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Lee HK, Bonilha HS, Hong I. Relationship Between Voice Problems and Depression Among American Adults. Otolaryngol Head Neck Surg 2024. [PMID: 39342505 DOI: 10.1002/ohn.946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Revised: 07/01/2024] [Accepted: 08/03/2024] [Indexed: 10/01/2024]
Abstract
OBJECTIVE Voice problems have a large impact on quality-of-life and societal participation. It has been previously reported that persons with voice problems have a higher likelihood of depression than those without voice problems. Despite this knowledge, little has changed in clinical practice related to screening for depression or incorporating the presence of depression in treatment planning. This study aims to provide an updated analysis of the prevalence of depressive symptoms in persons with voice disorders to elucidate the current magnitude of the relationship in hopes that this will provoke greater awareness of the co-occurrence of voice problems and depression and improve clinical care. STUDY DESIGN Cross-sectional design with a national survey. SETTING None. METHODS The study examined the 23,706 adults from the 2022 National Health Interview Survey database. A series of logistic regression models with propensity score matching approaches were used to examine the association between voice problems and depression by accounting for demographics and health conditions. RESULTS When comparing persons with and without voice problems, there were statistical differences in demographics and health conditions (all P < .05); however, those differences were balanced by propensity score matching methods (all P > .05). The balanced samples revealed that those with voice problems were approximately twice as likely to experience depressive symptoms (odds ratios ranged from 1.532 to 2.024, all P < .05) compared to those without voice problems. Depressive symptoms increased with the severity (P < .0001) and duration of the voice problem (P = .0328). CONCLUSION The study found robust associations between voice problems and depression within the current American adult population in 2022. To achieve optimal treatment outcomes, it is critical that the co-occurrence of voice problems and depression is understood, and that treatment planning addressed both conditions, when applicable.
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Affiliation(s)
- Ho Kyung Lee
- Department of Occupational Therapy, Graduate School, Yonsei University, Wonju, Republic of Korea
| | - Heather Shaw Bonilha
- Communication Sciences and Disorders, University of South Carolina, Columbia, South Carolina, USA
| | - Ickpyo Hong
- Department of Occupational Therapy, College of Software and Digital Healthcare Convergence, Yonsei University, Wonju, Republic of Korea
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Heyes R, Adler CH, Yee C, Lott DG, Karle WE. Analgesia in Transcutaneous Laryngeal Botulinum Toxin Injections: A Randomized Crossover Trial. Laryngoscope 2024; 134:2277-2281. [PMID: 38157199 DOI: 10.1002/lary.31208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 10/25/2023] [Accepted: 11/16/2023] [Indexed: 01/03/2024]
Abstract
OBJECTIVES There is an absence of data in the literature regarding methods to improve the patient experience during the performance of awake in-office laryngeal injections. This study sought to evaluate whether the use of local anesthetic or a vibrating instrument decreased overall pain experienced by patients with laryngeal dystonia, frequently referred to as spasmodic dysphonia (SD), undergoing transcervical botulinum toxin injections. METHODS This was an unblinded, prospective randomized control trial with a crossover design where each patient received transcutaneous transcricothyroid injection of botulinum toxin with alternating use of no anesthesia, local anesthesia (2% lidocaine in 1:100,000 epinephrine), and vibrating instrument in three consecutive laryngeal injections to treat adductor SD. Patients were randomized to the order they received these treatments. Patients measured pain on a 0-10 visual analogue scale (VAS) and selected their preferred technique after receiving all three analgesic modalities. RESULTS Thirty-two patients completed the study. There was no statistically significant difference in pain between the three analgesic techniques (p = 0.38). The most preferred analgesic technique was the vibrating wand (44% (14/32)). Lidocaine was the second most preferred (37% (12/32)) and 19% (6/32) of patients preferred nothing. When combining the wand and nothing groups, 63% of patients preferred one of these two methods (95% exact CI: 44%-79%). CONCLUSION There was no statistically significant difference in median pain experienced by patients during laryngeal botulinum toxin injection between these different analgesic modalities. More than half of the patients selected a preference for a technique that did not include lidocaine. This data supports individualization of analgesia during transcutaneous laryngeal injections. LEVEL OF EVIDENCE 2 Laryngoscope, 134:2277-2281, 2024.
