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abnormal pitch can be characterized by a voice that is too high or low whereas abnormal loudness can be characterized by a voice that is too quiet or loud. Similarly, a voice that has frequent, inappropriate breaks characterizes abnormal quality while a voice that is monotone (i.e., very flat) or inappropriately fluctuates characterizes abnormal variability. While hoarseness is used interchangeably with the term dysphonia, it is important to note that the two are not synonymous. Hoarseness is merely a subjective term to explain the perceptual quality (or sound) of a dysphonic voice. While hoarseness is a common symptom (or complaint) of dysphonia, there are several other signs and symptoms that can be present such as: breathiness, roughness, and dryness. Furthermore, a voice can be classified as dysphonic when it poses problems in the functional or occupational needs of the individual or is inappropriate for their age or sex.
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treatment for voice disorders such as
Spasmodic Dysphonia. Voice therapy is mainly used with patients who have an underlying cause of voice misuse or abuse. Laryngologists also recommend this type of treatment to patients who have an organic voice disorder - such as vocal fold nodules, cysts or polyps as well as to treat functional dysphonia. Certain surgical treatments can be implemented as well - phono microsurgery (removal of vocal fold lesions performed with a microscope), laryngeal framework surgery (the manipulation of the voice box), as well as injection augmentation (injection of substance to vocal folds to improve closure). Surgical treatments may be recommended for patients having an organic dysphonia.
643:, a condition known to be associated with vocally damaging behaviours. However, a causal relationship has not yet been definitively proven. The overall prevalence of dysphonia in children ranges from 3.9% - 23.4%, most commonly affecting children between the ages of 8 - 14. Among the elderly, dysphonia is associated with both naturally occurring anatomical and physiological changes as well as higher rates of pathological conditions. The point prevalence of dysphonia among the elderly is 29%. Findings regarding the prevalence of geriatric dysphonia in the general population are very variable, ranging from 4 - 29.1%. This variability is likely due to different
147:); in contrast, structural dysphonia is defined as impaired functioning of the vocal mechanism that is caused by some sort of physical change (e.g. a lesion on the vocal folds). Notably, an additional subcategory of functional dysphonia recognized by professionals is psychogenic dysphonia, which can be defined as a type of voice disorder that has no known cause and can be presumed to be a product of some sort of psychological stressors in one's environment. It is important to note that these types are not mutually exclusive and much overlap occurs. For example,
533:
there are two types of vocal training recognized by professionals to help with prevention: direct and indirect. Direct prevention describes efforts to reduce conditions that may serve to increase vocal strain (such as patient education, relaxation strategies, etc.), while indirect prevention strategies refer to changes in the underlying physiological mechanism for voice production (e.g., adjustments to the manner in which vocal fold adduction occurs, respiratory training, shifting postural habits, etc.).
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and rest, avoidance of vocal abuse (e.g., shouting, clearing of the throat), and taking into consideration lifestyle choices that may affect vocal health (e.g., smoking, sleeping habits). Vocal warm-ups and cool-downs may be employed to improve muscle tension and decrease risk of injury before strenuous vocal activities. It should be taken into account that vocal hygiene practices alone are minimally effective in treating dysphonia, and thus should be paired with other therapies.
86:. Cheering at sporting events, speaking loudly in noisy situations, talking for too long without resting one's voice, singing loudly, or speaking with a voice that is too high or too low can also cause temporary hoarseness. A number of other causes for losing one's voice exist, and treatment is generally by resting the voice and treating the underlying cause. If the cause is misuse or overuse of the voice, drinking plenty of water may alleviate the problems.
524:, air flow and sub glottal air pressure. The normal aerodynamic parameters of voice vary considerably among individuals, which leads to a large overlapping range of values between dysphonic and non-dysphonic patients. This limits the use of these measures as a diagnostic tool. Nonetheless, they are useful when used in adjunct with other voice assessment measures, or as a tool for monitoring therapeutic effects over time.
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variety of voice features, including overall severity, roughness, breathiness, strain, loudness and pitch. These evaluations are done during spontaneous speech, sentence or passage reading or sustained vowel productions. The GRBAS (Grade, Roughness, Breathiness, Asthenia, Strain) and the CAPE-V (Consensus
Auditory Perceptual Evaluation—Voice) are two formal voice rating scales commonly used for this purpose.
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422:. As air moves through the glottis, it causes a distortion of the air particles which sets the vocal folds into vibratory motion. It is this vibratory motion that produces phonation or voice. In dysphonia, there is an impairment in the ability to produce an appropriate level of phonation. More specifically, it results from an impairment in vocal fold vibration or the nerve supply of the larynx.
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582:. An example of a direct therapy is circumlaryngeal manual therapy, which has been used to reduce tension and massage hyoid-laryngeal muscles. This area is often tense from chronic elevation of the larynx. Pressure is applied to these areas as the patient hums or sustains a vowel. Traditional voice therapy is often used to treat muscular tension dysphonia.
485:), another imaging technique, is not subject to the same limitations as laryngeal stroboscopy. A rigid endoscope is used to take images at a rate of 8000 frames per second, and the image is displayed in real time. As well, this technique allows imaging of aperiodic vibrations and can thus be used with patients presenting with all severities of dysphonia.
126:. Multiple treatments have been developed to address organic and functional causes of dysphonia. Dysphonia can be targeted through direct therapy, indirect therapy, medical treatments, and surgery. Functional dysphonias may be treated through direct and indirect voice therapies, whereas surgeries are recommended for chronic, organic dysphonias.
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on the category that the voice disorder falls into, there are various treatment methods that can be suggested to the patient. The professional has to keep in mind there is not one universal treatment, but rather the clinical approach must find what the optimal effective course of action for that particular patient is.
