Skip to main navigation menu Skip to main content Skip to site footer

Odynophonia: a Clinical Update

Odinofonía: una actualización clínica



Open | Download


Section
Review Articles

How to Cite
1.
Odynophonia: a Clinical Update. Rev. Investig. Innov. Cienc. Salud [Internet]. 2023 Jul. 13 [cited 2024 Dec. 5];5(1):191-214. Available from: https://riics.info/index.php/RCMC/article/view/169

Dimensions
PlumX
Christopher Hernán Fuentes Aracena

    Introduction. At present, odynophonia is considered one more symptom within voice disorders and, therefore, its study has had less relevance if compared to the research of pain expressed in other regions of the human body.

    Objective. To update the concept of odynophonia, according to the latest findings that explain its etiology, evaluation and therapeutic management.

    Methodology. The databases PubMed, Scopus, ScienceDirect, and SciELO were searched. Articles were selected according to various criteria, including date of publication, design and objective.

    Results. The etiology of odynophonia, according to criteria of intensity and chronicity of pain, includes primary and secondary odynophonia. The evaluation of odynophonia entails a detailed clinical interview; the identification of its frequency, intensity and duration using scales and indexes; and the application of tools such as algometry, to recognize the degree of sensitivity of the affected tissues. The intervention of odynophonia depends on its nature (primary or secondary) and, in general, includes educational, symptomatic, biomechanical and psychosocial approaches.

    Conclusion. Current literature positions odynophonia as a complex condition, whose etiology, evaluation, and intervention are still not fully understood.