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Affiliation(s)
- Richard Heyes
- Department of Otorhinolaryngology-Head and Neck Surgery, Mayo Clinic Arizona, Phoenix, Arizona, U.S.A
| | - Charles H Adler
- Department of Neurology, Mayo Clinic Arizona, Phoenix, Arizona, U.S.A
| | - Claire Yee
- Department of Biostatistics and Bioinformatics, Mayo Clinic Arizona, Phoenix, Arizona, U.S.A
| | - David G Lott
- Department of Otorhinolaryngology-Head and Neck Surgery, Mayo Clinic Arizona, Phoenix, Arizona, U.S.A
| | - William E Karle
- Department of Otolaryngology, Northwell, New Hyde Park, NY, U.S.A
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Reid EW, Nobriga CV. Spasmodic dysphonia: introductory phonetic analyses. CLINICAL LINGUISTICS & PHONETICS 2023; 37:883-898. [PMID: 35818753 DOI: 10.1080/02699206.2022.2096483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 05/16/2022] [Accepted: 06/27/2022] [Indexed: 06/15/2023]
Abstract
Adductor spasmodic dysphonia (ADSD) is a neurological dystonia characterised by involuntary adductor spasms of the larynx during speech. Spasm frequency is often reported to increase during syllables that begin with voiced speech sounds, especially glottal stops. Because of its underlying physical and acoustic complexities, the voicing contrast in American English (AE) appears unlikely to interact consistently with a singular physical phenomenon like laryngeal spasm. This retrospective study investigated additional phonetic contrasts and their relationship to spasm frequency. Standardised, 144-word recordings of 36 participants with adductor spasmodic dysphonia were analysed. Productions were coded for rater-perceived syllable stress, voiced/voiceless onset, vowel/consonant onset, and word-onset place and manner of production. Phonetic contexts were compared using independent sample t-tests and Kruskal-Wallis statistics. Contexts in which spasm varied significantly included stressed/unstressed syllables, content/function words, and multisyllabic/monosyllabic words. Study results reaffirm the clinical usefulness of standardised ADSD/ABSD sentences during differential diagnosis but conflict with previous studies that report a connection between ADSD spasm and phoneme voicing.
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Affiliation(s)
- Eric W Reid
- School of Allied Health, Communication Sciences & Disorders Department, Loma Linda University, Loma Linda, California, USA
| | - Christina V Nobriga
- School of Allied Health, Communication Sciences & Disorders Department, Loma Linda University, Loma Linda, California, USA
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Ravi S, Lopez V, Carter KV, Sharpe SA, George D, Ebersole B, Machiorlatti M, Jamal N. Intersection of Mental Health and Dysphonia: A Scoping Review. J Voice 2023:S0892-1997(23)00130-3. [PMID: 37210321 DOI: 10.1016/j.jvoice.2023.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 04/11/2023] [Accepted: 04/11/2023] [Indexed: 05/22/2023]
Abstract
OBJECTIVE Previous research has indicated that voice disorders frequently co-occur with mental health disorders, which may influence voice treatment seeking behavior and effectiveness. Our goal is to characterize the existing literature on the relationship between voice disorders and mental health and to investigate nuances related to mental health and voice disorder diagnosis. DATA SOURCES Ovid MEDLINE, ProQuest PsycINFO, and Web of Science. REVIEW METHODS Using the PRISMA protocol, a scoping review was performed. Databases searched included: Ovid MEDLINE, ProQuest PsycINFO, and Web of Science. Our inclusion criteria were all adults seen in an outpatient setting for voice and mental health disorders, excluding those with a prior history of head and neck surgery, cancers, radiation, or developmental anomalies, and certain mental health disorders. Results were screened by two independent screeners for inclusion. Data were then extracted and analyzed to present key findings and characteristics. RESULTS A total of 156 articles, with publication dates ranging from 1938 to 2021, were included in the analysis, with females and teachers being the most described population groups. The most frequently studied laryngeal disorders were dysphonia (n = 107, 68.6%), globus (n = 33, 21.2%), and dysphonia with globus (n = 16, 10.2%). The two most common mental health disorders found in the included studies were anxiety disorders (n = 123, 78.8%) and mood disorders (n = 111, 71.2%). The Voice Handicap Index was the most used tool to gather data on voice disorders (n = 36, 23.1%), while the Hospital Anxiety and Depression Scale was the most used tool to gather data on mental health disorders (n = 20, 12.8%). The populations studied within the included articles were predominately female and worked in educational occupations. Race and ethnicity was only reported for 10.2% of included articles (n = 16) and the most commonly studied race was White/Caucasian (n = 13, 8.3%). CONCLUSION Our scoping review of the current literature on mental health and voice disorders reveals an intersection between the conditions. The current literature represents change over time in terms of terminology that recognizes the patient's individualized experience of mental health and laryngeal conditions. However, there is still a great deal of homogeneity in the studied patient populations in terms of race and gender, with patterns and gaps that require further investigation.