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Dejonckere PH, Bradley P, Clemente P, Cornut G, Crevier-Buchman L, Friedrich G, Van De
Heyning P, Remacle M, Woisard V (February 2001). "A basic protocol for functional assessment of voice pathology, especially for investigating the efficacy of (phonosurgical) treatments and evaluating new assessment
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Although there is no universal classification of voice problems, voice disorders can be separated into certain categories: organic (structural or neurogenic), functional, neurological (psychogenic) or iatrogenic, for example. Depending on the diagnosis and severity of the voice problem, and depending
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Given that certain occupations are more at risk for developing dysphonia (e.g., teachers) research into prevention studies have been conducted. Research into the effectiveness of prevention strategies for dysphonia have yet to produce definitive results, however, research is still ongoing. Primarily,
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Schwartz SR, Cohen SM, Dailey SH, Rosenfeld RM, Deutsch ES, Gillespie MB, Granieri E, Hapner ER, Kimball CE, Krouse HJ, McMurray JS, Medina S, O'Brien K, Ouellette DR, Messinger-Rapport BJ, Stachler RJ, Strode S, Thompson DM, Stemple JC, Willging JP, Cowley T, McCoy S, Bernad PG, Patel MM (September
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Indirect therapies take into account external factors that may influence vocal production. This incorporates maintenance of vocal hygiene practices, as well as the prevention of harmful vocal behaviours. Vocal hygiene includes adequate hydration of the vocal folds, monitoring the amount of voice use
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There are three main type of treatments: medical treatments, voice therapy and surgical treatments. When necessary, certain voice disorders use a combination of treatment approaches. A medical treatment involves the use of botulinum toxin (botox) or anti-reflux medicines, for example. Botox is a key
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Voice disorders can be divided into two broad categories: organic and functional. The distinction between these broad classes stems from their cause, whereby organic dysphonia results from some sort of physiological change in one of the subsystems of speech (for voice, usually respiration, laryngeal
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Auditory-perceptual measures are the most commonly used tool by clinicians to evaluate the voice quality due to its quick and non-invasive nature. Additionally, these measures have been proven to be reliable in a clinical setting. Ratings are used to evaluate the quality of a patient's voice for a
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Dysphonia is a broad clinical term which refers to abnormal functioning of the voice. More specifically, a voice can be classified as "dysphonic" when there are abnormalities or impairments in one or more of the following parameters of voice: pitch, loudness, quality, and variability. For example,
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It has been suggested that certain occupational groups may be at increased risk of developing dysphonia due to the excessive or intense vocal demands of their work. Research on this topic has primarily focused on teachers and singers, although some studies have examined other groups of heavy voice
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users (e.g. actors, cheerleaders, aerobic instructors, etc.). At present, it is known that teachers and singers are likely to report dysphonia. Moreover, physical education teachers, teachers in noisy environments, and those who habitually use a loud speaking voice are at increased risk. The term
70:, is when the voice involuntarily sounds breathy, raspy, or strained, or is softer in volume or lower in pitch. A hoarse voice can be associated with a feeling of unease or scratchiness in the throat. Hoarseness is often a symptom of problems in the vocal folds of the larynx. It may be caused by
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of dysphonia in adults under the age of 65 is 6.6%. Dysphonia is more common in adult females than males, possibly due to sex-related anatomical differences of the vocal mechanism. In childhood, however, dysphonia is more often found in boys than girls. As there are no anatomical differences in
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to vibrate normally during exhalation, which affects the voice. The assessment and diagnosis of dysphonia is done by a multidisciplinary team, and involves the use of a variety of subjective and objective measures, which look at both the quality of the voice as well as the physical state of the
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The assessment and diagnosis of a dysphonic voice is completed by a multidisciplinary team, such as an otolaryngologist (ear, nose and throat doctor) and Speech-Language
Pathologist, involving the use of both objective and subjective measures to evaluate the quality of the voice as well as the
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release at the thyro-arytenoid muscle. Although the use of botulinum toxin injections is considered relatively safe, patients' responses to treatment differ in the initial stages; some have reported experiencing swallowing problems and breathy voice quality as a side-effect to the injections.
151:(MTD) has been found to be a result of many different causes including the following: MTD in the presence of an organic pathology (i.e. organic type), MTD stemming from vocal use (i.e. functional type), and MTD as a result of personality and/or psychological factors (i.e. psychogenic type).
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was previously used for painful dysphonia associated with public speaking, particularly among preachers. However, the exact prevalence rates for occupational voice users are unclear, as individual studies have varied widely in the methodologies used to obtain data (e.g. employing different
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for more than a few days. For voice to be classified as "dysphonic", abnormalities must be present in one or more vocal parameters: pitch, loudness, quality, or variability. Perceptually, dysphonia can be characterised by hoarse, breathy, harsh, or rough vocal qualities, but some kind of
418:. At the level of the larynx, the exhaled air causes the vocal folds to move toward the midline of the tract (a process called adduction). The adducted vocal folds do not close completely but instead remain partially open. The narrow opening between the folds is referred to as the
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larynges of boys and girls prior to puberty, it has been proposed that the higher rate of voice impairment found in boys arises from louder social activities, personality factors, or more frequent inappropriate vocal use. The most common laryngeal diagnosis among children is
116:
Dysphonia can be categorized into two broad main types: organic and functional, and classification is based on the underlying pathology. While the causes of dysphonia can be divided into five basic categories, all of them result in an interruption of the ability of the
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Direct therapies address the physical aspects of vocal production. Techniques work to either modify vocal fold contact, manage breathing patterns, and/or change the tension at level of the larynx. Notable techniques include, but are not limited to, the
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Johns MM, Sataloff RT, Merati AL, Rosen CA (August 2010). "Shortfalls of the
American Academy of Otolaryngology-Head and Neck Surgery's Clinical practice guideline: Hoarseness (Dysphonia)".
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anatomy, and/or other parts of the vocal tract are affected). Conversely, functional dysphonia refers to hoarseness resulting from vocal use (i.e. overuse/abuse). Furthermore, according to
509:, jitter, shimmer, and noise-to-harmonic ratios. However, due to limitations imposed by the algorithms employed, these measures cannot be used with patients who exhibit severe dysphonia.
139:, organic dysphonia can be subdivided into structural and neurogenic; neurogenic dysphonia is defined as impaired functioning of the vocal structure due to a neurological problem (in the
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Dr Pragya Semwal, Dr Shobit Garg
Chronic Dissociation Presenting as Dysphonia Plica Ventricularis: An Atypical Presentation. Int. j. med. case reports Vol 6 Issue 3 Jul-Sep 2020 1-3.
