title: Patient perceptions of factors leading to spasmodic dysphonia: a combined clinical experience of 350 patients.
abstract: OBJECTIVE
  Spasmodic dysphonia (SD) is an idiopathic voice disorder that is characterized by either a strained, strangled voice quality or a breathy voice with aphonic segments of connected speech. It has been suggested that environmental factors play a role in triggering the onset. Clinical observation suggests that some patients associate onset with specific events or factors while others do not. The purpose of this study was to examine a large database of SD patients to determine if specific triggers are associated with the onset of SD.
  
  
  METHODS
  Retrospective chart review.
  
  
  RESULTS
  A total of 350 charts of patients with SD were identified and were categorized as either "sudden onset" or "gradual onset." One hundred sixty-nine recalled their circumstances surrounding onset. Forty-five percent of these patients described the onset as sudden. Patient perceptions of inciting events in the sudden onset group were identified 77% of the time and 2% of the time in the gradual onset group. The most common factors identified were stress (42%), upper respiratory infection (33%), and pregnancy and parturition (10%).
  
  
  CONCLUSIONS
  Thirty-five percent of SD patients perceive their disorder to have a sudden onset with identified inciting events. This prevalence raises questions regarding possible behavioral and environmental factors surrounding the onset of this disorder.
authors: New York Head and Neck Institute, Center for Voice and Swallowing Disorders, New York, New York 10019, USA. childs.lesley@gmail.com
authors: Lesley
authors: L
authors: Childs
authors: Scott
authors: S
authors: Rickert
authors: Thomas
authors: T
authors: Murry
authors: Andrew
authors: A
authors: Blitzer
authors: Lucian
authors: L
authors: Sulica
mesh_terms: D000208:Acute Disease; D000328:Adult; D017677:Age Distribution; D017668:Age of Onset; D002908:Chronic Disease; D015331:Cohort Studies; D016208:Databases, Factual; D055154:Dysphonia / Q000453:epidemiology* / Q000503:physiopathology* / Q000534:rehabilitation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D058748:Pain Perception / Q000502:physiology*; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D017678:Sex Distribution; D014834:Voice Training