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Affiliation(s)
- Saisree Ravi
- School of Medicine, The University of Texas Rio Grande Valley, Edinburg, Texas.
| | - Vanessa Lopez
- School of Medicine, The University of Texas Rio Grande Valley, Edinburg, Texas
| | - Kathleen V Carter
- School of Medicine, The University of Texas Rio Grande Valley, Edinburg, Texas
| | - Stephanie A Sharpe
- School of Medicine, The University of Texas Rio Grande Valley, Edinburg, Texas
| | - Deepu George
- School of Medicine, The University of Texas Rio Grande Valley, Edinburg, Texas
| | - Barbara Ebersole
- Department of Head and Neck Surgery, Speech Pathology and Audiology Section, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | | | - Nausheen Jamal
- School of Medicine, The University of Texas Rio Grande Valley, Edinburg, Texas
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Vilaseca I, Hidalgo J, Cámara A, Compta Y, Martí MJ. Non-motor symptoms in spasmodic dysphonia: A case control-study. Auris Nasus Larynx 2021; 49:100-105. [PMID: 34092434 DOI: 10.1016/j.anl.2021.05.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 04/30/2021] [Accepted: 05/18/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Non-motor symptoms (NMS) have been identified in some focal adult-onset dystonia. In the present study we aimed to evaluate the presence of NMS in patients with spasmodic dysphonia (SD), a focal action-induced dystonia that affects intrinsic laryngeal muscle control. METHODS Seventeen SD patients and 17 control subjects not significantly different in age and sex were evaluated for the presence of NMS. Additionally, voice handicap index (VHI-10), reflux symptom index, neuropsychiatric symptoms and QoL were assessed by validated scales and questionnaires. RESULTS Patients' group significantly differed from control group in mild depressive symptoms (4.35 ± 3.9 vs. 1.47 ± 2; p=0.01), insomnia (35.3% vs. 14.7%; p=0.016), smell and taste loss (11.8% vs. 0%; p=0.033), swallowing difficulties (17.6% vs. 0%; p=0.007) and throat pain (17.6% vs. 0%; p=0.007). In the group of SD, there was no correlation between voice perception evaluated by VHI-10, number of NMS or QoL. CONCLUSION Patients with SD have a greater burden of depressive, smell, taste, and sleep NMS than control subjects.
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Affiliation(s)
- Isabel Vilaseca
- Otorhinolaryngology Department, Hospital Clínic, Barcelona, Spain; Faculty of Medicine, University of Barcelona, Barcelona, Spain; Institut d'Investigació Biomèdica Agustí Pi Sunyer (IDIBAPS), Barcelona, Spain; CIBERNED: CB06/05/0018-ISCIII, ERN-RND (ID No 739510), Barcelona, Spain.