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method (an approach used where the mechanisms functioning during the use of the vocal folds, such as phonation or respiration, are the main focus) may be used to treat dysphonia.
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Stachler RJ, Francis DO, Schwartz SR, Damask CC, Digoy GP, Krouse HJ, McCoy SJ, Ouellette DR, Patel RR, Reavis CC, Smith LJ, Smith M, Strode SW, Woo P, Nnacheta LC (March 2018).
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to provide an image of the vocal fold motion; the image is created by averaging over several vibratory cycles and is thus not provided in real-time. As this technique relies on
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de AraĂşjo
Pernambuco L, Espelt A, Balata PM, de Lima KC (October 2015). "Prevalence of voice disorders in the elderly: a systematic review of population-based studies".
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2004:"Treatment efficacy of electromyography versus fiberscopy-guided botulinum toxin injection in adductor spasmodic dysphonia patients: a prospective comparative study"
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A variety of different causes, which result in abnormal vibrations of the vocal folds, can cause dysphonia. These causes can range from vocal abuse and misuse to
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It appears to occur more commonly in females and the elderly. Furthermore, certain occupational groups, such as teachers and singers, are at an increased risk.
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Surgeries involve myoectomies of the laryngeal muscles to reduce voice breaks, and laryngoplasties, in which laryngeal cartilage is altered to reduce tension.
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of hoarse voice complaints among primary care patients is 30%. Since hoarseness is a general symptom, it is associated with a number of laryngeal diagnoses.
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Mansuri B, Tohidast SA, Soltaninejad N, Kamali M, Ghelichi L, Azimi H (September 2018). "Nonmedical
Treatments of Vocal Fold Nodules: A Systematic Review".
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Ruotsalainen J, Sellman J, Lehto L, Verbeek J (May 2008). "Systematic review of the treatment of functional dysphonia and prevention of voice disorders".
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227:. Causes of dysphonia can be divided into five basic categories, although overlap may occur between categories. (Note that this list is not exhaustive):
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Cantor Cutiva LC, Vogel I, Burdorf A (March 2013). "Voice disorders in teachers and their associations with work-related factors: a systematic review".
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is the primary clinical tool used for this purpose. Laryngeal stroboscopy uses a synchronized flashing light passed through either a rigid or flexible
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Technical: Associated with poor muscle functioning or psychological stresses, with no corresponding physiological abnormalities of the larynx.
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Cohen SM, Kim J, Roy N, Asche C, Courey M (February 2012). "Prevalence and causes of dysphonia in a large treatment-seeking population".
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A combination of both an indirect treatment method (an approach used to change external factors affecting the vocal folds) and a direct
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Pestana PM, Vaz-Freitas S, Manso MC (November 2017). "Prevalence of Voice
Disorders in Singers: Systematic Review and Meta-Analysis".
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vocal fold vibration, it cannot be used in patients with moderate to severe dysphonia. High speed digital imaging of the vocal folds (
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should be assessed by a medical doctor. It is also recommended to see a doctor if hoarseness is associated with coughing up blood,
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Duffy JR, Yorkston KM (2003). "Medical interventions for
Spasmodic Dysphonia and some related conditions: A systematic review".
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Boutsen F, Cannito MP, Taylor M, Bender B (June 2002). "Botox treatment in adductor spasmodic dysphonia: a meta-analysis".
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Nacci A, Romeo SO, Berrettini S, Matteucci J, Cavaliere MD, Mancini V, Panicucci E, Ursino F, Fattori B (August 2017).
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410:(also known as the voice box), a structure made up of several supporting cartilages and ligaments, which houses the
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used in obtaining information from participants. The most common laryngeal diagnoses among the elderly are polyps,
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Long-term hoarseness, or hoarseness that persists over three weeks, especially when not associated with a cold or
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techniques. Guideline elaborated by the Committee on Phoniatrics of the European Laryngological Society (ELS)".
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Vocal fold imaging techniques are used by clinicians to examine the vocal folds and allows them to detect vocal
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Medical and surgical treatments have been recommended to treat organic dysphonias. An effective treatment for
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Chow YW, Pietranico R, Mukerji A (October 1975). "Studies of oxygen binding energy to hemoglobin molecule".
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Ulis JM, Yanagisawa E (June 2009). "What's new in differential diagnosis and treatment of hoarseness?".
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Morris R, Bernard Harmon A (2010). "Describing Voice Disorders". In Damico J, Muller N, Ball MJ (eds.).
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212:(acute 42.1%; chronic 9.7%) and functional dysphonia (30%). Hoarseness can also be caused by laryngeal
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2090:"Stabilometric findings in patients affected by organic dysphonia before and after phonomicrosurgery"
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Morrison MD, Rammage LA (May 1993). "Muscle misuse voice disorders: description and classification".
603:(hoarseness resulting from periodic breaks in phonation due to hyperadduction of the vocal folds) is
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1965:"The Acoustic Voice Quality Index: toward improved treatment outcomes assessment in voice disorders"
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voice quality of hoarseness. It is the reason for 1% of all visits to primary care providers. The
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Acoustic measures can be used to provide objective measures of vocal function. Signal processing
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414:. In normal voice production, exhaled air moves out of the lungs and passes upward through the
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Dysphonia is a general term for voice impairment that is sometimes used synonymously with the
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216:(benign 10.7 - 31%; malignant 2.2 - 3.0%). Causes that are overall less common include
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Understanding voice problems: A physiological perspective for diagnosis and treatment
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Harries M (2013). "Hoarseness and Voice Disorders". In Ludman HS, Bradley PJ (eds.).
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Trauma (Iatrogenic: surgery, intubation) - (Accidental: blunt, penetrating, thermal)
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There is an interplay of sex and age differences associated with dysphonia. The
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Verdolini K, Ramig LO (2001). "Review: occupational risks for voice problems".
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Behlau M, Oliveira G (June 2009). "Vocal hygiene for the voice professional".
