Consistency of Voice Produced by Patients With Adductor Spasmodic Dysphonia

Adductor spasmodic dysphonia (ADSD) is an idiopathic focal laryngeal movement disorder causing involuntary and uncontrollable spasms in the vocal fold musculature, primarily during voice onset. Although phonatory instability has been reported through clinical observation and empirical study, no examination of phonatory performance consistency in ADSD has been done. Phonatory instability refers to phonatory unsteadiness and has been previously defined by the presence of acoustic aberrations during speech. Performance consistency pertains to variations in these phonatory aberrations across repeated trials or over time. This study focused on the phonatory performance consistency of those with ADSD by using three acoustic measures of phonatory instability. Twenty patients with ADSD were recorded during three trials of reading a standard passage. Eight of the 20 patients were recorded twice during two separate recording sessions held approximately 6 months apart.The number of phonatory breaks, frequency shifts, and aperiodic segments were the dependent measures. Data were subjected to inferential statistical analysis to test for significant differences among the measures in two conditions: across three trials produced within one recording session and across multiple trials produced during two distinct recording sessions. No significant differences were found for any of the measures either as a function of trials recorded on the same day or across the two recording sessions. The data suggest a need for describing phonatory instability and performance consistency as separate entities with regard to neurological voice disorders.

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Cross-Innervation of the Thyroarytenoid Muscle by a Branch from the External Division of the Superior Laryngeal Nerve

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348949710600712 ◽

1997 ◽

Vol 106 (7) ◽

pp. 594-598 ◽

Cited By ~ 41

Author(s):

Sina Nasri ◽

Joel A. Sercarz ◽

Pouneh Beizai ◽

Young-Mo Kim ◽

Ming Ye ◽

...

Keyword(s):

Vocal Fold ◽

Superior Laryngeal Nerve ◽

Laryngeal Nerve ◽

Spasmodic Dysphonia ◽

Clinical Implications ◽

Motor Innervation ◽

Vocal Fold Vibration ◽

Adductor Spasmodic Dysphonia ◽

Thyroarytenoid Muscle ◽

Stimulation Of

The neuroanatomy of the larynx was explored in seven dogs to assess whether there is motor innervation to the thyroarytenoid (TA) muscle from the external division of the superior laryngeal nerve (ExSLN). In 3 animals, such innervation was identified. Electrical stimulation of microelectrodes applied to the ExSLN resulted in contraction of the TA muscle, indicating that this nerve is motor in function. This was confirmed by electromyographic recordings from the TA muscle. Videolaryngostroboscopy revealed improvement in vocal fold vibration following stimulation of the ExSLN compared to without it. Previously, the TA muscle was thought to be innervated solely by the recurrent laryngeal nerve. This additional pathway from the ExSLN to the TA muscle may have important clinical implications in the treatment of neurologic laryngeal disorders such as adductor spasmodic dysphonia.

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Laryngeal Framework Surgery in the Management of Spasmodic Dysphonia

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348948909800111 ◽

1989 ◽

Vol 98 (1) ◽

pp. 52-54 ◽

Cited By ~ 34

Author(s):

Harvey M. Tucker

Keyword(s):

Vocal Fold ◽

Vocal Folds ◽

Long Term Results ◽

Spasmodic Dysphonia ◽

Management Problem ◽

Cure Rate ◽

Adductor Spasmodic Dysphonia ◽

Laryngeal Framework Surgery ◽

Selective Lysis

Spasmodic dysphonia continues to be a management problem for otolaryngologists. Selective lysis of the recurrent laryngeal nerve has been useful in the management of this disease. Reported long-term results, however, reveal that spasm recurs in approximately 40% to 50% of initially successful patients in spite of persistence of the unilateral vocal fold paralysis. Although some of these failures can be recaptured with subsequent laser surgery, the overall “cure” rate does not exceed 70%, even in the best hands. The contributions of Isshiki, LeJeune, and Tucker have demonstrated that tension in the vocal folds can be adjusted by laryngeal framework surgery. Experience with 16 patients suffering from adductor spasmodic dysphonia suggests that laryngeal framework surgery is useful in the management of this disorder.

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Artificial Intelligence Application for Vocal Fold Disease Prediction Through Voice Recognition: Development and Usability Study (Preprint)

10.2196/preprints.25247 ◽

2020 ◽

Author(s):

Hao-Chun Hu ◽

Shyue-Yih Chang ◽

Chuen-Heng Wang ◽

Kai-Jun Li ◽

Hsiao-Yun Cho ◽

...