| | - Judit Hidalgo
- Faculty of Medicine, University of Barcelona, Barcelona, Spain
| | - Ana Cámara
- Institut d'Investigació Biomèdica Agustí Pi Sunyer (IDIBAPS), Barcelona, Spain; CIBERNED: CB06/05/0018-ISCIII, ERN-RND (ID No 739510), Barcelona, Spain; Parkinson's disease and Movement Disorders Unit, Neurology Service, Hospital Clinic Barcelona, Universitat de Barcelona
| | - Yaroslau Compta
- Institut d'Investigació Biomèdica Agustí Pi Sunyer (IDIBAPS), Barcelona, Spain; CIBERNED: CB06/05/0018-ISCIII, ERN-RND (ID No 739510), Barcelona, Spain; Parkinson's disease and Movement Disorders Unit, Neurology Service, Hospital Clinic Barcelona, Universitat de Barcelona
| | - María José Martí
- Institut d'Investigació Biomèdica Agustí Pi Sunyer (IDIBAPS), Barcelona, Spain; CIBERNED: CB06/05/0018-ISCIII, ERN-RND (ID No 739510), Barcelona, Spain; Parkinson's disease and Movement Disorders Unit, Neurology Service, Hospital Clinic Barcelona, Universitat de Barcelona
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Karatayli Ozgursoy S, Vargas ER, Heckman MG, Rutt AL. Demographics and coexisting tremor, cervical dystonia and vocal fold disorders in a group of patients with spasmodic dysphonia. ACTA OTORHINOLARYNGOLOGICA ITALICA 2020; 40:198-203. [PMID: 32773781 PMCID: PMC7416374 DOI: 10.14639/0392-100x-n0284] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 10/18/2019] [Indexed: 11/25/2022]
Abstract
The primary aim of this study is to describe the demographic and clinical characteristics of a group of patients with spasmodic dysphonia (SD). As a secondary aim, we examined associations of age at SD diagnosis and sex with co-existing cervical dystonia and nonvocal tremor; as well as association of vocal tremor with sex and nonvocal tremor. Seventy-four consecutive patients who were treated for SD at the Mayo Clinic in Jacksonville, Florida between October 1, 2015 and March 31, 2018 were included in this retrospective study. Information was collected regarding sex, age at SD diagnosis, BMI, SD diagnosis type, recent history of major stress/depression, recent history of upper respiratory tract infection (URTI), co-existing neurological diseases, and co-existing vocal disorders. The majority of patients were female (75.7%) and median age at SD diagnosis was 61 years (range: 17 – 80 years). The median BMI was 25.7 (range: 16.9 – 63.7). The most common diagnostic combinations were adductor dysphonia only (52.7%), adductor dysphonia and MTD (18.9%), and adductor dysphonia and tremor (17.6%). Co-existing tremor was present in 36.6% of patients and cervical dystonia was present in 15.5%. Co-existing vocal disorders were observed as follows: paresis/paralysis (3.1%), cyst (3.1%), mass (4.7%), polyp (1.6%), and anterior glottis web (1.6%). Sex was not notably associated with either cervical dystonia or nonvocal tremor (all P ≥ 0.30). Older age at SD diagnosis was significantly associated with cervical dystonia (P = 0.049), but not nonvocal tremor (P = .22). Other than co-existing tremor, most patients had no co-existing neurological diseases or vocal disorders. Additionally, patients who were older at SD diagnosis were significantly more likely to have co-existing cervical dystonia.
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Trajano FMP, Almeida LNA, de Alencar SAL, Braga JEF, Almeida AA. Group Voice Therapy Reduces Anxiety in Patients With Dysphonia. J Voice 2019; 34:702-708. [PMID: 30979532 DOI: 10.1016/j.jvoice.2019.03.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 02/26/2019] [Accepted: 03/12/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To evaluate the impact of group therapy in patients with dysphonia, as well as to verify the correlation between vocal symptoms and levels of anxiety. METHODS The study was composed of 52 patients subdivided into two groups, named the Experimental Group (EG) with 28 volunteers and the Control Group (CG) with 24 volunteers. Anxiety and voice protocols were used for data collection. The State-Trait Anxiety Inventory (STAI) was used to measure trait levels of anxiety that after collection were categorized according to the variation in scores value: low anxiety (20-40 points); average anxiety (40-60 points); high anxiety (60-80 points). In addition, the Voice Symptom Scale (VoiSS) was used for voice assessment. Inferential statistical analysis from the Student's t test for paired and independent data, in order to compare the average scores of STAI trait levels and VoiSS domains of the pre- and postmoments, intra- and intergroups, EG and CG, respectively. For that purpose, the program Statistical Package for Social Sciences (SPSS) was used. RESULTS Half of the patients in the survey presented an average trait level of anxiety. Regarding the EG, there was a significant reduction of state anxiety when comparing the moments before and after group therapy. There was also a significant reduction in the values of the VoiSS-Total and VoiSS-Physical domains when compared to the pre- and postgroup therapy moments. It was verified the existence of a positive correlation between the levels of anxiety after group therapy and VoiSS-Total, VoiSS-Limitation, and VoiSS-Physical domains. As for the CG, there was an increase in anxiety levels as well as in all domains of the VoiSS scale when compared to the pre- and postmoments. CONCLUSIONS Group voice therapy was effective for a significant reduction of vocal symptoms and anxiety - common conditions in patients with dysphonia. It was possible to perceive the positive correlation between anxiety levels and vocal symptoms.