    Article visits 1119 | PDF visits 260


    1. Fuentes C, Briones V, Curinao C, Duque F, Hernández I. Repercusiones vocales del síndrome de hiperlaxitud articular. Revista de Logopedia, Foniatría y Audiología. 2019;39:173–81. doi: https://doi.org/10.1016/j.rlfa.2019.05.002
    2. Van Lierde KM, Dijckmans J, Scheffel L, Behlau M. Type and Severity of Pain During Phonation in Professional Voice Users and Nonvocal Professionals. Journal of Voice. 2012;26:671.e19-671.e23. doi: https://doi.org/10.1016/j.jvoice.2011.11.008
    3. Silverio KCA, Siqueira LTD, Lauris JRP, Brasolotto AG. Muscleskeletal pain in dysphonic women. Codas. 2014;26:374–81. doi: https://doi.org/10.1590/2317-1782/20142013064
    4. Durazzo M, Lupi G, Cicerchia F, Ferro A, Barutta F, Beccuti G, et al. Extra-Esophageal Presentation of Gastroesophageal Reflux Disease: 2020 Update. J Clin Med. 2020;9:1–21. doi: https://doi.org/10.3390/JCM9082559
    5. Van Der Velden AW, Sessa A, Altiner A, Carlos A, Pignatari C, Shephard A. Patients with Sore Throat: A Survey of Self-Management and Healthcare-Seeking Behavior in 13 Countries Worldwide. Pragmat Obs Res. 2020;11:91–102. doi: https://doi.org/10.2147/POR.S255872
    6. Tibbetts KM, Dion GR, Dominguez LM, Loochtan MJ, Simpson CB. In-Office Superior Laryngeal Nerve Block for Paralaryngeal Pain and Odynophonia. Laryngoscope. 2022;132:401–5. doi: https://doi.org/10.1002/LARY.29780
    7. Lechien JR, Saussez S, Harmegnies B, Finck C, Burns JA. Laryngopharyngeal Reflux and Voice Disorders: A Multifactorial Model of Etiology and Pathophysiology. Journal of Voice. 2017;31:733–52. doi: https://doi.org/10.1016/j.jvoice.2017.03.015
    8. Fuentes Aracena C, Biermann C, Catrín L, Zúñiga T. Características perilaríngeas y semiológicas de mujeres con odinofonía. Revista de Investigación en Logopedia. 2021;11:e69857–e69857. doi: https://doi.org/10.5209/RLOG.69857
    9. Tohidast SA, Mansuri B, Bagheri R, Azimi H. Determining pain in patients with voice disorders: a qualitative study. Logoped Phoniatr Vocol. 2020:1–8. doi: https://doi.org/10.1080/14015439.2020.1791249
    10. Ramos AC, Floro RL, Ribeiro VV, Brasolotto AG, Silverio KCA. Musculoskeletal Pain and Voice-related Quality of Life in Dysphonic and Non-dysphonic Subjects. Journal of Voice. 2018;32:307–13. doi: https://doi.org/10.1016/j.jvoice.2017.05.019
    11. Green BN, Johnson CD, Adams A. Writing narrative literature reviews for peer-reviewed journals: secrets of the trade. J Chiropr Med. 2006;5:101. doi: https://doi.org/10.1016/S0899-3467(07)60142-6
    12. Raja SN, Carr DB, Cohen M, Finnerup NB, Flor H, Gibson S, et al. The revised International Association for the Study of Pain definition of pain: concepts, challenges, and compromises. Pain. 2020;161:1976–82. doi: https://doi.org/10.1097/j.pain.0000000000001939
    13. Mischkowski D, Palacios-Barrios EE, Banker L, Dildine TC, Atlas LY. Pain or nociception? Subjective experience mediates the effects of acute noxious heat on autonomic responses. Pain 2018;159:699–711. https://doi.org/10.1097/J.PAIN.0000000000001132
    14. Dueñas M, Ojeda B, Salazar A, Mico JA, Failde I. A review of chronic pain impact on patients, their social environment and the health care system. J Pain Res. 2016;9:457–67. doi: https://doi.org/10.2147/JPR.S105892
    15. Kim S, Atkinson C, Harris AH, Tibbetts K, Mau T, Tibbetts, et al. Primary odynophonia: When pain is out of proportion to dysphonia. Laryngoscope. 2020;130:E183–9. doi: https://doi.org/10.1002/lary.28154
    16. Rubin A, Codino J, Bottalico P, Parrish S, Jackson-Menaldi C. Hyoid Bone Syndrome and Dysphonia: Can Throat Pain Affect the Voice? Laryngoscope. 2021;131:E2303–8. doi: https://doi.org/10.1002/LARY.29464
    17. Sinha P, Grindler DJ, Haughey BH. A pain in the neck: Lateral Thyrohyoid Ligament Syndrome. Laryngoscope. 2014;124:116–8. doi: https://doi.org/10.1002/lary.24419
