Updates on Vocal Tremor and its Management

2012 ◽  
Vol 22 (3) ◽  
pp. 97-103 ◽  
Author(s):  
Julie Barkmeier-Kraemer
Keyword(s):  
Neurological Disorders ◽  
Botulinum Toxin Type A ◽  
Muscle Tension ◽  
Botulinum Toxin Type ◽  
Voice Disorder ◽  
Behavioral Modification ◽  
Periodic Modulation ◽  
Pharmaceutical Treatment ◽  
Muscle Tension Dysphonia ◽  
Vocal Tremor

Vocal tremor is a neurogenic voice disorder characterized by a nearly periodic modulation in pitch and loudness during sustained phonation. This voicing pattern is the result of tremor affecting structures within the speech mechanism, resulting in modulation of lung pressure, phonation, articulation, and resonance during speaking. Speaking patterns in these individuals may be perceived as similar to spasmodic dysphonia or muscle tension dysphonia. The key to determining the presence of vocal tremor and distinguishing it from other voice disorders requires familiarity with the perceptual, acoustic, and physiologic patterns associated with vocal tremor during different voicing and speech contexts. Management of those with vocal tremor can be challenging because of its co-occurrence with other neurological disorders. The two most common methods for managing vocal tremor include pharmaceutical treatment, most commonly applied via injections of Botulinum Toxin Type A (Botox®), and behavioral modification of speaking patterns. The latter approach is in early clinical phases of research and has not yet been subjected to clinical trials. In this paper, I will summarize the clinical characteristics of vocal tremor in comparison to what is known about tremor in general and describe Botox® and behavioral approaches for managing individuals with this voice disorder.

scholarly journals Intractable Muscle Tension Dysphonia Treated by Injection Laryngoplasty and Lidocaine Injection

2021 ◽  
Vol 32 (2) ◽  
pp. 94-97
Author(s):  
You Young An ◽  
Jun Yeong Jeong ◽  
Ki Nam Park ◽  
Seung Won Lee
Keyword(s):  
Gold Standard ◽  
Muscle Tension ◽  
Voice Quality ◽  
Laryngeal Nerve ◽  
Voice Therapy ◽  
Voice Disorder ◽  
Injection Laryngoplasty ◽  
Muscle Tension Dysphonia ◽  
Lidocaine Injection ◽  
Botox Injection

Muscle tension dysphonia (MTD) is a voice disorder characterized by excessive tension of the laryngeal muscles during phonation. Voice therapy is the gold standard of treatment for MTD. However, patients with MTD do not always respond to voice therapy. Multidisciplinary approaches have been attempted to treat intractable MTD such as lidocaine instillation, lidocaine injection to recurrent laryngeal nerve, botox injection and excision of false ventricle using CO2 laser. Recently, injection laryngoplasty is suggested that assists in more efficient phonation and voice therapy to MTD patients. A patient with intractable MTD underwent lidocaine injection and injection laryngoplasty showed improved voice quality and remained stable until postoperative 3 months without any complications.

scholarly journals Entrapment Neuropathy: A Concept for Pathogenesis and Treatment of Headaches—A Narrative Review

2019 ◽  
Vol 12 ◽  
pp. 117955061983494 ◽  
Author(s):  
J Alexander de Ru ◽  
Boris Filipovic ◽  
Jonathan Lans ◽  
Erwin L van der Veen ◽  
Peter JFM Lohuis
Keyword(s):  
Effective Treatment ◽  
Neurological Disorders ◽  
Botulinum Toxin Type A ◽  
Botulinum Toxin Type ◽  
Surgical Decompression ◽  
Entrapment Neuropathy ◽  
Pathophysiological Mechanism ◽  
Headache Disorders ◽  
Large Numbers ◽  
Neck Area

Entrapment neuropathy is a known cause of neurological disorders. In the head and neck area, this pathophysiological mechanism could be a trigger for headache. Over the last few decades, injection of botulinum toxin type A in the muscles that are causing the compression as well as surgical decompression have proved to be effective treatment methods worldwide for large numbers of patients with daily headaches. In particular the entrapment of the supraorbital nerves in the glabellar musculature and the occipital nerves in the neck musculature are triggers for headache disorders for which many patients are still seeking an effective treatment. This article reviews the literature and aims to bring the concept of neural entrapment to the attention of a wider audience. By doing so, we hope to give more exposure to an effective and relatively safe headache treatment.

