Diagnostic vocal fold injection as an intervention for secondary muscle tension dysphonia

2021 ◽  
pp. 1-8
Author(s):  
Christopher D. Dwyer ◽  
Thomas L. Carroll
Keyword(s):  
Vocal Fold ◽  
Muscle Tension ◽  
Muscle Tension Dysphonia ◽  
Vocal Fold Injection

Spasmodic Dysphonia: A Review. Part 2: Characterization of Pathophysiology

2017 ◽  
Vol 157 (4) ◽  
pp. 558-564 ◽  
Author(s):  
Justin M. Hintze ◽  
Christy L. Ludlow ◽  
Stephen F. Bansberg ◽  
Charles H. Adler ◽  
David G. Lott
Keyword(s):  
Vocal Fold ◽  
High Speed ◽  
Muscle Tension ◽  
Data Sources ◽  
Cochrane Library ◽  
Spasmodic Dysphonia ◽  
Muscle Tension Dysphonia ◽  
Laryngeal Dystonia ◽  
Diagnostic Difficulties ◽  
Technological Developments

Objective The purpose of this review is to describe the recent advances in characterizing spasmodic dysphonia. Spasmodic dysphonia is a task-specific focal laryngeal dystonia characterized by irregular and uncontrolled voice breaks. The pathophysiology is poorly understood, and there are diagnostic difficulties. Data Sources PubMed, Google Scholar, and Cochrane Library. Review Methods The data sources were searched using the following search terms: ( spasmodic dysphonia or laryngeal dystonia) and ( etiology, aetiology, diagnosis, pathogenesis, or pathophysiology). Conclusion The diagnosis of spasmodic dysphonia can be difficult due to the lack of a scientific consensus on diagnostic criteria and the fact that other voice disorders may present similarly. Confusion can arise between spasmodic dysphonia and muscle tension dysphonia. Spasmodic dysphonia symptoms are tied to particular speech sounds, whereas muscle tension dysphonia is not. With the advent of more widespread use of high-speed laryngoscopy and videokymography, measures of the disruptions in phonation and delays in the onset of vocal fold vibration after vocal fold closure can be quantified. Recent technological developments have expanded our understanding of the pathophysiology of spasmodic dysphonia. Implications for Practice A 3-tiered approach, involving a questionnaire, followed by speech assessment and nasolaryngoscopy is the most widely accepted method for making the diagnosis in most cases. More experimental and invasive techniques such as electromyography and neuroimaging have been explored to further characterize spasmodic dysphonia and aid in diagnosing difficult cases.

Perceptions of Voice Therapy From Patients Diagnosed With Primary Muscle Tension Dysphonia and Benign Mid-Membranous Vocal Fold Lesions

2014 ◽  
Vol 28 (6) ◽  
pp. 742-752 ◽  
Author(s):  
Aaron Ziegler ◽  
Christina Dastolfo ◽  
Rita Hersan ◽  
Clark A. Rosen ◽  
Jackie Gartner-Schmidt
Keyword(s):  
Vocal Fold ◽  
Muscle Tension ◽  
Voice Therapy ◽  
Muscle Tension Dysphonia

Muscle Tension Dysphonia as a Sign of Underlying Glottal Insufficiency

2002 ◽  
Vol 127 (5) ◽  
pp. 448-451 ◽  
Author(s):  
Peter C. Belafsky ◽  
Gregory N. Postma ◽  
Todd R. Reulbach ◽  
Bradford W. Holland ◽  
James A. Koufman
Keyword(s):  
Vocal Fold ◽  
Muscle Tension ◽  
Voice Disorder ◽  
Vocal Function ◽  
Muscle Tension Dysphonia ◽  
The Face ◽  
Organic Condition ◽  
Glottal Insufficiency ◽  
Organic Voice Disorder ◽  
Male Subjects