    18. Jung S, Park H, Bae H, Yoo J, Park H, Park K, et al. Laryngeal myofascial pain syndrome as a new diagnostic entity of dysphonia. Auris Nasus Larynx. 2017;44:182–7. doi: https://doi.org/10.1016/j.anl.2016.05.001
    19. Sonoda, Naohiro; Tamatsu Y. Observation on the attachment of muscles onto the hyoid bone in human adults. 2008;85:79–90. doi: https://doi.org/10.2535/ofaj.85.79
    20. Aydil U, Ekinci Ö, Köybaşioǧlu A, Kizil Y. Hyoid bone insertion tendinitis: Clinicopathologic correlation. European Archives of Oto-Rhino-Laryngology. 2007;264:557–60. doi: https://doi.org/10.1007/s00405-006-0220-x
    21. Fuentes Aracena C, Biermann Orizola C, Portilla Rojas J. Consecuencias de la sobrecarga vocal en el umbral doloroso de los tejidos perilaríngeos. Revista de Logopedia, Foniatría y Audiología. 2022;42:17–23. doi: https://doi.org/10.1016/J.RLFA.2020.05.005
    22. Berdan M, Petekkaya E, Yücel AH. Effect of Chant Training on the Morphology of the Lateral Thyrohyoid Ligament: A Biometric and Acoustic Assessment. Journal of Voice. 2019;33:802.e17-802.e23. doi: https://doi.org/10.1016/J.JVOICE.2018.04.014
    23. Stern N, Jackson-Menaldi C, Rubin AD. Hyoid Bone Syndrome: A Retrospective Review of 84 Patients Treated with Triamcinolone Acetonide Injections. Annals of Otology, Rhinology & Laryngology. 2013;122:159–62. doi: https://doi.org/10.1177/000348941312200303
    24. Tamaki A, Thuener J, Weidenbecher M. Superior Laryngeal Nerve Neuralgia: Case Series and Review of Anterior Neck Pain Syndromes. Ear Nose Throat J. 2019;98:500–3. doi: https://doi.org/10.1177/0145561318823373
    25. Kupfer RA, Merati AL, Sulica L. Medialization laryngoplasty for odynophonia. JAMA Otolaryngol Head Neck Surg. 2015;141:556–61. doi: https://doi.org/10.1001/jamaoto.2015.0333.
    26. Desai MJ, Saini V, Saini S. Myofascial Pain Syndrome: A Treatment Review. Pain Ther. 2013;2:21–36. doi: https://doi.org/10.1007/S40122-013-0006-Y/TABLES/2
    27. Minerbi A, Vulfsons S. Challenging the Cinderella Hypothesis: A New Model for the Role of the Motor Unit Recruitment Pattern in the Pathogenesis of Myofascial Pain Syndrome in Postural Muscles. Rambam Maimonides Med J. 2018;9: e0021. doi: https://doi.org/10.5041/RMMJ.10336
    28. Kim H, Yang HS, Cheon JH, Won KH. The Management of Foreign Body Sensation in the Throat after Stroke by Trigger Point Injection on Posterior Belly of Digastric Muscles. Kosin Medical Journal. 2021;36:34–9. doi: https://doi.org/10.7180/KMJ.2021.36.1.34
    29. Kalladka M, Thondebhavi M, Ananthan S, Kalladka G, Khan J. Myofascial pain with referral from the anterior digastric muscle mimicking a toothache in the mandibular anterior teeth: a case report. Quintessence Int. 2020;51:56–62. doi: https://doi.org/10.3290/J.QI.A43615
    30. Shetty S, Pitti V, Babu CLS, Kumar GPS, Deepthi BC. Bruxism: A Literature Review. J Indian Prosthodont Soc. 2010;10:141. doi: https://doi.org/10.1007/S13191-011-0041-5
    31. Fuentes Aracena C, Calderón González C, Figueroa Álvarez C, Sánchez Romo L, Yáñez Saldaña C. Diferencias en el umbral de presión de los tejidos perilaríngeos entre pacientes con odinofonía e individuos asintomáticos. Revista de Logopedia, Foniatría y Audiología. 2021;41:124–32. doi: https://doi.org/10.1016/J.RLFA.2020.03.016
    32. Piersiala K, Akst LM, Hillel AT, Best SR. Chronic Pain Syndromes and Their Laryngeal Manifestations. JAMA Otolaryngol Head Neck Surg. 2020;146:543–9. doi: https://doi.org/10.1001/jamaoto.2020.0530
    33. Haleem EKA, Hassan ES, Yassen DG, Aref AHAE-A. Irritable larynx syndrome (Internal and external correlates). Journal of Current Medical Research and Practice. 2020;5:7. doi: https://doi.org/10.4103/JCMRP.JCMRP_73_18
    34. O’Rourke C, Attique S, Rehman AU, Saunders J, Fenton JE. Hyoid Bone Tenderness as a Clinical Indicator of Laryngeal Pathology. Journal of Voice. 2014;28:835–7. doi: https://doi.org/10.1016/j.jvoice.2014.02.012
    35. Messina G. The Tongue, Mandible, Hyoid System. Eur J Transl Myol. 2017;27:6363. doi: https://doi.org/10.4081/ejtm.2017.6363