Botulinum Toxin Type A and B for the Reduction of Hypersalivation in Children with Neurological Disorders: A Focus on Effectiveness and Therapy Adherence

2012 ◽  
Vol 43 (01) ◽  
pp. 027-036 ◽  
Author(s):  
A. Schroeder ◽  
Theresia Kling ◽  
Kristina Huß ◽  
Ingo Borggraefe ◽  
Inga Koerte ◽  
...  
Keyword(s):  
Botulinum Toxin ◽  
Neurological Disorders ◽  
Botulinum Toxin Type A ◽  
Type A ◽  
Botulinum Toxin Type ◽  
Therapy Adherence

scholarly journals Application of manual therapy in muscle tensional dysphonia

2021 ◽  
Vol 18 (1) ◽  
pp. 20-28
Author(s):  
Stevan Jovanović ◽  
Slađana Arsić ◽  
Biljana Stojanović-Jovanović ◽  
Dragana Kljajić ◽  
Marija Trajkov
Keyword(s):  
Manual Therapy ◽  
Repeated Measures ◽  
Muscle Tension ◽  
Voice Disorder ◽  
Therapeutic Effects ◽  
Small Pilot Study ◽  
Muscle Tension Dysphonia ◽  
Vocal Qualities ◽  
Before And After ◽  
Control Study

Muscle tension dysphonia is a functional voice disorder caused by unbalanced activity of the laryngeal and extralaryngeal muscles. People with dysphonia may have changes in the cervical and perilaryngeal muscles, limited amplitude of movement of the cervical spine, but also posture disorders. The aim of this paper is to present the analyzed therapeutic effects of manual techniques in muscle tension dysphonia, based on a review of the available literature. In accordance with the set criteria and the goal of the paper, the collection and analysis of professional and scientific research papers available in PubMed / MEDLINE databases and others, published in the period from 2004 to 2018, was performed. The analyzed studies belong to the type of clinical studies and by design, two types of studies are included: the type of randomized control study and the study of one group of subjects with before and after-examination. Some studies with one group of respondents were characterized by the authors as a series of cases and one, as a small pilot study of repeated measures. The results of the research indicate a larger number of corrective effects of laryngeal manual therapy. It is certain that by developing a broader manual-therapeutic approach, the etiological factor of muscle tension dysphonia can be more effectively influenced which leads to a reduction in pain, improvement of physical functioning as well as improvement of specific vocal qualities.

scholarly journals The Assessment Methods of Laryngeal Muscle Activity in Muscle Tension Dysphonia: A Review

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Seyyedeh Maryam Khoddami ◽  
Noureddin Nakhostin Ansari ◽  
Farzad Izadi ◽  
Saeed Talebian Moghadam
Keyword(s):  
Muscle Activity ◽  
Muscle Tension ◽  
Surface Emg ◽  
Assessment Methods ◽  
Voice Disorder ◽  
Laryngeal Muscle ◽  
Muscle Tension Dysphonia ◽  
Muscular Tension ◽  
Clinical Methods ◽  
Physiological Information

The purpose of this paper is to review the methods used for the assessment of muscular tension dysphonia (MTD). The MTD is a functional voice disorder associated with abnormal laryngeal muscle activity. Various assessment methods are available in the literature to evaluate the laryngeal hyperfunction. The case history, laryngoscopy, and palpation are clinical methods for the assessment of patients with MTD. Radiography and surface electromyography (EMG) are objective methods to provide physiological information about MTD. Recent studies show that surface EMG can be an effective tool for assessing muscular tension in MTD.

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.

Sign in / Sign up

Export Citation Format

Share Document