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Ruotsalainen JH, Sellman J, Lehto L, Jauhiainen M, Verbeek JH (October 2007).
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conditions (2.8 - 8.0%), psychogenic conditions (2.0 - 2.2%), and aging (2%).
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832:"Occupational groups at risk for voice disorders: A review of the literature"
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Pylypowich A, Duff E (2016). "Differentiating the Symptom of Dysphonia".
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Breathiness may last for a longer period of time for males than females.
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Neoplasm (Premalignant: dysplasia) - (Malignant: Squamous cell carcinoma)
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1550:. Baltimore, MB: Lippincott Williams & Wilkins. pp. 372–385.
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Feierabend RH, Shahram MN (August 2009). "Hoarseness in adults".
266:: Changes in the vocal fold tissue as a result of inflammation.
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and assess the quality of the vocal fold vibrations. Laryngeal
1413:"Clinical Practice Guideline: Hoarseness (Dysphonia) (Update)"
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Current Opinion in Otolaryngology & Head and Neck Surgery
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Current Opinion in Otolaryngology & Head and Neck Surgery
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Current Opinion in Otolaryngology & Head and Neck Surgery
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Current Opinion in Otolaryngology & Head and Neck Surgery
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Current Opinion in Otolaryngology & Head and Neck Surgery
19:"Hoarse" redirects here. For the album by 16 Horsepower, see
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Neuromuscular: Disturbances in any of the components of the
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Laryngitis (Acute: viral, bacterial) - (Chronic: smoking,
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Hicks DM (June 1999). "The efficacy of voice treatment".
1881:"Interventions for preventing voice disorders in adults"
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Reiter R, Hoffmann TK, Pickhard A, Brosch S (May 2015).
235:/structural: Abnormal growths of the vocal fold tissue.
100:, a lump in the neck, pain when speaking or swallowing,
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are applied to voice recordings made during sustained
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Encyclopedia of otolaryngology, head and neck surgery
1627:"Clinical practice guideline: hoarseness (dysphonia)"
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Biochemical and Biophysical Research Communications
1123:Van Houtte E, Van Lierde K, Claeys S (March 2011).
406:Located in the anterior portion of the neck is the
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2140:. Kountakis, Stilianos E. Berlin: Springer. 2013.
1771:Archives of Otolaryngology–Head & Neck Surgery
1546:Colton, R. H., Casper, J. K., Leonard, R. (2011).
663:, and neurologic conditions affecting the larynx.
2340:Journal of Speech, Language, and Hearing Research
1809:Little MA, McSharry PE, Roberts SJ, Costello DA,
333:which have manifestations that affect the voice.
2621:ASHA: Clinical Topics - Voice Disorders Overview
1282:. West Sussex, UK: Wiley-Blackwell. p. 95.
1312:. Chichester, U.K.: Wiley-Blackwell. pp.
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8:
2191:American Speech-Language-Hearing Association
1560:: CS1 maint: multiple names: authors list (
1095:Journal of Medical Speech-Language Pathology
1073:American Speech-Language Hearing Association
1885:The Cochrane Database of Systematic Reviews
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2930:Reproductive endocrinology and infertility
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2648:
2634:
2626:
2514:
2428:Maia AA, Gama AC, KĂĽmmer AM (April 2014).
2382:European Archives of Oto-Rhino-Laryngology
1724:European Archives of Oto-Rhino-Laryngology
825:
823:
821:
659:, vocal fold mass, glottic insufficiency,
28:
3271:Bachelor of Medicine, Bachelor of Surgery
2445:
2113:
2029:
2019:
2002:Kim JW, Park JH, Park KN, Lee SW (2014).
1904:
1850:
1840:
1830:
1782:
1694:
1642:
1600:
1541:
1539:
1537:
1535:
1533:
1428:
1308:Handbook of language and speech disorders
1200:
983:
931:
929:
927:
925:
923:
921:
919:
917:
915:
913:
847:
361:Psychogenic such as dissociation disorder
208:The most common causes of hoarseness is
176:Endocrine (Hypothyroidism, hypogonadism)
777:
775:
672:
2423:
2421:
2419:
2375:
2373:
2371:
2369:
2285:
2283:
2281:
2279:
2208:
2206:
2161:
1963:Maryn Y, De Bodt M, Roy N (May 2010).
1553:
1450:
1448:
1406:
1404:
1402:
1400:
1398:
1396:
1394:
1358:
1356:
1354:
1352:
1170:
1168:
1166:
1164:
1162:
1160:
1158:
1118:
1116:
1114:
1112:
1110:
1108:
607:injection. The toxin acts by blocking
520:measures of voice include measures of
2333:
2331:
2329:
2181:
2179:
1874:
1872:
1870:
1804:
1802:
1716:
1714:
1672:
1670:
1299:
1297:
1295:
1293:
1291:
1289:
1063:
1061:
1059:
1057:
1021:
1019:
1017:
1015:
1013:
1011:
1009:
1007:
1005:
1003:
706:
704:
702:
700:
698:
696:
694:
692:
690:
7:
3465:Symptoms and signs: Speech and voice
3409:
3170:Physical medicine and rehabilitation
1631:Otolaryngology–Head and Neck Surgery
1417:Otolaryngology–Head and Neck Surgery
1028:Otolaryngology–Head and Neck Surgery
953:
951:
949:
947:
738:Otolaryngology–Head and Neck Surgery
182:Iatrogenic (inhaled corticosteroids)
74:, which in turn may be caused by an
3419:
1253:The Journal for Nurse Practitioners
3306:Medical Scientist Training Program
2094:Acta Otorhinolaryngologica Italica
1969:Journal of Communication Disorders
1575:Mehta DD, Hillman RE (June 2008).
1365:Journal of Communication Disorders
1181:Deutsches Ă„rzteblatt International
1177:"Hoarseness-causes and treatments"
14:
940:. New York: Thieme. pp. 1–5.
876:Logopedics, Phoniatrics, Vocology
299:that control laryngeal function.