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Affiliation(s)
- Flávia Maiele Pedroza Trajano
- Cognitive Neuroscience and Behavior at the Federal University of Paraíba (Universidade Federal da Paraíba - UFPB), João Pessoa, Brazil; Decision and Health Models, UFPB, João Pessoa, Brazil
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Clinical Experience With Patients With Spasmodic Dysphonia and Primary Meige Syndrome. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2019. [DOI: 10.1016/j.otoeng.2018.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Pedrero-Escalas MF, García-López I, Santiago-Pérez S, Vivancos F, Gavilán J. Experiencia clínica en pacientes con síndrome de Meige primario y disfonía espasmódica. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2019; 70:1-5. [DOI: 10.1016/j.otorri.2017.11.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 11/19/2017] [Accepted: 11/29/2017] [Indexed: 11/29/2022]
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Hu A, Hillel A, Zhao W, Meyer T. Anxiety and depression in spasmodic dysphonia patients. World J Otorhinolaryngol Head Neck Surg 2018; 4:110-116. [PMID: 30101219 PMCID: PMC6074012 DOI: 10.1016/j.wjorl.2018.04.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Accepted: 04/17/2018] [Indexed: 12/01/2022] Open
Abstract
Objective/Hypothesis Experts used to believe that spasmodic dysphonia (SD) was a psychogenic disorder. Although SD is now established as a neurological disorder, the rates of co-morbid anxiety and depression range from 7.1% to 62%. Our objective was to study the prevalence and risk factors associated with these mood disorders in SD patients. Study design Retrospective. Methods SD patients who presented for botulinum toxin injections were recruited. Demographic data, Hospital Anxiety and Depression Scale (HADS), Voice Handicap Index-10 (VHI-10), General Self-Efficacy scale (GSES), Disease Specific Self-Efficacy in Spasmodic Dysphonia scale (DSSE), and Consensus Auditory Perceptual Evaluation of Voice (CAPE-V) were collected. Results One hundred and forty two patients (age (59.2 ± 13.6) years, 25.4% male) had VHI-10 of 26.3 ± 6.9 (mean ± standard deviation), GSES 33.2 ± 5.8, CAPE-V 43.9 ± 20.9, HADS anxiety 6.7 ± 3.7, and HADS depression 3.6 ± 2.8. About 19 (13.4%) and 4 (2.8%) had symptoms of anxiety and depression respectively. Final linear regression model for HADS anxiety (R2 = 32.90%) showed that patients who were less likely to have anxiety symptoms were older age (p < 0.001), male (p = 0.002), have higher GSES (p < 0.001) and lower VHI-10 (p = 0.004). Final linear regression model for HADS depression score (R2 = 34.42%) showed that patients who were less likely to have depressive symptoms had high DSSES (p < 0.001). Conclusions Prevalence of anxiety (13.4%) and depression (2.8%) in SD were lower than previously reported in the literature. Risk factors for anxiety were: younger age, female gender, lower general self-efficacy, and higher perceived vocal handicap. The main risk factor for depression was lower disease specific self-efficacy.
