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The complementary relationship among these various physical, voice use, and psychological influences ensures that many voice disorders and laryngeal pathologies will have contributions from more than one etiologic factor and that there may be considerable overlap among these three groupings.1-3 For example, inappropriate vocal behaviors or excessive vocal demands may incite structural changes in the vocal fold
The prevalence of voice disorders is dif- ficult to establish because figures vary with age, gender, and occupation, but estimates range from 3% to 10% in the general population.3 Thirty years ago, a study of 428 otolaryngology patients, aged 18 to 82 years, found that 7.2% of the males and 5% of the females had some form of laryngeal pathology.4 Ten years later, 1158 new patient records from the same otolaryngology practice were reviewed to replicate those find- ings.5 The most frequent voice patholo- gies for those treatment-seeking patients were benign vocal fold lesions (such as nodules, granuloma, and edema) and functional voice disorders (including
Diagnoses of vocal fold paralysis, carcinoma, and vocal fold bowing were frequent, but occurred more often in elderly speakers.
Vocal fold
Typical prevalence rates range from as low as 6% to as high as 23%10-11 In a major children's medical center, the most common medical diagnoses were subglottic stenosis, vocal nodules, laryn- gomalacia, dysphonia without visible organic pathology, and vocal fold paral- ysis.12 However, that specialist practice may tend to overestimate the type and number of extreme medical conditions in children's voice disorders.
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