BACKGROUND: Hyperkinetic vocal function (muscle tension dysphonia) may be an indication of underlying glottal insufficiency. In the face of an organic voice disorder such as presbylaryngis or vocal fold paresis. Hyperkinetic laryngeal behaviors may be used to achieve glottal closure. Such compensatory laryngeal behaviors may mask the correct underlying diagnosis. OBJECTIVE We sought to evaluate the association between vocal fold bowing due to presbylaryngis and abnormal muscle tension patterns (MTPs). METHODS: One hundred consecutive volunteers >40 years old were prospectively evaluated. All underwent a comprehensive head and neck examination that included transnasal fiberoptic laryngoscopy with videostroboscopy. Abnormal MTPs were compared in subjects with and without vocal fold bowing. RESULTS: The mean age of the cohort was 61 years. Eighty-four percent (42 of 50) of the male subjects and 60% (30 of 50) of female subjects had evidence of vocal fold bowing. Of the 72 patients with bowing, 94% (68 of 72) had abnormal MTPs. Compared with subjects without vocal fold bowing, persons with bowing were 17 times more likely to exhibit abnormal MTPs (P < 0.001). CONCLUSIONS: Abnormal MTPs are common in persons with underlying glottal insufficiency. Patients with vocal fold bowing are 17 times more likely to exhibit abnormal MTPs (95% confidence interval, 4.9 to 59.4). Clinicians should be aware that compensatory hyperkinetic laryngeal behaviors may mask an underlying organic condition.

A Study of Fat Tissue Used in Vocal Fold Injection Augmentation

2019 ◽  
Vol 70 (2) ◽  
pp. 190-190
Author(s):  
E. Tamura ◽  
S. Niimi ◽  
S. Kanou ◽  
Y. Wada ◽  
M. Iida ◽  
...  
Keyword(s):  
Vocal Fold ◽  
Fat Tissue ◽  
Vocal Fold Injection

Vocal Fold Injection Augmentation for Post-Airway Reconstruction Dysphonia: A Case Series

2021 ◽  
pp. 000348942110125
Author(s):  
Mathieu Bergeron ◽  
John Paul Giliberto ◽  
Meredith E. Tabangin ◽  
Alessandro de Alarcon
Keyword(s):  
Vocal Fold ◽  
Care Center ◽  
Case Series ◽  
Retrospective Chart Review ◽  
Pediatric Care ◽  
Voice Perception ◽  
Perceptual Evaluation ◽  
Airway Reconstruction ◽  
Vocal Fold Injection ◽  
History Of

Objectives: Post airway reconstruction dysphonia (PARD) is common and has a significant effect on the quality of life of patients. Vocal fold injection augmentation (VFIA) is one treatment that can be used to improve glottic insufficiency in some patients. The goal of this study was to characterize the use and outcomes of VFIA for PARD. Methods: Retrospective chart review from January 2007 to July 2018 at a tertiary pediatric care center. Consecutive patients with PARD who underwent VFIA, who had a preoperative voice evaluation and a follow-up evaluation within 3 months after VFIA (fat, carboxymethylcellulose gel, hyaluronic acid). Results: Thirty-four patients (20 female) underwent VFIA. The mean age at the time of the injection was 13.6 years (SD 6.1). Twenty patients (58.8%) had a history of prematurity and a mean of 1.8 open airway surgeries. After injection, 29/34 patients (85.3%) noted a subjective voice improvement. The baseline Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) overall severity score decreased by a mean of 5.7 (SD = 19.6) points, P = .12. Total pediatric Voice Handicap Index (pVHI) improved by 6.0 (SD = 19.5) points, from 57.4 (SD = 20.0) to 51.4 (SD = 17.2), P = .09. Functional pVHI subscore demonstrated a significant improvement, with a decrease of 3.4 (SD = 7.3) points, P = .02. All procedures were performed as an overnight observation and no complication occurred. Conclusion: Patients with PARD represent a complex subset of patients. VFIA is a straightforward intervention that may improve voice perception. Many patients reported subjective improvement despite minimal objective measurement. Further work is warranted to elucidate the role of injection in management of PARD

Muscle Tension Dysphonia: A Rationale for Symptomatic Subtypes, Expedited Treatment, and Increased Therapy Compliance

2015 ◽  
Vol 25 (1) ◽  
pp. 5-15 ◽  
Author(s):  
Martin L. Spencer
Keyword(s):  
Interest Group ◽  
Special Interest ◽  
Muscle Tension ◽  
Special Interest Group ◽  
Patient Awareness ◽  
Muscle Tension Dysphonia ◽  
Variable Nature ◽  
Therapy Compliance

This article will briefly identify the variable nature of muscle tension dysphonia (MTD). Causes such as psychogenicity and maladaptive “vocal posture” will be described and questioned. Special Interest Group (SIG) 3 members may benefit from identification of the strengths and weaknesses of an ongoing movement towards a symptomatically generic “MTD.” More specific subtyping of MTD into 9 categories will be proposed, as well as description of associated therapy methods. Increased patient awareness that some subtypes may be self-correctable could simplify intervention, increase compliance, and improve clinician and researcher effectiveness.

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