纤维肌痛语音患者的疼痛与中枢敏化：初步报告

文献信息

中文摘要

目的： 纤维肌痛（FM）是一种慢性疼痛疾病，其特征是通过多种敏化模式导致疼痛处理异常。尽管已有报道称FM患者存在语音障碍，但关于FM如何影响喉部疼痛的表现和管理，目前知之甚少。本病例系列描述了在语音障碍评估和治疗过程中，FM患者出现特定语音相关疼痛表现的情况。
方法： 对在一家三级喉科诊所接受治疗的、同时诊断为FM和至少一种语音障碍的成年患者进行了回顾性病历审查。共识别出5例患者，并对其临床表现、治疗过程和结局进行了回顾。
结果： 患者表现为持续性喉部及相关疼痛，并伴有多种喉部病变；在各病例中，疼痛严重程度似乎与客观喉部检查发现不成比例。尽管治疗后语音质量有所改善，疼痛往往仍持续存在。部分患者还表现出术后疼痛放大或对标准语音治疗的耐受性有限。
结论： 这些病例提示，FM和疼痛处理异常可能影响语音障碍患者的症状负担和结局。认识到纤维肌痛和敏化在语音障碍中的作用，可能有助于支持多学科管理和个体化治疗策略。

英文摘要

OBJECTIVES: Fibromyalgia (FM) is a chronic pain condition characterized by altered pain processing through various modes of sensitization. Although voice disorders have been reported in patients with FM, little is known about how FM influences the presentation and management of laryngeal pain. This case series describes patients with FM with specific presentations of voice-related pain during evaluation and treatment of voice disorders.
METHODS: A retrospective chart review was conducted of adult patients with diagnoses of both FM and at least one voice disorder treated at a tertiary laryngology practice. Five patients were identified, and their clinical presentation, treatment course, and outcomes were reviewed.
RESULTS: Patients presented with persistent laryngeal and related pain in conjunction with a variety of laryngeal pathologies; across cases, pain severity appeared disproportionate to objective laryngeal findings. Pain often persisted despite improvement in voice quality following treatment. Some patients also demonstrated amplified pain postoperatively or limited tolerance of standard voice therapy.
CONCLUSIONS: These cases suggest that FM and altered pain processing may influence symptom burden and outcomes in patients with voice disorders. Recognition of the role of fibromyalgia and sensitization in voice disorders may support multidisciplinary management and individualized treatment strategies.