Expert System-Type Approach to Voice Disorders: Scheduling Botulinum Toxin Treatment for Adductor Spasmodic Dysphonia

One of the most debilitating voice disorders is adductor spasmodic dysphonia (ADSD), a voice disorder caused by involuntary movements of the muscles of the larynx (voice box). For treating ADSD, botulinum toxin (BT) injections turned out to be very useful. However, the effects of BT are highly variable, so at present, there is no objective criterion of when such a BT treatment is necessary. It is therefore desirable to develop such a criterion. In this paper, we show that traditional statistical techniques are unable to generate such a criterion, while a natural expert system approach seems to be capable of generating reasonably simple rules that determine when a BT treatment is necessary.

Download Full-text

Adductor Spasmodic Dysphonia and Botulinum Toxin Treatment: The Effect on Well-Being

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348940111001009 ◽

2001 ◽

Vol 110 (10) ◽

pp. 941-945 ◽

Cited By ~ 12

Author(s):

Ton P. M. Langeveld ◽

Frans Luteijn ◽

Harm A. Drost ◽

Maya van Rossum ◽

Robert J. Baatenburg de Jong

Keyword(s):

Botulinum Toxin ◽

Well Being ◽

Personality Characteristics ◽

Voice Disorder ◽

Spasmodic Dysphonia ◽

Normal Personality ◽

Adductor Spasmodic Dysphonia ◽

Normal Voice ◽

Norm Group ◽

Botulinum Toxin Treatment

Adductor spasmodic dysphonia (AdSD) is a controversial and enigmatic voice disorder. It is generally accepted that it has a neurologic, although undetermined, cause, and it is accompanied by much psychological and physical distress. In this prospective study, standardized psychometric tests were used to assess the personality characteristics and psychological and somatic well-being of 46 patients with AdSD. Moreover, the effect of botulinum toxin (Botox) treatment on their well-being was evaluated. No significant differences could be detected between patients and a representative norm group concerning 7 personality characteristics. Nevertheless, before treatment, there were significantly more psychological and somatic complaints. After establishment of a normal to near-normal voice with Botox injections, these complaints were reduced to normal levels — a finding suggesting these phenomena to be secondary to the voice disorder. These findings, and the normal personality characteristics, do not support a psychogenic cause of AdSD.

Download Full-text

Evaluation of Voice Quality in Adductor Spasmodic Dysphonia before and after Botulinum Toxin Treatment

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348940111000707 ◽

2001 ◽

Vol 110 (7) ◽

pp. 627-634 ◽

Cited By ~ 35

Author(s):

Ton P. M. Langeveld ◽

Edgar H. Houtman ◽

Jeroen J. Briaire ◽

Maya van Rossum ◽

Aeilko H. Zwinderman ◽

...

Keyword(s):

Botulinum Toxin ◽

Voice Quality ◽

Spasmodic Dysphonia ◽

Adductor Spasmodic Dysphonia ◽

Before And After ◽

Botulinum Toxin Treatment

Download Full-text

Botulinum toxin treatment of false vocal folds in adductor spasmodic dysphonia: Functional outcomes

The Laryngoscope ◽

10.1002/lary.25515 ◽

2015 ◽

Vol 126 (1) ◽

pp. 118-121 ◽

Cited By ~ 11

Author(s):

C. Blake Simpson ◽

Christopher T. Lee ◽

Jeanne L. Hatcher ◽

Joel Michalek

Keyword(s):

Botulinum Toxin ◽

Functional Outcomes ◽

Vocal Folds ◽

Spasmodic Dysphonia ◽

Adductor Spasmodic Dysphonia ◽

Botulinum Toxin Treatment ◽

False Vocal

Download Full-text

Botulinum Toxin Treatment of Adductor Spasmodic Dysphonia: Longitudinal Functional Outcomes

Yearbook of Otolaryngology-Head and Neck Surgery ◽

10.1016/j.yoto.2012.03.022 ◽

2012 ◽

Vol 2012 ◽

pp. 85-86

Author(s):

R. Franco

Keyword(s):

Botulinum Toxin ◽

Functional Outcomes ◽

Spasmodic Dysphonia ◽

Adductor Spasmodic Dysphonia ◽

Botulinum Toxin Treatment

Download Full-text

Botulinum toxin treatment of adductor spasmodic dysphonia: Longitudinal functional outcomes

The Laryngoscope ◽

10.1002/lary.21395 ◽

2011 ◽

Vol 121 (3) ◽

pp. 606-612 ◽

Cited By ~ 50

Author(s):

Daniel Novakovic ◽

Heather H. Waters ◽

Joanna B. D'Elia ◽

Andrew Blitzer

Keyword(s):

Botulinum Toxin ◽

Functional Outcomes ◽

Spasmodic Dysphonia ◽

Adductor Spasmodic Dysphonia ◽

Botulinum Toxin Treatment

Download Full-text

Effects of botulinum toxin treatment for adductor spasmodic dysphonia on voice and social function

Logopedics Phoniatrics Vocology ◽

10.3109/14015439709075324 ◽

1997 ◽

Vol 22 (3) ◽

pp. 129-134 ◽

Cited By ~ 3

Author(s):

Per-ÅKe Lindestad ◽

Stellan Hertegård ◽

Riitta Ylitalo

Keyword(s):

