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عمومی::
مواجهه شیمیایی
Telephone interviews with 1, 326 adults between the ages of 21 to 66 in the states of Utah and Iowa revealed that nearly 30% reported a lifetime prevalence of a voice disorder, and approximately 7% reported a current voice problem.6 Chronic voice problems were more com- mon in women, in middle adult ages (40-59 years), and in individuals who reported heavy voice demands, reflux symptoms, chemical exposures, and frequent upper respiratory infections.6 Another random sampling of 117 elderly individuals between the ages of 65 to 94 in the states of Utah and Ken- tucky revealed a larger lifetime preva- lence of a voice disorder, at 47%, with 29% of participants reporting a current voice problem.7 Contributors to voice problems in this elderly group included reflux symptoms, history of a neck or back injury, and reports of chronic pain conditions.
Thermal and Chemical Exposure
Some individuals appear to develop consistent and repeated sensitivity to airborne chemical exposures that trig- ger abnormal airway and voice changes, including dysphonia, weak voice qual- ity, and vocal fatigue.
Nonetheless, these patients typically report symptom onset following a known exposure to some airborne chemical, such as toxic gases, fumes, carpet or fabric treatments, smoke, aerosols, pollution, perfumes or scents, and other stimulants in the environment.48-52 Irritable larynx syn- drome (ILS) is the term given to the cluster of symptoms reported com- monly in these patients, including one or more of the following: dysphonia following exposure, airway distress or episodic laryngospasm, globus, chronic cough, throat pain or dryness, and reflux.53 Differential diagnosis of ILS is difficult unless the symptoms are con- sistently acute and time-locked with a known chemical exposure as a trigger.
Internal Laryngeal Trauma: Thermal and Chemical Exposure; Intubation/Extubation Injury
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