphonia; hard glottal attack; not pitch-locked; may have pain
normal or mucosal ulcers or plica ventricularis or granulomas
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