Differentiation of spasmodic and psychogenic dysphonias with phonoscopic evaluation.

Abstract

Identify laryngeal behaviors that differentiate patients with spasmodic dysphonia and patients with psychogenic dysphonia. Retrospective review of patients evaluated over a 3-year period with a diagnosis of either spasmodic or psychogenic dysphonia. Videotaped phonoscopic (laryngeal imaging) examinations of all noted aberrant behaviors were examined. Tally behaviors according to each subject group. Three examiners unfamiliar with patients' previous diagnoses reviewed videotaped studies. Aberrant behaviors were noted and each patient was assigned to spasmodic or psychogenic dysphonia group. Agreement among examiners and agreement with previous diagnoses was established. Six abnormal behaviors were noted, including tremor, hyperadduction, false fold constriction, sphincteric constriction, hyperabduction and paradoxical movements of the true and false folds. Percentage of patients in each group with each behavior was determined. Individual behaviors did not generally appear to differentiate the two groups; however, patterns of behaviors did, and may be of considerable value in differentiating spasmodic and psychogenic dysphonias.