3438:
3428:
3418:
3408:
3399:
3398:
2227:10.1097/00020840-199906000-00005
1683:Folia Phoniatrica et Logopaedica
3439:
744:(2): 175–7, discussion 175–80.
3296:Doctor of Osteopathic Medicine
2730:Oral and maxillofacial surgery
1897:10.1002/14651858.cd006372.pub2
329:Associated Systemic Diseases:
1:
1981:10.1016/j.jcomdis.2009.12.004
1819:BioMedical Engineering OnLine
1490:Broadwater, Kimberly (2021).
1377:10.1016/j.jcomdis.2013.01.001
936:Aronson AE, Bless DM (2009).
580:Lee Silverman Voice Treatment
3276:Bachelor of Medical Sciences
3043:Neurosurgical anesthesiology
2483:10.1016/j.jvoice.2017.08.023
2304:10.1097/moo.0b013e32832af105
2254:10.1097/moo.0b013e32832a2230
2187:"Voice Disorders: Treatment"
2067:10.1016/0006-291x(75)90518-5
1644:10.1016/j.otohns.2009.06.744
1593:10.1097/moo.0b013e3282fe96ce
1469:10.1016/j.jvoice.2017.02.010
1280:ABC of ear, nose, and throat
1265:10.1016/j.nurpra.2016.04.025
1141:10.1016/j.jvoice.2009.10.009
1040:10.1016/j.otohns.2008.01.014
976:10.1097/moo.0b013e32832aef6f
750:10.1016/j.otohns.2010.05.026
651:, muscle tension dysphonia,
452:Auditory-perceptual measures
431:condition of the vocal fold
179:Haematological (Amyloidosis)
2447:10.1590/2317-1782/2014408IN
2352:10.1044/1092-4388(2002/037)
76:upper respiratory infection
3501:
1069:"Voice Disorders Overview"
18:
3394:
2394:10.1007/s00405-014-3252-7
2008:TheScientificWorldJournal
1942:10.3109/00016489309135839
1765:Kendall KA (March 2009).
1492:"Clergyman's Sore Throat"
1226:American Family Physician
1193:10.3238/arztebl.2015.0329
145:peripheral nervous system
3230:Transplantation medicine
3121:Clinical neurophysiology
3038:Obstetric anesthesiology
2958:Interventional radiology
2718:Digestive system surgery
1784:10.1001/archoto.2008.557
1430:10.1177/0194599817751030
938:Clinical voice disorders
830:Williams, N. R. (2003).
649:laryngopharyngeal reflux
149:Muscle Tension Dysphonia
3101:Intensive care medicine
3075:Mass gathering medicine
2920:Maternal–fetal medicine
2106:10.14639/0392-100x-1035
958:Ludlow CL (June 2009).
396:operational definitions
98:difficulties swallowing
2693:Cardiothoracic surgery
2168:: CS1 maint: others (
1930:Acta Oto-Laryngologica
1842:10.1186/1475-925X-6-23
888:10.1080/14015430119969
595:Medication and surgery
572:laryngeal manipulation
141:central nervous system
106:complete loss of voice
3344:Personalized medicine
3203:Reproductive medicine
3128:Occupational medicine
3082:Evolutionary medicine
2616:ASHA: Voice Disorders
1736:10.1007/s004050000299
1637:(3 Suppl 2): S1–S31.
1338:http://www.ijomcr.net
849:10.1093/occmed/kqg113
836:Occupational Medicine
503:fundamental frequency
187:Functional dysphonia
40:Hoarseness, dysphonia
3364:Traditional medicine
3324:Alternative medicine
3191:Addiction psychiatry
3005:Transfusion medicine
3000:Medical microbiology
2915:Gynecologic oncology
2767:Reproductive surgery
513:Aerodynamic measures
391:dysphonia clericorum
102:difficulty breathing
3480:Otorhinolaryngology
3386:History of medicine
3369:Veterinary medicine
3176:Preventive medicine
3028:Adolescent medicine
2870:Infectious diseases
2021:10.1155/2014/327928
1423:(1_suppl): S1–S42.
601:spasmodic dysphonia
318:Spasmodic Dysphonia
313:Parkinson's disease
3334:Molecular oncology
3291:Doctor of Medicine
3281:Master of Medicine
3198:Radiation oncology
3070:Emergency medicine
3023:Addiction medicine
2990:Clinical chemistry
2985:Clinical pathology
2777:Transplant surgery
2735:Orthopedic surgery
2713:Colorectal surgery
2588:External resources
1496:Journal of Singing
1343:2021-02-07 at the
796:10.1002/lary.22426
653:vocal fold paresis
641:vocal fold nodules
586:Indirect therapies
461:Vocal fold imaging
386:clergyman's throat
303:Multiple Sclerosis
156:Organic dysphonia
3452:
3451:
3286:Master of Surgery
3250:
3249:
3235:Tropical medicine
3181:Prison healthcare
3096:Hospital medicine
3060:Disaster medicine
3050:Aviation medicine
2865:Hospital medicine
2772:Surgical oncology
2757:Pediatric surgery
2751:
2698:Endocrine surgery
2611:
2610:
1696:10.1159/000200768
1508:10.53830/CNLB1302
661:malignant lesions
489:Acoustic measures
331:Systemic diseases
308:Myasthenia Gravis
225:systemic diseases
56:
55:
26:Medical condition
3492:
3475:Larynx disorders
3442:
3441:
3432:
3422:
3421:
3412:
3411:
3402:
3401:
3106:Medical genetics
3091:General practice
2968:Nuclear medicine
2843:Gastroenterology
2799:Vascular surgery
2749:
2676:
2650:
2643:
2636:
2627:
2515:
2503:
2502:
2471:Journal of Voice
2466:
2460:
2459:
2449:
2425:
2414:
2413:
2377:
2364:
2363:
2335:
2324:
2323:
2287:
2274:
2273:
2237:
2231:
2230:
2210:
2201:
2200:
2198:
2197:
2183:
2174:
2173:
2167:
2159:
2134:
2128:
2127:
2117:
2085:
2079:
2078:
2050:
2044:
2043:
2033:
2023:
1999:
1993:
1992:
1960:
1954:
1953:
1925:
1919:
1918:
1908:
1876:
1865:
1864:
1854:
1844:
1834:
1806:
1797:
1796:
1786:
1762:
1756:
1755:
1718:
1709:
1708:
1698:
1677:Oates J (2009).
