77 KB30 KB192920262004Hočevar-Boltežar, Irenaletnik:73številka:7-8str. 605-609ISSN:1318-0347COBISSID_HOST:18350297URN:URN:NBN:SI:doc-T2PLPAH0slSlovensko zdravniško društvoZdravniški vestnikDiagnosisEtiologyGlas, motnjeHoarsenessHripavostMišična kontrakcijaMuscle ContractionTherapyVoice DisordersMišično tenzijska disfonija| Muscle tension dysphonia|Background. Muscle tension dysphonia (MTD) is the cause of hoarseness in almost one half of the patients with voice disorders. The otorhinolaryngologicexamination discovers no evident organic lesions in the larynx at least in the beginning of the voice problems. The reason for the hoarse voice is a disordered and maladjusted activity of the muscles taking part in phonation and/or articulation. In some patients, the irregular function of the larynx results in mucosal lesions on vocal folds. The factors participating in the development of MTD, directly or indirectly influence the quality of laryngeal mucosa, the activity of the phonatory muscles and/or increase of the vocal load. In the diagnostics and treatment of the MTD a phoniatrician, a speech and language therapist and a psychologist closely cooperate with the patient who must take an active role. The treatment is a long-lasting one but resulted in a high percentage of clinical success. Conclusions. Most likely, MTD is not a special disease but only a reflection of any disorder in the complicated system of regulation and realization of phonation. The prognosis of treatment is good when all unfavourable factors participating in development of MTD are eliminated and a proper professional voice- and psychotherapy startedIzhodišča. Mišično tenzijska disfonija (MTD) je vzrok hripavosti pri skoraj polovici bolnikov z glasovnimi motnjami. Pri otorinolaringološkem pregledu vsaj v začetku očitnih organskih sprememb na grlu ne najdemo, saj je vzrok hripavosti nepravilna (praviloma prevelika) in slabo usklajena dejavnost mišic, ki sodelujejo pri tvorbi in oblikovanju glasu. Zaradi nepravilnega delovanja grla med fonacijo pri nekaterih bolnikih nastanejo sluznične spremembe na glasilkah. Dejavniki, ki sodelujejo pri nastanku ali razvoju MTD,neposredno ali posredno vplivajo na kakovost sluznice grla, aktivnost mišic, ki sodelujejo pri fonaciji, ali pa povečajo glasovno obremenitev bolnika. V diagnostičnem postopku ter zdravljenju tesno sodelujejo foniater, logoped in psiholog, za uspešno zdravljenje pa je nujno tudi aktivno sodelovanje bolnika samega. Zaključki. MTD najverjetneje ni posebna bolezenskaentiteta, ampak samo zrcali motnje kjer koli v zapletenem sistemu uravnavanja in izvedbe fonacije. Z odstranitvijo dejavnikov, ki so prispevali k nastanku MTD, ter z ustrezno strokovno glasovno in psihoterapijo je napoved zdravljenja MTD dobraTEXTznanstveno časopisjejournalsSlovenian National E-content AggregatorNational and University Library of SloveniaSlovensko zdravniško društvo