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.

Presbylarynx, Functional Voice Disorders, Muscle Tension Dysphonia

2021 ◽  
Author(s):  
Elizabeth Erickson-DiRenzo ◽  
Christine M. Kim ◽  
C. Kwang Sung Sung
Keyword(s):  
Muscle Tension ◽  
Voice Disorders ◽  
Neuromuscular Control ◽  
Vocal Folds ◽  
Voice Therapy ◽  
Type I ◽  
Muscle Tension Dysphonia ◽  
Functional Dysphonia ◽  
Age Related ◽  
Type I Thyroplasty

Presbylarynx refers to age-related structural changes of the vocal folds that include muscle atrophy, reduced neuromuscular control, loss of superficial lamina propria layer, and reduced pliability. The changes result in thin and bowed vocal folds, increased vocal effort requirements, breathy voice, change in habitual pitch, and strain. The primary treatment options are voice therapy focused on strengthening breath support and the intrinsic muscles of the larynx, and optimization of resonance; injection augmentation of the vocal folds; and type I thyroplasty. Functional dysphonia is defined as change in voice quality in the absence of structural or neurological abnormalities of the larynx. Muscle tension dysphonia (MTD) is a subtype of functional voice disorders and involves laryngeal muscle tension imbalance due to excessive or dysregulated activation resulting often in strained or breathy voice. MTD can be divided into primary (psychological etiology or vocal misuse) and secondary (compensatory for organic laryngeal pathology). The mainstay of treatment for MTD is voice therapy, along with medical or surgical treatment of the underlying vocal pathology in secondary MTD. Mutational falsetto, or puberphonia, is a functional voice disorder where a high-pitched, pre-adolescent voice fails to transition to the lower pitch of adulthood. This review contains 5 figures, 7 tables, 4 videos and 10 references Key Words: Presbylarynx, Injection augmentation, Type I thyroplasty, Primary muscle tension dysphonia, Secondary muscle tension dysphonia, Muscle tension patterns, Manual circumlaryngeal therapy, Functional dysphonia, Mutational falsetto  

Comparative Evaluation and Management of Dysphonia Between Adults <65 and ≥65 Years of Age

2020 ◽  
pp. 019459982097843
Author(s):  
Amy Jacks ◽  
Hannah Kavookjian ◽  
Shannon Kraft
Keyword(s):  
Vocal Cord ◽  
Laryngopharyngeal Reflux ◽  
Tertiary Care ◽  
Muscle Tension ◽  
Voice Handicap Index ◽  
Voice Therapy ◽  
Old Patients ◽  
Presenting Symptoms ◽  
Muscle Tension Dysphonia ◽  
Significant Relationships

Objective To compare presenting symptoms, etiology, and treatment outcomes among dysphonic adults <65 and ≥65 years of age. Study Design Retrospective cohort study. Setting Tertiary care voice center between January 2011 and June 2016. Methods A total of 755 patients presenting for dysphonia were included in the study: 513 adults <65 years of age and 242 adults ≥65. Data collected included demographics, referral information, prior diagnoses, prior treatments, clinical examination findings, diagnosis, coexisting symptoms, treatments, and pre- and postintervention Voice Handicap Index scores. Statistical analysis was performed with SPSS to determine significant relationships between variables of interest. Results The most common etiologies of dysphonia were vocal cord atrophy (44.8%) in the ≥65 cohort and benign vocal cord lesions (17.8%) in the <65 cohort. When compared with adults <65 years old, patients ≥65 had a higher incidence of neurologic dysphonia ( P = .006) and vocal cord atrophy ( P < .001) but were less likely to have laryngopharyngeal reflux ( P = .001), benign vocal cord lesions ( P < .001), or muscle tension dysphonia ( P < .001). Overall, 139 patients had surgery, 251 received medical therapy, and 156 underwent voice therapy. The ≥65 cohort demonstrated improvement in Voice Handicap Index scores after surgery ( P = .001) and voice therapy ( P = .034), as did the <65 cohort (surgery, P < .001; voice therapy, P = .015). Adult surgical patients <65 reported greater improvements than patients ≥65 ( P = .021). Conclusions There are notable differences in the pathophysiology of dysphonia between patients aged ≥65 and <65 years. Although adults <65 reported slightly better outcomes with surgery, patients ≥65 obtained significant benefit from surgery and voice therapy.

scholarly journals Voice Therapy for Muscle Tension Dysphonia (MTD)

2013 ◽  
Vol 54 (1) ◽  
pp. 40-44
Author(s):  
Yukiko Yanagi ◽  
Daigo Komazawa ◽  
Michiko Kanno ◽  
Michi Aikawa ◽  
Chiho Ozaki ◽  
...  
Keyword(s):  
Muscle Tension ◽  
Voice Therapy ◽  
Muscle Tension Dysphonia

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.

Physical Therapy for Muscle Tension Dysphonia with Cervicalgia

2021 ◽  
pp. 014556132110632
Author(s):  
Alan D Tate ◽  
Carey A Tomlinson ◽  
David Oliver Francis ◽  
Emily D Wishik ◽  
Anne S Lowery ◽  
...  
Keyword(s):  
Physical Therapy ◽  
Confidence Interval ◽  
Tertiary Care ◽  
Muscle Tension ◽  
Standard Of Care ◽  
Voice Therapy ◽  
Anterior Neck ◽  
Myofascial Release ◽  
Muscle Tension Dysphonia ◽  
Full Body

Objectives This study investigated the effectiveness of a specialized manual physical therapy (PT) program at improving voice among patients diagnosed with concomitant muscle tension dysphonia (MTD) and cervicalgia at a tertiary care voice center. Materials and Methods Cervicalgia was determined by palpation of the anterior neck. Both voice therapy (VT) and PT was recommended for all patients diagnosed with MTD and cervicalgia. PT included full-body manual physical therapy with myofascial release. Patients underwent: 1) VT alone, 2) concurrent PT and VT (PT with VT), 3) PT alone, 4) VT, but did not have PT ordered by treating clinician (VT without PT order) or 5) VT followed by PT (VT then PT). The pairwise difference in post–Voice Handicap Index-10 (VHI-10) controlling for baseline variables was calculated with a linear regression model. Results 178 patients met criteria. All groups showed improvement with treatment. The covariate-adjusted differences in mean post–VHI-10 improvement comparing the VT alone group as a reference were as follows: PT with VT 9.95 (95% confidence interval 7.70, 12.20); PT alone 8.31 (6.16, 10.45); VT without PT order 8.51 (5.55, 11.47); VT then PT 5.47 (2.51, 8.42). Conclusion Among patients diagnosed with MTD with cervicalgia, treatment with a specialized PT program was associated with improvement in VHI-10 scores regardless of whether they had VT. While VT is the standard of care for MTD, PT may also offer benefit for MTD patients with cervicalgia.

A randomized controlled trial of stretch-and-flow voice therapy for muscle tension Dysphonia

2015 ◽  
Vol 125 (6) ◽  
pp. 1420-1425 ◽  
Author(s):  
Christopher R. Watts ◽  
Amy Hamilton ◽  
Laura Toles ◽  
Lesley Childs ◽  
Ted Mau
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Muscle Tension ◽  
Voice Therapy ◽  
Muscle Tension Dysphonia ◽  
Randomized Controlled
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