Keyword(s):

Neural Network ◽

Artificial Intelligence ◽

Primary Care ◽

Convolutional Neural Network ◽

Vocal Fold ◽

Voice Recognition ◽

Spasmodic Dysphonia ◽

Adductor Spasmodic Dysphonia ◽

Normal Voice ◽

Pathological Voice

BACKGROUND Dysphonia influences the quality of life by interfering with communication. However, laryngoscopic examination is expensive and not readily accessible in primary care units. Experienced laryngologists are required to achieve an accurate diagnosis. OBJECTIVE This study sought to detect various vocal fold diseases through pathological voice recognition using artificial intelligence. METHODS We collected 29 normal voice samples and 527 samples of individuals with voice disorders, including vocal atrophy (n=210), unilateral vocal paralysis (n=43), organic vocal fold lesions (n=244), and adductor spasmodic dysphonia (n=30). The 556 samples were divided into two sets: 440 samples as the training set and 116 samples as the testing set. A convolutional neural network approach was applied to train the model and findings were compared with human specialists. RESULTS The convolutional neural network model achieved a sensitivity of 0.70, a specificity of 0.90, and an overall accuracy of 65.5% for distinguishing normal voice, vocal atrophy, unilateral vocal paralysis, organic vocal fold lesions, and adductor spasmodic dysphonia. Compared to human specialists, the overall accuracy was 58.6% and 49.1% for the two laryngologists, and 38.8% and 34.5% for the two general ear, nose, and throat doctors. CONCLUSIONS We developed an artificial intelligence-based screening tool for common vocal fold diseases, which possessed high specificity after training with our Mandarin pathological voice database. This approach has clinical potential to use artificial intelligence for general vocal fold disease screening via voice and includes a quick survey during a general health examination. It can be applied in telemedicine for areas that lack laryngoscopic abilities in primary care units.

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Partial Thyroarytenoid Myectomy: An Animal Study Investigating a Proposed New Treatment for Adductor Spasmodic Dysphonia

Otolaryngology ◽

10.1177/019459989310800309 ◽

1993 ◽

Vol 108 (3) ◽

pp. 256-264 ◽

Cited By ~ 26

Author(s):

Sheldon H. Genack ◽

Peak Woo ◽

Raymond H. Colton ◽

Donna Goyette

Keyword(s):

Recurrent Laryngeal Nerve ◽

Nerve Stimulation ◽

Vocal Fold ◽

Compound Muscle Action Potential ◽

Contralateral Side ◽

Laryngeal Nerve ◽

Spasmodic Dysphonia ◽

True Vocal Cord ◽

Laryngeal Function ◽

Adductor Spasmodic Dysphonia

A new surgical procedure with potential application for the treatment of adductor spasmodic dysphonia was performed on ten rabbits to assess surgical effects on laryngeal function. Using an external approach, partial unilateral thyroarytenoid (TA) muscle excision was performed through a thyroplasty cartilage window. The contralateral side was left undisturbed as a control. The animals were studied acutely and at 3 months using videolaryngoscopy. Electrophysiologic measurements were recorded at 3 months. The procedure was well tolerated by all animals, with no postoperative infection or aspiration. At 3 months, spontaneous and evoked (recurrent laryngeal nerve stimulation) TA muscle electromyographic potentials were measurable bilaterally. TA compound muscle action potential amplitudes were reduced on the side of myectomy. The threshold of recurrent laryngeal nerve stimulation needed to produce observable vocal fold adduction was increased on the side operated on. Perioperative and long-term (3 months) videolaryngoscopy demonstrated preservation of laryngeal competence with good true vocal cord adduction. Histologic analysis with whole organ sections showed replacement of excised muscle with loose fibroareolar tissue. No evidence of muscle regeneration was observed. The vocal ligament and vocal fold mucosa were intact and undistorted in all specimens. This procedure is technically simple and appears to effectively result in a functional yet weakened TA muscle. Because myectomy includes motor unit end-plate excision, problems associated with reinnervation may be circumvented. TA myectomy may be applicable in patients with focal laryngeal dystonia to decrease muscle spasm.

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Acoustic Variations in Adductor Spasmodic Dysphonia as a Function of Speech Task

Journal of Speech Language and Hearing Research ◽

10.1044/jslhr.4201.127 ◽

1999 ◽

Vol 42 (1) ◽

pp. 127-140 ◽

Cited By ~ 23

Author(s):

Christine M. Sapienza ◽

Suzanne Walton ◽

Thomas Murry

Keyword(s):

High Reliability ◽

Spasmodic Dysphonia ◽

Vowel Production ◽

Acoustic Parameters ◽

Frequency Shifts ◽

Speech Task ◽

Acoustic Event ◽

Adductor Spasmodic Dysphonia ◽

Reading Frequency

Acoustic phonatory events were identified in 14 women diagnosed with ADSD and compared to those of 14 women age-matched (±2 years) with no evidence of vocal pathology/dysfunction. The three acoustic parameters examined during sustained vowel production and reading included phonatory breaks, aperiodicity, and frequency shifts. Intra- and intermeasurer correlations showed high reliability for the measures. Findings indicated that those with ADSD produced a greater frequency of aberrant acoustic events than the controls during both tasks. For the group with ADSD, the amount and type of each event also varied with utterance type. The sustained vowel sample produced by those with ADSD consisted of a greater percentage of aperiodic segments followed by phonatory breaks and frequency shifts. During reading, frequency shifts were the predominant acoustic event, followed by phonatory breaks and aperiodicity. The advantage of segmenting the acoustic waveform into these measures and the relevancy of examining intertask performances by those with ADSD is discussed.

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