1674:
1665:
1664:
1646:
1621:
1615:
1614:
1604:
1572:
1566:
1565:
1559:
1551:
1543:
1528:
1527:
1487:
1481:
1480:
1457:Journal of Voice
1452:
1443:
1442:
1432:
1408:
1389:
1388:
1360:
1347:
1334:
1328:
1327:
1311:
1301:
1284:
1283:
1275:
1269:
1268:
1248:
1242:
1241:
1221:
1215:
1214:
1204:
1172:
1153:
1152:
1129:Journal of Voice
1120:
1103:
1102:
1090:
1084:
1083:
1081:
1079:
1065:
1052:
1051:
1023:
998:
997:
987:
955:
942:
941:
933:
908:
907:
871:
862:
861:
851:
827:
816:
815:
784:The Laryngoscope
779:
770:
769:
733:
727:
726:
724:
723:
708:
685:
684:
677:
636:point prevalence
564:yawn-sigh method
557:Direct therapies
62:, also known as
29:
3500:
3499:
3495:
3494:
3493:
3491:
3490:
3489:
3455:
3454:
3453:
3448:
3390:
3379:Chief physician
3312:
3257:
3246:
3240:Travel medicine
3225:Sports medicine
3208:Sexual medicine
3148:Palliative care
3143:Pain management
3087:Family medicine
3065:Diving medicine
3011:
2939:
2901:
2894:
2810:
2803:
2762:Plastic surgery
2708:General surgery
2688:Cardiac surgery
2669:
2667:
2659:
2654:
2612:
2607:
2606:
2583:
2582:
2526:
2512:
2507:
2506:
2468:
2467:
2463:
2427:
2426:
2417:
2379:
2378:
2367:
2337:
2336:
2327:
2289:
2288:
2277:
2239:
2238:
2234:
2212:
2211:
2204:
2195:
2193:
2185:
2184:
2177:
2160:
2148:
2136:
2135:
2131:
2087:
2086:
2082:
2052:
2051:
2047:
2001:
2000:
1996:
1962:
1961:
1957:
1927:
1926:
1922:
1891:(4): CD006372.
1878:
1877:
1868:
1808:
1807:
1800:
1764:
1763:
1759:
1720:
1719:
1712:
1676:
1675:
1668:
1623:
1622:
1618:
1574:
1573:
1569:
1552:
1545:
1544:
1531:
1489:
1488:
1484:
1454:
1453:
1446:
1410:
1409:
1392:
1362:
1361:
1350:
1345:Wayback Machine
1335:
1331:
1324:
1303:
1302:
1287:
1277:
1276:
1272:
1250:
1249:
1245:
1223:
1222:
1218:
1174:
1173:
1156:
1122:
1121:
1106:
1092:
1091:
1087:
1077:
1075:
1067:
1066:
1055:
1025:
1024:
1001:
957:
956:
945:
935:
934:
911:
873:
872:
865:
829:
828:
819:
781:
780:
773:
735:
734:
730:
721:
719:
710:
709:
688:
679:
678:
674:
669:
621:
605:botulinum toxin
597:
588:
574:, humming, the
559:
539:
530:
515:
491:
483:videokymography
463:
454:
445:
428:
404:
398:for "singer").
380:
375:
206:
201:
132:
27:
24:
17:
12:
11:
5:
3498:
3496:
3488:
3487:
3482:
3477:
3472:
3467:
3457:
3456:
3450:
3449:
3447:
3446:
3436:
3426:
3416:
3406:
3395:
3392:
3391:
3389:
3388:
3383:
3382:
3381:
3371:
3366:
3361:
3356:
3351:
3346:
3341:
3336:
3331:
3326:
3320:
3318:
3317:Related topics
3314:
3313:
3311:
3310:
3309:
3308:
3298:
3293:
3288:
3283:
3278:
3273:
3268:
3266:Medical school
3262:
3260:
3252:
3251:
3248:
3247:
3245:
3244:
3243:
3242:
3232:
3227:
3222:
3220:Sleep medicine
3217:
3216:
3215:
3205:
3200:
3195:
3194:
3193:
3183:
3178:
3173:
3167:
3162:
3161:
3160:
3150:
3145:
3140:
3135:
3130:
3125:
3124:
3123:
3113:
3108:
3103:
3098:
3093:
3084:
3079:
3078:
3077:
3067:
3062:
3057:
3052:
3047:
3046:
3045:
3040:
3033:Anesthesiology
3030:
3025:
3019:
3017:
3013:
3012:
3010:
3009:
3008:
3007:
3002:
2997:
2992:
2987:
2982:
2972:
2971:
2970:
2965:
2963:Neuroradiology
2960:
2949:
2947:
2941:
2940:
2938:
2937:
2932:
2927:
2922:
2917:
2912:
2906:
2904:
2900:Obstetrics and
2896:
2895:
2893:
2892:
2887:
2882:
2877:
2872:
2867:
2862:
2857:
2852:
2851:
2850:
2840:
2835:
2830:
2825:
2815:
2813:
2805:
2804:
2802:
2801:
2796:
2795:
2794:
2784:
2782:Trauma surgery
2779:
2774:
2769:
2764:
2759:
2754:
2753:
2752:
2745:Otolaryngology
2742:
2737:
2732:
2727:
2722:
2721:
2720:
2715:
2705:
2700:
2695:
2690:
2684:
2682:
2673:
2671:subspecialties
2661:
2660:
2655:
2653:
2652:
2645:
2638:
2630:
2624:
2623:
2618:
2609:
2608:
2605:
2604:
2592:
2591:
2589:
2585:
2584:
2581:
2580:
2569:
2558:
2543:
2527:
2522:
2521:
2519:
2518:Classification
2511:
2510:External links
2508:
2505:
2504:
2477:(5): 609–620.