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Affiliation(s)
- Amanda Hu
- Division of Otolaryngology - Head & Neck Surgery, Department of Surgery, University of British Columbia, Vancouver, Canada
| | - Al Hillel
- Department of Otolaryngology - Head & Neck Surgery, University of Washington, Seattle, WA, USA
| | - Wei Zhao
- Albert Einstein College of Medicine, Bronx, NY, USA
| | - Tanya Meyer
- Department of Otolaryngology - Head & Neck Surgery, University of Washington, Seattle, WA, USA
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Bradley JP, Barrow EM, Hapner ER, Klein AM, Johns MM. Botulinum Toxin-A Dosing Trends for Adductor Spasmodic Dysphonia at a Single Institution Over 10 Years. J Voice 2017; 31:363-365. [DOI: 10.1016/j.jvoice.2016.09.022] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 09/17/2016] [Accepted: 09/19/2016] [Indexed: 11/25/2022]
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Hu A, Hillel A, Meyer T. Factors Associated With Patient-perceived Hoarseness in Spasmodic Dysphonia Patients. J Voice 2015; 30:769.e23-769.e26. [PMID: 26704415 DOI: 10.1016/j.jvoice.2015.11.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Accepted: 11/10/2015] [Indexed: 11/16/2022]
Abstract
OBJECTIVES/HYPOTHESIS The American Academy of Otolaryngology-Head and Neck Surgery Clinical Practice Guidelines on Hoarseness distinguishes between hoarseness, which is a symptom perceived by the patient, and dysphonia, which is a diagnosis made by the clinician. Our objective was to determine factors that are associated with patient-perceived hoarseness in spasmodic dysphonia (SD) patients. STUDY DESIGN Retrospective study. METHODS Adductor SD patients who presented for botulinum toxin injections from September 2011 to June 2012 were recruited. The main outcome variable, Voice Handicap Index-10 (VHI-10), was used to quantify patient-perceived hoarseness. Clinical data, Hospital Anxiety and Depression Scale (HADS), and VHI-10 were collected. Clinician-perceived dysphonia was measured by a speech-language pathologist with Consensus Auditory Perceptual Evaluation of Voice (CAPE-V). Statistical analysis included univariate analyses and multiple linear regression. RESULTS One hundred thirty-nine SD patients had VHI-10 score of 26.0 ± 7.2 (mean ± standard deviation), disease duration of 10.5 + 7.0 years, CAPE-V overall score of 43.2 ± 21.8, HADS anxiety score of 6.7 ± 3.8, and HADS depression score of 3.6 ± 2.8. In univariate analyses, there were positive correlations (P < 0.05) between VHI-10 and female gender, CAPE-V overall, older age, HADS anxiety, and depression. There was no correlation with professional voice use and disease duration. In multiple linear regression (R2 = 0.178, P < 0.001), age, HADS anxiety, female gender, and CAPE-V were significant. CONCLUSIONS Older age, higher anxiety levels, female gender, and clinician-perceived dysphonia are associated with higher levels of patient-perceived hoarseness in SD patients. Hoarseness is a very personal symptom. Multiple factors determine its self-perception.
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Affiliation(s)
- Amanda Hu
- Department of Otolaryngology-Head & Neck Surgery, Drexel University College of Medicine, Philadelphia, Pennsylvania.
| | - Al Hillel
- Department of Otolaryngology-Head & Neck Surgery, University of Washington, Seattle, Washington
| | - Tanya Meyer
- Department of Otolaryngology-Head & Neck Surgery, University of Washington, Seattle, Washington
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Marques da Rocha L, Behlau M, Dias de Mattos Souza L. Behavioral Dysphonia and Depression in Elementary School Teachers. J Voice 2015; 29:712-7. [PMID: 26142760 DOI: 10.1016/j.jvoice.2014.10.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Accepted: 10/22/2014] [Indexed: 11/28/2022]
Abstract
OBJECTIVE/HYPOTHESIS To verify the relationship between behavioral dysphonia and current depressive episodes in municipal elementary school teachers. We hypothesize that teachers with behavioral dysphonia will be more susceptible to psychiatric disorders. DESIGN Cross-sectional study, quantitative, conducted across municipal schools in both rural and urban regions of Pelotas. METHOD Five-hundred seventy-five teachers from urban and rural areas of the same Brazilian state were included. The full version of the Voice Handicap Index validated into Brazilian Portuguese was used to determine the presence of behavioral dysphonia. A profile of vocal behaviors was also used to quantify the number of phonotraumatic events. In addition, the Mini-International Neuropsychiatric Interview was used to determine current episodes of depression. Data were analyzed via correlative studies using chi-square and Poisson regression analyses. RESULTS Across all teachers, the prevalence of dysphonia was 33.9% and 55% reported that they had already taken a leave because of their voice. Those teachers with a current depressive episode had a higher rate of dysphonia compared with those without depression (prevalence ratio [PR] 1.66; P < 0.000). Teachers who presented with a risk of serious vocal problems had a prevalence ratio of 2.58, indicating a greater proportion of dysphonia, whereas teachers classified as champions of abuse were five times more likely compared with those teachers with behaved or candidates for voice problems. CONCLUSIONS There is an association between behavioral dysphonia and current depressive episodes in elementary school teachers.
