Electrotherapy and the Human Voice: A Literature Review of the Historical Origins and Contemporary Applications

SUMMARY

The present article surveys the literature on the electrotherapy treatment for voice disorders from the mid-18th century to World War I (1914--1918) and the post 1970s reappearance of such therapies. The reappearance of electrotherapy as treatment for voice disorders in the past 20 years has been heralded as a major breakthrough. In light of our reading of the scientific literature of the 19th century, it can be shown to repeat many of the presuppositions of electrotherapists of that time. The current resurgence of interest and research in electrical stimulation of the larynx is buoyed by technological innovations analogous to those in the 19th century. Although the current state of research has enhanced our understanding of vocal fold physiology, it does not necessarily provide a new therapeutic approach as a survey of the most recent literature shows.

Die Behandlung laryngealer Bewegungsstörungen mit Botulinumtoxinen

Laryngeal dystonia (spasmodic dysphonia) is a movement disorder characterised by involuntary contractions of the laryngeal muscles involved in vocalisation. The introduction of botulinum toxin (BTX) in the treatment of laryngeal dystonia had a major clinical impact due to the striking improvement of symptoms. In general, BTX can be delivered by percutaneous injection or by the transoral route. The subcutaneous method is simple, but the effects of the transoral injection, applied through a curved device or by use of a flexible nasolaryngoscope with a working channel and visual control, might be more effective. However, for various reasons the transoral route does not work in every patient. We report our experiences using these different techniques for the monitoring of patients and their treatment with botulinum toxin in laryngeal movement disorders.

[Treatment of laryngeal movement disorders with botulinum toxins: part 1: History and mode of action]

Laryngeal dystonia (spasmodic dysphonia) is a movement disorder characterised by involuntary contractions of the laryngeal muscles involved in vocalisation. The introduction of botulinum toxin (BTX) in the treatment of laryngeal dystonia had a major clinical impact due to the striking improvement of symptoms. Most patients with severe types of spasmodic dysphonia are treated with injections of botulinum toxin type A. For patients with a resistance against type A toxin there is a new hypercleaned type A toxin or type B available. Research on type F toxin is also underway. In this article, the history of botulinum toxin, its therapeutic activity and possibilities for its use are described.

History and Principles of Exercise-Based Therapy: How They Inform Our Current Treatment

Exercises designed to strengthen muscles involved in respiration, phonation, and articulation play a key role in the remediation of voice and swallowing disorders. This article presents exercise physiology principles that are beginning to be used by a small group of speech and swallowing researchers to undergird their efficacy-based studies of exercise-based therapy. Three principles--contraction type, task specificity, and overload--are used to compare past exercise-based therapies with present therapies. Comparisons are made between today's methods and Oskar Guttmann's (1893) principles for strengthening muscles of respiration, Emil Froeschels' (1944) therapy to improve laryngeal function, and the myofunctional therapy of the 1960s to improve swallowing and articulation.

Notes on voice and speech disorders in ancient and Byzantine Greece

Voice and speech were considered important by the Ancient and Byzantine Greeks and their disorders were examined and treated on a reasoned basis, without prejudice, by such famous doctors and practitioners of these periods as Hippocrates, Aristotle, Galen, Orebassius and Paul the Aeginitian. In this article, we present the voice and speech disorders which were described and analysed in the texts of Ancient and Byzantine Greek doctors and historians.

[Voice pathology in the history of medicine]

This article, which will be followed by others dealing with the same subject, is mainly concerned with the outstanding figures of Ippocrathes of Cos and Galenus as far as voice treatment in Greek medicine and under the Roman Empire is concerned. But apart from them, many writers and scientists such as Homer, Democritus, Plato, Celsius Scribonius Largus, not to mention Plinius, Discorides and Martialis dealt with this topic. In addition, the article will briefly deal with the ancient Egyptian medicine as well as with the Indian one.

Botulinum toxin in the treatment of adductor spasmodic dysphonia

Spasmodic dysphonia (SD) is a voice disorder that causes marked disability in the affected individual because of the severe disruption of normal communication that the disorder creates. Of the two distinct types, adductor and abductor SD, the adductor type is the most common and the most amenable to treatment. It is felt to be a neurological problem, but the specific lesion has not been found. The best treatment for adductor SD is injection of botulinum toxin into the thyroarytenoid muscles of the larynx.

Spasmodic dysphonia

Few speech disorders have been more controversial as to etiology and treatment as spasmodic dysphonia. This article reviews the historical background and origins of spasmodic dysphonia theories and the legacy of their implications on the current treatment of afflicted patients. The evolution and impact of "organic theories" is discussed and a personal perspective on the central nervous system investigations performed by the authors is briefly elucidated and their practical experience in managing spasmodic dysphonia patients is offered for the reader's consideration.