2461:
2415:
2388:(10): 2601–9.
2365:
2325:
2275:
2232:
2202:
2175:
2146:
2129:
2100:(4): 286–294.
2080:
2061:(4): 1424–31.
2045:
1994:
1955:
1920:
1866:
1798:
1757:
1710:
1666:
1616:
1567:
1529:
1502:(1): 113–117.
1482:
1463:(6): 722–727.
1444:
1390:
1348:
1329:
1322:
1285:
1270:
1259:(7): 459–466.
1243:
1216:
1187:(19): 329–37.
1154:
1104:
1085:
1053:
999:
943:
909:
863:
842:(7): 456–460.
817:
771:
728:
686:
671:
670:
668:
665:
620:
617:
596:
593:
587:
584:
558:
555:
538:
535:
529:
526:
514:
511:
490:
487:
462:
459:
453:
450:
444:
441:
427:
424:
403:
400:
379:
376:
374:
373:
372:
371:
368:
365:
364:Excess demands
362:
356:
355:
354:
349:
347:Hypothyroidism
344:
339:
327:
326:
325:
320:
315:
310:
305:
297:nervous system
293:
292:
291:
288:
285:
282:
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272:
261:
260:
259:
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241:
229:
205:
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191:
185:
184:
183:
180:
177:
174:
171:
168:
153:
131:
128:
54:
53:
51:Otolaryngology
48:
42:
41:
38:
34:
33:
25:
21:Hoarse (album)
16:Voice disorder
15:
13:
10:
9:
6:
4:
3:
2:
3497:
3486:
3483:
3481:
3478:
3476:
3473:
3471:
3468:
3466:
3463:
3462:
3460:
3445:
3437:
3435:
3431:
3427:
3425:
3417:
3415:
3407:
3405:
3397:
3396:
3393:
3387:
3384:
3380:
3377:
3376:
3375:
3372:
3370:
3367:
3365:
3362:
3360:
3357:
3355:
3352:
3350:
3349:Public health
3347:
3345:
3342:
3340:
3337:
3335:
3332:
3330:
3329:Allied health
3327:
3325:
3322:
3321:
3319:
3315:
3307:
3304:
3303:
3302:
3299:
3297:
3294:
3292:
3289:
3287:
3284:
3282:
3279:
3277:
3274:
3272:
3269:
3267:
3264:
3263:
3261:
3259:
3253:
3241:
3238:
3237:
3236:
3233:
3231:
3228:
3226:
3223:
3221:
3218:
3214:
3211:
3210:
3209:
3206:
3204:
3201:
3199:
3196:
3192:
3189:
3188:
3187:
3184:
3182:
3179:
3177:
3174:
3171:
3168:
3166:
3163:
3159:
3156:
3155:
3154:
3151:
3149:
3146:
3144:
3141:
3139:
3138:Oral medicine
3136:
3134:
3133:Ophthalmology
3131:
3129:
3126:
3122:
3119:
3118:
3117:
3114:
3112:
3109:
3107:
3104:
3102:
3099:
3097:
3094:
3092:
3088:
3085:
3083:
3080:
3076:
3073:
3072:
3071:
3068:
3066:
3063:
3061:
3058:
3056:
3053:
3051:
3048:
3044:
3041:
3039:
3036:
3035:
3034:
3031:
3029:
3026:
3024:
3021:
3020:
3018:
3014:
3006:
3003:
3001:
2998:
2996:
2995:Cytopathology
2993:
2991:
2988:
2986:
2983:
2981:
2978:
2977:
2976:
2973:
2969:
2966:
2964:
2961:
2959:
2956:
2955:
2954:
2951:
2950:
2948:
2946:
2942:
2936:
2935:Urogynecology
2933:
2931:
2928:
2926:
2923:
2921:
2918:
2916:
2913:
2911:
2908:
2907:
2905:
2903:
2897:
2891:
2888:
2886:
2883:
2881:
2878:
2876:
2873:
2871:
2868:
2866:
2863:
2861:
2858:
2856:
2853:
2849:
2846:
2845:
2844:
2841:
2839:
2838:Endocrinology
2836:
2834:
2831:
2829:
2826:
2824:
2820:
2817:
2816:
2814:
2812:
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2488:
2484:
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2476:
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2465:
2462:
2457:
2453:
2448:
2443:
2440:(2): 159–63.
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2435:
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2346:(3): 469–81.
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2298:(3): 149–54.
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2147:9783642234996
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2032:
2027:
2022:
2017:
2013:
2009:
2005:
1998:
1995:
1990:
1986:
1982:
1978:
1975:(3): 161–74.
1974:
1970:
1966:
1959:
1956:
1951:
1947:
1943:
1939:
1936:(3): 428–34.
1935:
1931:
1924:
1921:
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1912:
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1890:
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1816:
1813:(June 2007).
1812:
1805:
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1799:
1794:
1790:
1785:
1780:
1777:(3): 274–81.
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1745:
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1403:
1401:
1399:
1397:
1395:
1391:
1386:
1382:
1378:
1374:
1371:(2): 143–55.
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1366:
1359:
1357:
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1353:
1349:
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1333:
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1325:
1323:9781405158626
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1281:
1274:
1271:
1266:
1262:
1258:
1254:
1247:
1244:
1239:
1235:
1232:(4): 363–70.
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1227:
1220:
1217:
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1208:
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1198:
1194:
1190:
1186:
1182:
1178:
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1054:
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1034:(5): 557–65.
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629:lifetime risk
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618:
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609:acetylcholine
606:
602:
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576:accent method
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569:
568:optimal pitch
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22:
3354:Rural health
3339:Nanomedicine
2890:Rheumatology
2821: /
2740:Hand surgery
2725:Neurosurgery
2602:Hoarse voice
2595:
2571:
2560:
2545:
2530:
2474:
2470:
2464:
2437:
2433:
2385:
2381:
2343:
2339:
2295:
2291:
2245:
2241:
2235:
2218:
2214:
2194:. Retrieved
2190:
2137:
2132:
2097:
2093:
2083:
2058:
2054:
2048:
2011:
2007:
1997:
1972:
1968:
1958:
1933:
1929:
1923:
1888:
1884:
1822:
1818:
1774:
1770:
1760:
1730:(2): 77–82.