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Affiliation(s)
- Luise Marques da Rocha
- Programa de Pós-Graduação em Saúde e Comportamento, Universidade Católica de Pelotas, Pelotas, Rio Grande do Sul, Brasil
| | - Mara Behlau
- Programa de Pós-Graduação em Distúrbios da Comunicação Humana, Universidade Federal de São Paulo, São Paulo, São Paulo, Brasil
| | - Luciano Dias de Mattos Souza
- Programa de Pós-Graduação em Saúde e Comportamento, Universidade Católica de Pelotas, Pelotas, Rio Grande do Sul, Brasil.
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Martinez CC, Cassol M. Measurement of Voice Quality, Anxiety and Depression Symptoms After Speech Therapy. J Voice 2015; 29:446-9. [DOI: 10.1016/j.jvoice.2014.09.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Accepted: 09/03/2014] [Indexed: 10/23/2022]
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Validation of a Telephone Screening Tool for Spasmodic Dysphonia and Vocal Fold Tremor. J Voice 2014; 28:711-5. [DOI: 10.1016/j.jvoice.2014.03.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2013] [Accepted: 03/17/2014] [Indexed: 11/23/2022]
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Abstract
G. Paul Moore influenced the study of spasmodic dysphonia (SD) with his 1960 publication that examined the neurological, medical, and vocal fold behavior in a group of patients with adductor spasmodic dysphonia (ADSD). This review of advances in the diagnosis and treatment of SD follows a time line of research that can be traced in part to the early work of Moore et al. This article reviews the research in ADSD over the past 50 plus years. The capstone events that brought SD to its present day level of management by laryngologists and speech-language pathologists are highlighted. A look to the future to understand more of the disorder is offered for this debilitating disorder.
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Affiliation(s)
- Thomas Murry
- Department of Otolaryngology-Head and Neck Surgery, Weill Cornell Medical College, New York, New York.
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17
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Rosow DE, Parikh P, Vivero RJ, Casiano RR, Lundy DS. Considerations for Initial Dosing of Botulinum Toxin in Treatment of Adductor Spasmodic Dysphonia. Otolaryngol Head Neck Surg 2013; 148:1003-6. [DOI: 10.1177/0194599813484685] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives To assess the effect on voice improvement and duration of breathiness based on initial dose of onabotulinum toxin A (BTX-A) in the management of adductor spasmodic dysphonia (SD) and to compare voice outcomes for initial bilaterally injected doses of 1.25 units (group A) vs 2.5 units (group B) of BTX-A. Study Design Case series with chart review of patients with adductor SD treated at a tertiary care facility from 1990 to 2011. Setting Academic subspecialty laryngology practice. Methods Demographic data (age and sex), voice rating, duration of voice improvement, and breathiness were evaluated and compared between groups A and B using the Student t test and χ2 analysis. Results Of 478 patients identified, 305 (223 in group A, 82 in group B) patients met inclusion criteria. The average age was 56.2 years in group A and 57.4 years in group B ( P = .5). The female to male ratio was 2.91 for group A vs 3.56 for group B ( P = .61). Good voice outcomes (grade 3 or 4) were reported by 91% of group A patients vs 94% of group B ( P = .75). The average duration of voice improvement was 99.7 days for group A and 108.3 days for group B ( P = .54). The average duration of breathiness was 10.88 days for group A vs 15.42 days for group B ( P = .02). Conclusion Patients injected with 1.25 units bilaterally had a statistically significant shorter duration of breathiness without a statistically significant difference in clinical effectiveness or voice outcome. It is therefore recommended that a relatively low initial BTX-A dose be used with subsequent titration to achieve improved voice outcomes.
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Affiliation(s)
- David E. Rosow
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Punam Parikh
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Richard J. Vivero
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Roy R. Casiano
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Donna S. Lundy
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, USA
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18
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Abstract
Recently research offers new insights into the pathogenesis, pathophysiology, and socioemotional implications of spasmodic dysphonia (SD). Among these advances are epidemiologic studies clarifying (1) SD onset and course, (2) SD risk factors, and (3) the relationships among SD course, treatment, and psychosocial impact. In this paper, I will provide a summary of recent epidemiologic and socioemotional research advances involving the onset, course, risk factors, and psychosocial impact of SD.
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Affiliation(s)
- Kristine Tanner
- Department of Communication Disorders, Brigham Young University Provo, Utah
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