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Frustration of a phonation at which the voice remains, but becomes hoarse and weak carries the name a dysphonia.

Dysphonia symptoms:

The variety of forms of functional narusheyoniya of a voice defines distinction of their clinical manifestations.
The general symptoms for a dysphonia, an aphonia, phonasthenias are poyostoyanny or periodic hoarseness, fatigue of a voice.
Each form of a disease has kliniyochesky manifestations, characteristic of it.
At a hypokinetic (paretic) dysphonia voice folds usually slightly hyperemic, at phonation the crack is formed various form (ovalyyony, triangular).
Voice of the deaf, hoarse.
For a giperkineyotichesky (spastic) dysphonia harakyoterno a condition of a spastic hyperkinesia of muscles of a throat with a preyoobladaniye of a tonic spasm.
During phonation the preddveyoriya is noted convulsive rapprochement of voice folds and folds.
Voice folds are not changed, mobile, at phonation are in a condition of sharp tension.
The most severe form of functional frustration of a voice, the spastiyochesky dysphonia is.

The beginning of a spastic dysphonia usually acute, as a rule, obuslovyoleno a mental injury which in certain cases predyoshestvut a long overstrain of a voice.
The disease of a spastic dysphonia has resistant long character, renders negative vliyayony on a mental condition of patients.

Gipotonusny dysphonia - permanent funktsionalyyony disturbance of a voice - are characterized by a diskoordination of all departments of a voice apyoparat.
At a gipotonusny dysphonia is defined:
• hypotone of voice folds,
• incomplete smykaniye of a glottis,
• decrease in intensity of a voice and disturbance of its timbre.

By special psychological obsleyodovaniye L. E. Goncharuk (1986) it is established that permanent functional disturbances of a voice represent not толь­ко a throat disease, and are connected with disturbance neuroпсихи­ческой spheres.

Dysphonia reasons:

Origins of voice frustration the most various. Most often disturbances of a voice arise against the background of flu, a SARS, quinsy, tracheitis, bronchitis.
Not the last place among the reasons of voice frustration is taken by a voice overstrain, especially when people try to outvoice others in the company, in the noisy room or, despite an indisposition, go to give a lecture. And if similar cases often repeat, a number of disturbances is possible: nodulation, polyps, fibromas, developing of hemorrhages in voice folds. The long and excessive tension of a voice leads to developing of chronic laryngitis which main symptom is the dysphonia.
Frustration of a voice can be connected also with a microclimate of the room in which the person spends much time. In this case the irritating factors are dampness, dust, and also temperature influences – cold or a heat. Voice function is influenced by also production factors. A throat, being a part of respiratory system, is affected by organic and inorganic dust, gases and various impurity which are contained in the inhaled air.

Treatment of the Dysphonia:

Functional disturbances of a voice are not local pathological process in a throat, and are connected with various disturbances, diseases and the raised layobilnost of a nervous system.
In this regard treatment of these bolyyony has to be complex, including:
• psychotherapy,
• respiratory gymnastics,
• speech and vocal fonopediya,
• medicamentous therapy.

The important place at treatment of patients is taken by the physical methods of treatment of functional disturbances of a voice directed mainly to regulation of a deyayotelnost of the central nervous system and local vozdeystyovy to a throat.

Treatment of functional disfoniya has to be directed to elimination of the pathological center of congestive braking in bark of a great brain and recovery of narushenyony reflex mechanisms.
For improvement of processes of an obyomen and carrying out excitement in interneural synapses the stimulating medicamentous therapy nayoznachatsya:
• poliviyotamina,
• ATP,
• strychnine,
• прозерин (intramuscular injections),
• sedatives,
• tranquilizers (Trioxazinum, Tazepamum) inside.
Medicamentous therapy of a dysphonia is carried out against the background of the golosoyovy mode in a complex with respiratory gymnastics and orthophonic treatment.

From physical methods of treatment of a dysphonia for immediate effect appoint galvanization, an electrophoresis of 0,1% of solution of strychnine to the neuromuscular device of a throat.
One electrode with laying of 40x60 mm in size place on об­ласть throats, raspolayogat other electrode of 60X80 mm in size in the lower cervical vertebras.
Current is up to 3 - 5 мА, 10-20 min., on a course of 10-15 procedures.

According to M. A. Ratenberg (1973), good results, especially at patients with existence are paresthesias, are observed at local darsonvalization of a throat.
The fungoid electrode is medyolenno moved on the front surface of a neck within 5-10 min.
Appoint also vibration massage of a throat.

For the purpose of stimulation of the neuromuscular device of a throat influence faradic and diadynamic tokayom is shown.
DD-therapy of the neuromuscular device of a throat is carried out by currents - a rhythm a syncope.
Electrodes of 80X90 mm establish at plates of a thyroid cartilage between the lower and average third of a grudinoklyuchichno-mastoidal muscle.
Begin treatment with two-half-period wave current.
Current before emergence expressed (but unpainful) feelings of vibration, 10 min., on a course to 15.
Good rezulyyotata are noted at a diadinamoelektroforeza of a prozerin.
Uluchyosheniye broken as a result of a disease of a peripheral kroyovoobrashcheniye and a trophicity of fabrics, along with normalization of funkyotion of the autonomic nervous system provides medical effect of SMT.