    36. German RZ, Campbell-Malone R, Crompton AW, Ding P, Holman S, Konow N, et al. The Concept of Hyoid Posture. Dysphagia. 2011;26:97–8. doi: https://doi.org/10.1007/s00455-011-9339-z
    37. Vaca M, Cobeta I, Mora E, Reyes P. Clinical Assessment of Glottal Insufficiency in Age-related Dysphonia. Journal of Voice. 2017;31:128.e1-128.e5. doi: https://doi.org/10.1016/J.JVOICE.2015.12.010
    38. Arulanandam S, Hakim AJ, Aziz Q, Sandhu G, Birchall MA. Laryngological presentations of Ehlers-Danlos syndrome: case series of nine patients from two London tertiary referral centres. Clinical Otolaryngology. 2017;42:860–3. doi: https://doi.org/https://doi.org/10.1111/coa.12708
    39. Pontes P, Brasolotto A, Behlau M. Glottic characteristics and voice complaint in the elderly. Journal of Voice. 2005;19:84–94. doi: https://doi.org/10.1016/j.jvoice.2004.09.002
    40. McKenna VS, Diaz-Cadiz ME, Shembel AC, Enos NM, Stepp CE. The Relationship Between Physiological Mechanisms and the Self-Perception of Vocal Effort. J Speech Lang Hear Res. 2019;62:815–34. doi: https://doi.org/10.1044/2018_JSLHR-S-18-0205
    41. Belafsky PC, Postma GN, Reulbach TR, Holland BW, Koufman JA. Muscle tension dysphonia as a sign of underlying glottal insufficiency. Otolaryngology - Head and Neck Surgery. 2002;127:448–51. doi: https://doi.org/10.1067/mhn.2002.128894
    42. Bielamowicz S, Kapoor R, Schwartz J, Stager S V. Relationship among glottal area, static supraglottic compression, and laryngeal function studies in unilateral vocal fold paresis and paralysis. Journal of Voice. 2004;18:138–45. doi: https://doi.org/10.1016/j.jvoice.2003.11.005
    43. Fuentes C, Biermann C. Diferencias en el comportamiento glótico y supraglótico y en la estructura de los pliegues vocales entre mujeres con odinofonía y asintomáticas. Revista de Investigación En Logopedia. 2022;12. doi: https://doi.org/doi.org/10.5209/rlog.77880
    44. Edmonson J, Esling J. The Valves of the Throat and Their Functioning in Tone, Vocal Register and Stress: Laryngoscopic Case Studies on JSTOR. Phonology. 2006;23. doi: https://doi.org/10.1017/S095267570600087X
    45. Miaśkiewicz B, Panasiewicz A, Gos E, Szkiełkowska A, Skarżyński PH, Włodarczyk E. Voice aspects in sulcus coexisting with benign lesions of the vocal folds. Acta Otorhinolaryngologica Italica. 2020;40:262–9. doi: https://doi.org/10.14639/0392-100X-N0555
    46. Cohen JT, Oestreicher-Kedem Y, Fliss DM, DeRowe A. Glottal Function Index: A predictor of glottal disorders in children. Annals of Otology, Rhinology and Laryngology. 2007;116:81–4. doi: https://doi.org/10.1177/000348940711600201
    47. Gerken L, Windisch A, Thalhammer R, Olwitz S, Fay E, Al Hussini H, et al. Patient perspective of pain assessment by nursing personnel : Qualitative cross-sectional study on use of the NRS. Der Schmerz. 2017;31:123–30. doi: https://doi.org/10.1007/s00482-016-0181-y
    48. Behrens N, Licht G, Schmitt H-J. Diagnosis of myofascial pain. Myofascial Trigger Points. 2013:69–98. doi: https://doi.org/10.1016/B978-0-7020-4312-3.00013-1
    49. Dansie EJ, Turk DC. Assessment of patients with chronic pain. Br J Anaesth. 2013;111:19–25. doi: https://doi.org/10.1093/bja/aet124
    50. Steffens D, Ferreira ML, Latimer J, Ferreira PH, Koes BW, Blyth F, et al. What Triggers an Episode of Acute Low Back Pain? A Case-Crossover Study. Arthritis Care Res (Hoboken). 2015;67:403–10. doi: https://doi.org/10.1002/acr.22533
    51. McDowell S, Morrison R, Mau T, Shembel AC. Clinical Characteristics and Effects of Vocal Demands in Occupational Voice Users With and Without Primary Muscle Tension Dysphonia. Journal of Voice. 2022. doi: https://doi.org/10.1016/J.JVOICE.2022.10.005
    52. Haefeli M, Elfering A. Pain assessment. European Spine Journal. 2006;15(Suppl1):S17-24. doi: https://doi.org/10.1007/s00586-005-1044-x