Botulinum Toxin ◽

Social Function ◽

Spasmodic Dysphonia ◽

Adductor Spasmodic Dysphonia ◽

Botulinum Toxin Treatment

Download Full-text

Botox Treatment in Adductor Spasmodic Dysphonia

Journal of Speech Language and Hearing Research ◽

10.1044/1092-4388(2002/037) ◽

2002 ◽

Vol 45 (3) ◽

pp. 469-481 ◽

Cited By ~ 48

Author(s):

Frank Boutsen ◽

Michael P. Cannito ◽

Merlin Taylor ◽

Brenda Bender

Keyword(s):

Botulinum Toxin ◽

Significant Variation ◽

Botulinum Toxin Type A ◽

Botulinum Toxin Type ◽

Spasmodic Dysphonia ◽

Treatment Benefit ◽

Treatment Conditions ◽

Adductor Spasmodic Dysphonia ◽

Efficacy Research ◽

Botulinum Toxin Treatment

Over the years many studies have been conducted to document the treatment effects of Botulinum toxin type A in adductor spasmodic dysphonia. The results of these studies have led to the view that overall Botulinum toxin treatment is moderately effective. This study reviews efficacy research qualitatively and quantitatively to determine the extent to which this conclusion is fully supported by the data. Although the data indicate moderate overall improvement as a result of Botulinum toxin treatment, they also suggest significant variation across patients, measurements, and treatment conditions. This result, together with methodological limitations and lack of standardization in BT efficacy research, justifies caution when making inferences regarding BT treatment benefit in adductor spasmodic dysphonia.

Download Full-text

Neurogenic Laryngeal Disorders

10.2310/ot.7068 ◽

2021 ◽

Author(s):

Yin Yiu ◽

Teresa Procter

Keyword(s):

Botulinum Toxin ◽

Botulinum Toxin Injection ◽

Muscle Tension ◽

Voice Disorders ◽

Spasmodic Dysphonia ◽

Swallowing Function ◽

Laryngeal Dystonia ◽

Adductor Spasmodic Dysphonia ◽

Neurologic Disorders ◽

Vocal Tremor

The larynx is critical to performing complex tasks of airway protection, phonation, respiration, and deglutition. Various focal and systemic neurologic disorders impact the larynx, causing deficits that lead to dysfunction in voice, speech, breathing, and swallowing function. The most common hyperfunctional neurolaryngeal disorders include spasmodic dysphonia (laryngeal dystonia), essential vocal tremor, and muscle tension dysphonia. Some hypofunctional neurolaryngeal disorders include parkinsonian disorders, neuromuscular junction diseases, and myopathies. A multidisciplinary approach involving evaluation by neurologists, voice-trained otolaryngologists and speech-language pathologists is often key to diagnosis and treatment of these challenging and sometimes lifelong disorders. Botulinum toxin injection into the laryngeal musculature is currently the gold-standard treatment for both spasmodic dysphonia and vocal tremor. However, much research is being conducted to advance less invasive and more definitive medical and surgical treatment interventions. This review contains 3 figures, 11 videos, 6 tables and 29 references Keywords: laryngeal neurophysiology, laryngeal dystonia, adductor spasmodic dysphonia, abductor spasmodic dysphonia, essential vocal tremor, hyperfunctional voice disorders, hypofunctional voice disorders, botulinum toxin injection

Download Full-text

Botulinum toxin treatment for adductor spasmodic dysphonia with EMG and endoscopic guidance

Neurology Asia ◽

10.54029/2021cwp ◽

2021 ◽

Vol 26 (4) ◽

pp. 715-719

Author(s):

Thanh Tuan Nguyen ◽

Ngoc Tai Tran ◽

Truc Dung Nguyen ◽

Thi Hung Nguyen

Keyword(s):

Botulinum Toxin ◽

Spasmodic Dysphonia ◽

Control Methods ◽

Laryngeal Muscles ◽

Adductor Spasmodic Dysphonia ◽

Endoscopic Guidance ◽

Botulinum Toxin Treatment ◽

The Voice ◽

Postural Disorders ◽

Thyroarytenoid Muscle

Background & Objective: Spasmodic dysphonia is idiopathic focal dystonia characterized by irregular contractions or postural disorders of the laryngeal muscles, resulting in abnormal speech. Progress in laryngoscopy has resulted in development of a precise technique of botulinum toxin (BTX) injection into the thyroarytenoid muscle under visual control. Methods: We used EMG and endoscopic guidance for BTX injection in adductor spasmodic dysphonia (AdSD). Results: Thirty eight patients with AdSD were injected with BTX in 84 treatment sessions. The voice handicap index (VHI) level of the patients were: severe (73.8%), moderate (26.2%) and mild (none). The average VHI score was 74.6 points. After 8 weeks of BTX treatment, the VHI level was: Severe (3.6%), moderate (10.8%), and mild (85.7%). The average VHI score was 27.7 points. The average values of jitter, shimmer and harmonic to noice ratio (HNR) improved statistically (p < 0.05). The incidence of side effects were: breathiness (17.9%), choking (15.5%); hoarseness (8.5%), and dysphagia (4.7%). Conclusions: Injection of BTX under both EMG and laryngoscopy guidance for treatment of adductor spasmodic dysphonia is an effective and safe treatment.

Download Full-text