Important factor of medical action of SMT at funktsioyonalny disturbances of a voice is their influence on the chuvstviyotelny sphere of a nervous system.
Influence by these currents causes rhythmic the arranged impulsation flow with ekstero-, intero-and proprioretseptor in the central nervous system.
Influence of SMT carry out by the doubled electrode (30X40 mm everyone), have them on the side surfaces of a throat ahead of grudinoklyuchichno-mastoidal muscles on the urovena of the lower and average third (area of a motor point of a phrenic nerve), place other electrode in areas of nizhyony cervical vertebrae.
The mode 1, sort of work II, frequency is 75 - 100 Hz, duration of half-cycles 2-3 with, depth of modulations is 50-100%, 10 min., on a course 10-12.
In the presence of a pain syndrome influence of SMT directly on об­ласть is shown to a throat, at considerable disturbances of neurohumoral regulation and a trophicity - on area of cervical sympathetic nodes.

For the purpose of recovery of the broken reflex mekhanizyom it is necessary to include reflex therapy in a complex of medical actions - influence by physical factors (an electrophoresis of 10% of solution of Calcii chloridum) for "vorotniyokovy" area, 15-20 procedures.

V. A. Trinos and соавт. (1984) suggest to carry out at the specified pathology electrostimulation of muscles of a throat under zayoshchity mutings (that the patient did not hear the sobstvenyony voice).
In process of improvement of phonation by voice skladyoka muting is removed.

The complex which includes step-by-step differenyotsirovanny use of a fonopediya, the psychotherapy, a psikhoprofiyolaktika and methods of physical therapy promoting a noryomalization of function of a nervous system is developed for treatment of permanent functional disturbances of a voice.
It is appointed:
• sedative therapy,
• hydrotherapy,
• a galvanic collar on Shcherbaka,
• breathing exercises which purpose is elaboration of the correct speech breath.
It is necessary to emphasize importance of exact differential diagnosis of nature of defeat and the reasons which caused a disease as the irrational terayopiya at these patients promotes fixing of a pathological soyostoyaniye.

At a hyperkinetic dysphonia treatment is directed generally to elimination of the excess muscle tension of a goryotana during phonation caused by dysfunction of the central nervous system.
At treatment of a hyperkinetic dysphonia appoint:
• psychotropic prepayorata,
• neuroleptics (Tisercinum, сонапакс),
• tranquilizers (Elenium, Seduxenum, Tazepamum),
• antidepressants (триптиозол, нипотен),
• spasmolytic drugs (Nospanum, Nicospanum, to midoka).

Along with medicamentous therapy the fizicheyosky methods of treatment of a hyperkinetic dysphonia promoting recovery of a normal funkyotion of a nervous system are applied.
Carry out:
• electrophoresis of 1% of solution of ephedrine,
• an electrophoresis of 10% - Calcii chloridum,
• an electrophoresis of 2% - an Euphyllinum on "voyorotnikovy" area,
• a galvanic collar on Shcherbaka.

In a complex of medical actions of treatment of a hyperkinetic dysphonia are shown:
• a balyyoneoterapiya (iodine-bromine bathing temperature of 35-36 °C 12-14 min., on a course of 10-12 bathtubs, pearl bathtubs of a temperayotura of 34-36 °C, 10-15 min., on a course of 12-15 bathtubs),
• electrophoresis, medical physical culture,
• electrophoresis, massage of "collar" area.
With poyolozhitelny effect of treatment of a hyperkinetic dysphonia at these patients use an electrosleep by a step technique with a frequency of 25-150 Hz, on a course 15 - 20 procedures, acupuncture.
For treatment of a hyperkinetic dysphonia the remedial respiratory gymnastics providing the set of exercises directed to elaboration of steady, coordinate fonatsionny breath is recommended.
The leading place in rehabilitation of patients with a hyperkinetic dysphonia is given to logopedic work.

The stimulating therapy at a hyperkinetic dysphonia is not shown.

At a spastic dysphonia the technique of impact of PEMP on a reflex and segmented zone is more effective.

The obtained data allow to schiyotat that use of PEMP in a complex with a voice and dykhayotelny training is shown at various forms of funktsioyonalny diseases of a throat.
Achievement of the maximum effect requires the differentiated definition of parametyor and zones of influence by magnetic field in each case [Vasilenko Yu. With, the Nikolaev V. P., Demchenko E. V., 1986].

At treatment of patients with functional diseases of a throat widely it is necessary to use the methods of a physical terayopiya exerting the normalizing impact on neuroпсихи­ческий the status of an organism.
Appoint a balneoterapiya (uglekisyoly, iodine-bromine, pearl bathtubs), an electrophoresis of calcium, bromine, magnesium to "collar" area, massage of a "vorotniyokovy" zone, the general electrophoresis of calcium across Vermel, the general UF-radiation, medical physical culture, etc.

Thus, at funkyotsionalny disturbances of a voice enter a complex of medical actions:
• psychotherapy,
• medikayomentozny means,
• the orthophonic treatment and methods of fiziyochesky therapy directed generally to regulation of a deyayotelnost of the central nervous system
local impact on a throat (afferent perceiving аппа­рат).
Such complex pathogenetic therapy, napravlenyony on various, connected among themselves links of patologicheyosky process, provides the potentiated effect of primeyonyaemy medical factors and allows to receive more blagoyopriyatny results.

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