    53. Lopes LW, Cabral GF, Figueiredo De Almeida AA. Vocal Tract Discomfort Symptoms in Patients With Different Voice Disorders. Journal of Voice. 2015;29:317–23. doi: https://doi.org/10.1016/J.JVOICE.2014.07.013
    54. Mittinty MM, Vanlint S, Stocks N, Mittinty MN, Moseley GL. Exploring effect of pain education on chronic pain patients’ expectation of recovery and pain intensity. Scand J Pain. 2018;18:211–9. doi: https://doi.org/10.1515/sjpain-2018-0023
    55. Sandborgh M, Johansson A-C, Söderlund A. The Relation between the Fear-Avoidance Model and Constructs from the Social Cognitive Theory in Acute WAD. Pain Res Manag. 2016;2016:1–7. doi: https://doi.org/10.1155/2016/8281926
    56. Geiger AA, Deroon-Cassini T, Brasel KJ. Considering the Patient’s Perspective in the Injury Severity Score. J Surg Res. 2011;170:133. doi: https://doi.org/10.1016/J.JSS.2011.03.026
    57. Wood RL, MacLean L, Pallister I. Psychological factors contributing to perceptions pain intensity after acute orthopaedic injury. Injury. 2011;42:1214–8. doi: https://doi.org/10.1016/J.INJURY.2010.07.245
    58. Archer KR, Abraham CM, Obremskey WT. Psychosocial Factors Predict Pain and Physical Health After Lower Extremity Trauma. Clin Orthop Relat Res. 2015;473:3519–26. doi: https://doi.org/10.1007/S11999-015-4504-6/TABLES/4
    59. Delgado DA, Lambert BS, Boutris N, McCulloch PC, Robbins AB, Moreno MR, et al. Validation of Digital Visual Analog Scale Pain Scoring With a Traditional Paper-based Visual Analog Scale in Adults. J Am Acad Orthop Surg Glob Res Rev. 2018;2:e088. doi: https://doi.org/10.5435/JAAOSGlobal-D-17-00088.
    60. Vicente Herrero M, Delgado Bueno S, Bandrés Moyá F, Ramírez M, Capdevila García L, Teófila Vicente Herrero M. Valoración del dolor. Revisión comparativa de escalas y cuestionarios. Rev Soc Esp Dolor. 2018;25:228–36. doi: https://doi.org/10.20986/resed.2018.3632/2017
    61. Li K, Harris K, Hadi S, Chow E. What Should be the Optimal Cut Points for Mild, Moderate, and Severe Pain? J Palliat Med. 2007;10:1338–46. doi: https://doi.org/10.1089/jpm.2007.0087
    62. Santos JK de O, Silvério KCA, Diniz Oliveira NFC, Gama ACC. Evaluation of Electrostimulation Effect in Women With Vocal Nodules. Journal of Voice. 2016;30:769.e1-769.e7. doi: https://doi.org/10.1016/j.jvoice.2015.10.023
    63. Bech RD, Lauritsen J, Ovesen O, Overgaard S. The Verbal Rating Scale Is Reliable for Assessment of Postoperative Pain in Hip Fracture Patients. Pain Res Treat. 2015;2015:676212. doi: https://doi.org/10.1155/2015/676212
    64. Newman CJ, Lolekha R, Limkittikul K, Luangxay K, Chotpitayasunondh T, Chanthavanich P. A comparison of pain scales in Thai children. Arch Dis Child. 2005;90:269–70. doi: https://doi.org/10.1136/adc.2003.044404
    65. Keen S, Lomeli-Rodriguez M, Williams ACDC. Exploring how people with chronic pain understand their pain: A qualitative study. Scand J Pain. 2021;21:743–53. doi: https://doi.org/10.1515/sjpain-2021-0060
    66. Fink R. Pain assessment: the cornerstone to optimal pain management. Proc (Bayl Univ Med Cent). 2000;13:236. doi: https://doi.org/10.1080/08998280.2000.11927681
    67. Sabini RC, Leo CS, Moore AE. The relation of experience in osteopathic palpation and object identification. Chiropr Man Therap. 2013;21:38. doi: https://doi.org/10.1186/2045-709X-21-38
    68. Pelfort X, Torres-Claramunt R, Sánchez-Soler JF, Hinarejos P, Leal-Blanquet J, Valverde D, et al. Pressure algometry is a useful tool to quantify pain in the medial part of the knee: An intra- and inter-reliability study in healthy subjects. Orthopaedics & Traumatology: Surgery & Research. 2015;101:559–63. doi: https://doi.org/10.1016/j.otsr.2015.03.016
    69. Wiwckiewicz W, Wofniak K, Pidtkowska D, Szyszka-Sommerfeld L, Lipski M, Więckiewicz W, et al. The Diagnostic Value of Pressure Algometry for Temporomandibular Disorders. Biomed Res Int. 2015;2015:1–8. doi: https://doi.org/10.1155/2015/575038