1727:
1723:
1689:(1): 49–56.
1686:
1682:
1634:
1630:
1619:
1587:(3): 211–5.
1584:
1580:
1570:
1547:
1499:
1495:
1485:
1460:
1456:
1420:
1416:
1368:
1364:
1332:
1307:
1279:
1273:
1256:
1252:
1246:
1229:
1225:
1219:
1184:
1180:
1135:(2): 202–7.
1132:
1128:
1098:
1094:
1088:
1076:. Retrieved
1072:
1031:
1027:
970:(3): 160–5.
967:
963:
937:
882:(1): 37–46.
879:
875:
839:
835:
790:(2): 343–8.
787:
783:
741:
737:
731:
720:. Retrieved
718:. 2015-08-18
715:
712:"Hoarseness"
681:"Hoarseness"
675:
633:
622:
619:Epidemiology
614:
598:
589:
560:
548:
544:
540:
531:
516:
492:
475:laryngoscope
464:
455:
446:
429:
405:
390:
384:
381:
370:Vocal strain
323:Nerve injury
264:Inflammatory
222:
207:
193:Vocal misuse
133:
115:
91:
88:
67:
63:
60:hoarse voice
59:
57:
32:Hoarse voice
3485:Laryngology
3470:Human voice
3424:Wikiproject
3213:Venereology
3158:Neonatology
3055:Dermatology
2910:Gynaecology
2902:gynaecology
2885:Pulmonology
2703:Eye surgery
2665:Specialties
645:methodology
518:Aerodynamic
471:stroboscopy
416:vocal tract
412:vocal folds
352:Sarcoidosis
342:Amyloidosis
290:Voice abuse
190:Psychogenic
119:vocal folds
37:Other names
3459:Categories
3186:Psychiatry
3172:(PM&R)
3165:Phlebology
3153:Pediatrics
2980:Anatomical
2945:Diagnostic
2925:Obstetrics
2875:Nephrology
2860:Hematology
2855:Geriatrics
2848:Hepatology
2833:Cardiology
2823:Immunology
2597:Patient UK
2573:DiseasesDB
2221:(3): 125.
2196:2018-10-03
2014:: 327928.
1078:October 2,
722:2017-07-24
667:References
625:perceptual
578:, and the
528:Prevention
522:air volume
495:algorithms
443:Definition
439:patterns.
378:Employment
337:Acromegaly
275:Infections
233:Neoplastic
218:neurogenic
210:laryngitis
196:Idiopathic
72:laryngitis
68:hoarseness
3374:Physician
3258:education
3116:Neurology
3111:Narcology
2975:Pathology
2953:Radiology
2828:Angiology
2792:Andrology
2164:cite book
2156:837855971
1832:0707.0086
1556:cite book
1524:239663449
1516:2769-4046
657:paralysis
551:treatment
537:Treatment
507:amplitude
505:, signal
499:phonation
467:pathology
437:vibration
426:Diagnosis
402:Mechanism
257:Carcinoma
239:Dysplasia
113:remains.
111:phonation
84:allergies
64:dysphonia
46:Specialty
3404:Category
2880:Oncology
2811:medicine
2809:Internal
2657:Medicine
2499:37755681
2491:29032130
2456:24918510
2410:24668793
2402:25149291
2360:12069000
2320:38511217
2312:19342952
2270:26072006
2262:19469052
2124:28872158
2040:25383369
1989:20080243
1915:17943906
1861:17594480
1811:Moroz IM
1793:19289706
1744:11307610
1705:19204393
1661:14655786
1653:19729111
1611:18475073
1477:28342677
1439:29494321
1385:23415241
1341:Archived
1238:19678604
1211:26043420
1149:20400263
1048:18439458
994:19337127
896:11432413
858:14581643
812:31457683
804:22271658
766:22553812
758:20647114
479:periodic
3444:Outline
3414:Commons
3359:Therapy
3256:Medical
2819:Allergy
2787:Urology
2680:Surgery
2567:D055154
2115:5584100
2031:4213399
1950:8517149
1906:8923518
1852:1913514
1752:3795132
1625:2009).
1602:3775647
1202:4458789
985:2763389
904:7436065
420:glottis
284:Smoking
270:Allergy
252:Nodules
214:tumours
3434:Portal
3301:MD–PhD
2556:784.42
2497:
2489:
2454:
2408:
2400:
2358:
2318:
2310:
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1948:
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756:
433:tissue
408:larynx
367:Stress
287:Trauma
280:Reflux
248:Polyps
204:Causes
124:larynx
3016:Other
2578:28364
2541:R49.0
2495:S2CID
2434:CoDAS
2406:S2CID
2316:S2CID
2266:S2CID
1827:arXiv
1748:S2CID
1657:S2CID
1520:S2CID
900:S2CID
808:S2CID
762:S2CID
716:NIDCD
244:Cysts
130:Types
104:, or
82:, or
2562:MeSH
2551:9-CM
2487:PMID
2452:PMID
2398:PMID
2356:PMID
2308:PMID
2258:PMID
2170:link
2152:OCLC
2142:ISBN
2120:PMID
2071:PMID
2036:PMID
2012:2014
1985:PMID
1946:PMID
1911:PMID
1857:PMID
1789:PMID
1740:PMID
1701:PMID
1649:PMID
1607:PMID
1562:link
1512:ISSN
1473:PMID
1435:PMID
1381:PMID
1318:ISBN
1234:PMID
1207:PMID
1145:PMID
1080:2016
1044:PMID
990:PMID
892:PMID
854:PMID
800:PMID
754:PMID
435:and
161:GERD
137:ASHA
80:cold
78:, a
2750:ENT
2668:and
2547:ICD
2532:ICD
2479:doi
2442:doi
2390:doi
2386:272
2348:doi
2300:doi
2250:doi
2223:doi
2110:PMC
2102:doi
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2026:PMC
2016:doi
1977:doi
1938:doi
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980:PMC
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