WordNet

in a hoarse or husky voice; "`Excuse me, he said hoarsely" (同)huskily

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(声の)しわがれた;(人・動物が)しわがれ声の
〈声〉‘を'しわがれさせる / 〈声が〉しわがれる
=hoary

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2013/03/24 22:06:12」(JST)

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Dysphonia is the medical term for disorders of the voice: an impairment in the ability to produce voice sounds using the vocal organs (it is distinct from dysarthria which signifies dysfunction in the muscles needed to produce speech). Thus, dysphonia is a phonation disorder. The dysphonic voice can be hoarse or excessively breathy, harsh, or rough, but some kind of phonation is still possible (contrasted with the more severe aphonia where phonation is impossible).

Dysphonia has either organic or functional causes due to impairment of any one of the vocal organs. However, typically it is caused by some kind of interruption of the ability of the vocal folds to vibrate normally during exhalation. Thus, it is most often observed in the production of vowel sounds. For example, during typical normal phonation, the vocal folds come together to vibrate in a simple open/closed cycle modulating the airflow from the lungs. Weakness (paresis) of one side of the larynx can prevent simple cyclic vibration and lead to irregular movement in one or both sides of the glottis. This irregular motion is heard as roughness. This is quite common in vocal fold paresis.^[1]

Common types of dysphonia

Organic dysphonia
- Laryngitis (Acute: viral / bacterial) - (Chronic: smoking / GERD / LPR (Laryngopharyngeal Reflux) ).
- Neoplasm (Premalignant: dysplasia) - (Malignant: Squamous cell carcinoma).
- Trauma (Iatrogenic: surgery / intubation) - (Accidental: blunt / penetrating / thermal).
- Endocrine (Hypothyroidism / hypogonadism).
- Haematological (Amyloidosis).
- Iatrogenic (inhaled corticosteroids)

Functional dysphonia
- Psychogenic
- Vocal misuse
- Idiopathic

Associated conditions (incomplete list)

Voice disorders
- Laryngitis
- Chorditis
- Vocal cord nodules
- Vocal fold cyst
- Reinke's Edema (Mostly caused by smoking)
- Laryngeal papillomatosis
Gastroesophageal reflux disease: When there is a clinical suspicion for GERD as the cause of the dysphonia, an Esophageal pH Monitoring is required to confirm the diagnosis and establish the relationship between GERD and dysphonia.

Laryngeal cancer
Myasthenia gravis
Hypothyroidism
Hyperthyroidism
Sinusitis
Lung cancer
Juvenile dermatomyositis
Parkinson's disease
Botulinum toxin

Clinical measurement

Dysphonia is measured using a variety of examination tools that allow the clinician to see the pattern of vibration of the vocal folds, principally laryngeal videostroboscopy. Acoustic examination is also common, obtained by recording the sounds made during sustained phonation or whilst speaking. Another tool is electroglottography.

Subjective measurement of the severity of dysphonia is carried out by trained clinical staff. The GRBAS (Grade, Roughness, Breathiness, Asthenia, Strain) scale or the Oates Perceptual Profile are widely used for this purpose. Objective measurement of the severity of dysphonia typically requires signal processing algorithms applied to acoustic or electroglottographic recordings. These include algorithms such as jitter, shimmer and noise-to-harmonics ratios, but these have been shown to have some critical limitations, particularly for severe dysphonia. Recent advances in signal processing theory have led to more robust algorithms.^[2]

References

^ Little, M.A. et al. (2009). Objective dysphonia quantification in vocal fold paralysis: comparing nonlinear with classical measures. Journal of Voice (in press).
^ Little, M.A. et al. (2007). Exploiting nonlinear recurrence and fractal scaling properties for voice disorder detection. Biomed Eng Online, 6:23.

External links

Vocal Dysphonia and Vocal Disorder Online Support Network
VoiceInfo.org
Pediatric ENT
WrongDiagnosis
Objective measurement of dysphonia for clinical purposes.
Marshall
NetDoctor
Singing Voice
National Center for Voice and Speech's official website
The Department of Speech Pathology and Audiology at the University of Iowa's official website
The Voice Academy's official website

UpToDate Contents

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1. 成人における嗄声 hoarseness in adults
2. 小児における嗄声の病因およびマネージメント etiology and management of hoarseness in children
3. 嗄声を有する小児の評価 evaluation of the child with hoarseness
4. 胸腺神経内分泌（カルチノイド）腫瘍 thymic neuroendocrine carcinoid tumors
5. 成人における急速交代性の双極性障害：大うつ病の治療 rapid cycling bipolar disorder in adults treatment of major depression

English Journal

Dysphonia and vocal fold telangiectasia in hereditary hemorrhagic telangiectasia.

Chang J1, Yung KC2.
The Annals of otology, rhinology, and laryngology.Ann Otol Rhinol Laryngol.2014 Nov;123(11):769-70. doi: 10.1177/0003489414538400. Epub 2014 Jun 9.
OBJECTIVE: This case report is the first documentation of dysphonia and vocal fold telangiectasia as a complication of hereditary hemorrhagic telangiectasia (HHT).METHODS: Case report of a 40-year-old man with HHT presenting with 2 years of worsening hoarseness.RESULTS: Hoarseness corresponded with
PMID 24913291

[55-year-old man with progressive dyspnoea and hoarseness after operatively corrected coarctation of the aorta].

Michels G1, Luebke T2, Lethaus-Weigl S3, Pfister R1.
Deutsche medizinische Wochenschrift (1946).Dtsch Med Wochenschr.2014 Nov;139(45):2299-300. doi: 10.1055/s-0034-1387376. Epub 2014 Oct 28.
PMID 25350244

A novel combination of the Arndt endobronchial blocker and the laryngeal mask airway ProSeal™ provides one-lung ventilation for thoracic surgery.

Li Q1, Li P1, Xu J1, Gu H1, Ma Q2, Pang L2, Liang W1.
Experimental and therapeutic medicine.Exp Ther Med.2014 Nov;8(5):1628-1632. Epub 2014 Sep 15.
In this study, the feasibility and performance of the combination of the Arndt endobronchial blocker and the laryngeal mask airway (LMA) ProSeal™ in airway establishment, ventilation, oxygenation and lung isolation was evaluated. Fifty-five patients undergoing general anesthesia for elective thora
PMID 25289071

Japanese Journal

体育大学における嗄声 : その問題点と改善に向けて

諸冨満希子
日本女子体育大学紀要 44, 71-81, 2014-03
NAID 40020058382

ECM1遺伝子変異を伴う皮膚粘膜ヒアリノーシス例

早水佳子,黒野祐一
耳鼻咽喉科臨床 104(8), 575-580, 2011-08-01
… Hyalinosis cuits et mucosae is a rare autosomal recessive disorder characterized by a hoarse voice and skin and mucosal changes. … Her chief complaint was a hoarse voice since birth. …
NAID 10029260387

EA2010-35 擬似音声信号を用いた評価による音源構造抽出法の最適化について

和田芳佳,板垣英恵,森勢将雅 [他],西村竜一,入野俊夫,河原英紀
電子情報通信学会技術研究報告. EA, 応用音響 110(71), 77-82, 2010-06-03
「痩れ声」や「だみ声」のように,感情音声や歌唱音声において強い印象を与える音声の分析・合成の研究を進めている.それらの音声を駆動する信号は,基本周波数のみでは十分に表すことのできない複雑な構造を有している.本資料では,この駆動信号の構造を分析する方法として提案しているXSX(eXcitation Structure eXtractor)法に含まれる設計パラメタの最適化と,評価方法を検討した結果につ …
NAID 110007890740