    70. Ylinen J, Nykänen M, Kautiainen H, Häkkinen A. Evaluation of repeatability of pressure algometry on the neck muscles for clinical use. Man Ther. 2007;12:192–7. doi: https://doi.org/10.1016/j.math.2006.06.010
    71. Sterling M. Pressure Algometry: What Does It Really Tell Us? Journal of Orthopaedic & Sports Physical Therapy. 2011;41:623–4. doi: https://doi.org/10.2519/jospt.2011.0106
    72. Darnall BD, Carr DB, Schatman ME. Pain Psychology and the Biopsychosocial Model of Pain Treatment: Ethical Imperatives and Social Responsibility. Pain Medicine: The Official Journal of the American Academy of Pain Medicine. 2017;18:1413. doi: https://doi.org/10.1093/PM/PNW166
    73. Vier C, Bracht MA, Neves ML, Junkes-Cunha M, Santos ARS. Effects of spinal manipulation and pain education on pain in patients with chronic low back pain: a protocol of randomized sham-controlled trial. Integr Med Res. 2018;7:271–8. doi: https://doi.org/10.1016/j.imr.2018.04.003
    74. Fuentes C. Rol de los agentes físicos en la rehabilitación vocal: una revisión de la literatura. Revista de Investigacion En Logopedia 2020;10. doi: https://doi.org/https://doi.org/10.5209/rlog.65341
    75. Fuentes C, Arrau J, Pino G, Valdivia N, Aguilar C. La estimulación eléctrica transcutánea de tipo acupuntura como herramienta aceleradora de la recuperación de los tejidos expuestos a sobrecarga vocal. Revista de Investigación en Logopedia. 2020;10:31–41. doi: https://doi.org/10.5209/rlog.64873
    76. Conde M de CM, Siqueira LTD, Vendramini JE, Brasolotto AG, Guirro RR de J, Silverio KCA. Transcutaneous Electrical Nerve Stimulation (TENS) and Laryngeal Manual Therapy (LMT): Immediate Effects in Women With Dysphonia. Journal of Voice. 2018;32:385.e17-385.e25. doi: https://doi.org/10.1016/j.jvoice.2017.04.019
    77. Mansuri B, Torabinezhad F, Jamshidi AA, Dabirmoghadam P, Vasaghi-Gharamaleki B, Ghelichi L. Application of High-Frequency Transcutaneous Electrical Nerve Stimulation in Muscle Tension Dysphonia Patients With the Pain Complaint: The Immediate Effect. Journal of Voice. 2019. doi: https://doi.org/10.1016/j.jvoice.2019.02.009
    78. Cotler HB, Chow RT, Hamblin MR, Carroll J, Cotler H. The Use of Low Level Laser Therapy (LLLT) For Musculoskeletal Pain. MOJ Orthop Rheumatol. 2015;2. doi: https://doi.org/10.15406/mojor.2015.02.00068
    79. Reimann AP, Siqueira LTD, Rondon AV, Brasolotto AG, Silverio KCA. Immediate effect of laryngeal manual therapy in dysphonic individuals. Codas. 2016;28:59–65. doi: https://doi.org/10.1590/2317-1782/20162015089
    80. Mathieson L, Hirani SP, Epstein R, Baken RJ, Wood G, Rubin JS. Laryngeal manual therapy: a preliminary study to examine its treatment effects in the management of muscle tension dysphonia. Journal of Voice. 2009;23:353–66. doi: https://doi.org/10.1016/J.JVOICE.2007.10.002
    81. Craig J, Tomlinson C, Stevens K, Kotagal K, Fornadley J, Jacobson B, et al. Combining Voice Therapy and Physical Therapy: A Novel Approach to Treating Muscle Tension Dysphonia. J Commun Disord. 2015;58:169. doi: https://doi.org/10.1016/J.JCOMDIS.2015.05.001
    82. Espejo-Antúnez L, Tejeda JFH, Albornoz-Cabello M, Rodríguez-Mansilla J, de la Cruz-Torres B, Ribeiro F, et al. Dry needling in the management of myofascial trigger points: A systematic review of randomized controlled trials. Complement Ther Med. 2017;33:46–57. doi: https://doi.org/10.1016/J.CTIM.2017.06.003
    83. Reed DE, Cobos B, Nagpal AS, Eckmann M, McGeary DD. The role of identity in chronic pain cognitions and pain-related disability within a clinical chronic pain population. Int J Psychiatry Med. 2022;57:35–52. doi: https://doi.org/10.1177/0091217421989141
    84. Ebersole B, Soni RS, Moran K, Lango M, Devarajan K, Jamal N. The Influence of Occupation on Self-perceived Vocal Problems in Patients With Voice Complaints. Journal of Voice. 2018;32:673–80. doi: https://doi.org/10.1016/J.JVOICE.2017.08.028
    Sistema OJS 3.4.0.7 - Metabiblioteca |