From Big Medical Encyclopedia

FONASTENYYa (Greek phone a sound, a voice ~ r astheneia powerlessness, weakness) — the frustration of a phonation because of neurosis consisting in a lack of coordination of function of muscles of the voice device without visible anatomic changes in it. At F. lack of coherence between breath, phonation, an articulation and function of resonator cavities is observed.

T. the typical professional disturbance of a voice (see) which is found preferential at persons, a profession represents to-rykh it is connected with speech and vocal loading. In an etiology F. voice overloads, insufficient voice training are of great importance; as the promoting factors serve functional frustration of a nervous system, hysteria (see), the phenomena of a psychasthenia (see), the general overfatigue (see. At languor), etc.

Background COLOURINGS 371

Patients complain of hoarseness, change of a timbre and sonority of a voice, the bystry fatigue, a burning sensation and the pricking pain in a throat arising during the singing (especially in an upper part of range) and a conversation. The phenomena of paresthesia are characteristic (see): feeling of accumulation of slime in a throat (at its actual absence), an itch, tickling, irritation and pressure in a throat and a throat. At such patients various defects of a voice, napr come to light, the voice can suddenly vanish (a so-called failure of a voice). At a laringoskopiya (see) aberrations usually do not come to light. By means of a laringostroboskopi-chesky research (see Stroboskopiya) asynchrony, small amplitude, frequent and moderate rate of fluctuations of phonatory bands (their full smykaniye, formation of an oval or triangular crack between them), disappearance of so-called stroboscopic comfort is found. Quite often during creation of conditions for absolute synchronization of frequency of pulse light and fluctuations of phonatory bands their reductions or twitchings on certain sites are visible. Time of the maximum duration of phonation is sharply reduced.

In an initial stage of a phonasthenia its diagnosis is quite difficult. Carefully collected anamnesis, repeated surveys, consultations of the neuropathologist or psychiatrist are of great importance. At expressed F., followed by a detonirovaniye, a tremolirovaniye (so-called swing) of a sound, change of a timbre of a voice, diagnosis comes easy. In this case the diagnosis is specified at a laringostro-boskopicheoky research.

Treatment includes a complex of actions: elimination of the reasons, you

calling F., reception of the pharmaceuticals promoting an equilibration of processes of excitement and braking in c. N of page, restriction of voice loadings, inhalation (see) pharmaceuticals, massage and self-massage of a neck (see Massage:), the fonopedichesky exercises providing a training of respiratory, articulation and golosoobrazuyushchy systems. If necessary carry out psychotherapy (see).

Forecast favorable.

Prevention F. provides voice training, observance of the voice mode. Observance of the correct work-rest schedule, food, dream, and also walk, morning exercises (see Charging), etc. are recommended. The patients treated concerning F., need dispensary observation (see D ispanserization).

Bibliography: Yermolaev V. G., Le

of a bedev N. F. and Morozov V. P. Guide to a phoniatrics, L., 1970;

Mitrinovich-Modzheevsk A. Patofiziologiya of the speech, a voice and hearing, the lane with polsk., Warsaw, 1965; R and x m and l e in and the p A. And Lavrova of E. V. Klinik, treatment and prevention of phonasthenias, Vestn. otorinolar., No. 5, page 35, 1978; Functional a dysphonia

and their treatment at professionals of a voice. (Methodical recommendations), sost. Yu. S. Vasilenko, M., 1978.

S. L. Taptapova.