scholarly journals Resolution of Muscle Tension Dysphonia with Reinke’s Edema Following STRETTA Therapy in a Patient with GERD: A Case Report

2021 ◽  
pp. 1-4
Author(s):  
Viswanath YKS ◽  
James E Dixon ◽  
Edward J Nevins ◽  
Michael John ◽  
Viswanath YKS
Keyword(s):  
Acoustic Analysis ◽  
Muscle Tension ◽  
Voice Quality ◽  
Operative Management ◽  
Laryngeal Edema ◽  
Perceptual Evaluation ◽  
Muscle Tension Dysphonia ◽  
Reinke’S Edema ◽  
Laparoscopic Nissen ◽  
The Cost

Muscle Tension Dysphonia (MTD) is a syndrome involving abnormal vocal cord behaviour due to increased tension of laryngeal musculature. It has a complex etiology, but gastroesophageal reflux disease (GERD) is implicated in up to half of cases. The authors present the first reported case of MTD being successfully treated using STRETTA, an endoscopic radio-frequency therapy, licenced for GERD. Since 2016, a 60- year-old female had symptoms of laryngo-pharyngeal reflux. These included dysphonia, cough, sore throat, and persistent throat clearing. She underwent flexible nasendoscopy demonstrating significant posterior laryngeal edema, and anterior-posterior constriction on phonation, suggestive of MTD. Despite anti-reflux medication, her symptoms persisted. Repeat flexible nasendoscopy demonstrated bilateral Reinke's edema. Her symptoms failed to improve despite incision and drainage of the Reinke’s edema. An EGD demonstrated reflux esophagitis, and a blunt angle of His. She underwent STRETTA and reports significant improvement of symptoms. Repeat nasoendoscopy showed convalescence of the Reinke’s edema. Existing evidence suggests that management of MTD with proton pump inhibitor (PPI) improves reflux symptoms such as chronic cough and heartburn but has a limited effect on measures of voice such as voice range profile, perceptual evaluation, and acoustic analysis. Given that the present patient found subjective improvement in voice quality, it is possible STRETTA may be preferable to PPI in treating MTD with regard to voice, but further assessment of voice quality pre- and post-STRETTA is needed. In LPR refractory to PPI, there is evidence that Laparoscopic Nissen Fundoplication (LNF) is successful; however, the cost-effectiveness of endoscopic anti-reflux procedures such as STRETTA is superior to operative management such as LNF. Therefore, STRETTA may well be more beneficial than both PPI and LNF in the treatment of MTD with LPR.

Measuring Vocal Fatigue in Sports Coaches

2017 ◽  
Vol 23 (1) ◽  
pp. 1-20
Author(s):  
Kathy Connaughton ◽  
Irena Yanushevskaya
Keyword(s):  
Acoustic Analysis ◽  
Voice Quality ◽  
Professional Sports ◽  
Muscle Adaptation ◽  
Voice Change ◽  
Acoustic Measures ◽  
Perceptual Evaluation ◽  
Coaching Session ◽  
Sports Coaches ◽  
Voice Use

Objective: This study explores the immediate impact of prolonged voice use by professional sports coaches. Method: Speech samples including sustained phonation of vowel /a/ and a short read passage were collected from two professional sports coaches. The audio recordings were made within an hour before and after a coaching session, over three sessions. Perceptual evaluation of voice quality was done using the GRBAS scale. The speech samples were subsequently analyzed using Praat. The acoustic measures included fundamental frequency (f0), jitter, shimmer, Harmonics-to-Noise ratio and Cepstral Peak Prominence. Main results: The results of perceptual and acoustic analysis suggest a slight shift towards a tenser phonation post-coaching session, which is a likely consequence of laryngeal muscle adaptation to prolonged voice use. This tendency was similar in sustained vowels and connected speech. Conclusion: Acoustic measures used in this study can be useful to capture the voice change post-coaching session. It is desirable, however, that more sophisticated and robust and at the same time intuitive and easy-to-use tools for voice assessment and monitoring be made available to clinicians and professional voice users.

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 Effect of Mathieson Laryngeal Manual Therapy in Patients With Muscle Tension Dysphonia After a Therapeutic Course

2021 ◽  
Author(s):  
Mohammad Fallah ◽  
Seyyedeh Maryam Khoddami ◽  
Shohreh Jalaie ◽  
Keyvan Aghazadeh ◽  
Amin Rezaei Rad
Keyword(s):  
Manual Therapy ◽  
Spontaneous Recovery ◽  
Vocal Tract ◽  
Muscle Tension ◽  
Nonparametric Test ◽  
Perceptual Evaluation ◽  
Muscle Tension Dysphonia ◽  
Significant Difference ◽  
Perceptual Characteristics ◽  
Wilcoxon Nonparametric Test

Introduction: This study aimed to investigate the effect of Mathieson Laryngeal Manual Therapy (MLMT) following a therapeutic course in patients with primary Muscle Tension Dysphonia (MTD). Materials and Methods: Twelve patients with primary MTD participated in this study. At first, videostroboscopy and perceptual voice assessment was performed, and the Persian version of Vocal Tract Discomfort (VTDp) scale was completed. After two and a half weeks that patients received no treatment, the assessments were repeated to evaluate the effect of spontaneous recovery. For studying the effect of MLMT, it was presented in five sessions. Then, all assessments were repeated. The frequency of supraglottic activity was elicited. For the perceptual evaluation and VTDp, the Wilcoxon nonparametric test was used to study and compare the effect of spontaneous recovery and MLMT. Results: After spontaneous recovery, a significant difference was observed only in strain (P<0.05). After MLMT, the frequency of supraglottic activity decreased, and perceptual voice parameters significantly changed (P<0.05), but the VTDp showed no significant difference (P>0.05). There was no significant difference between spontanous recovery and MLMT based on the paerceptual voice evaluation and VTDp scale (P>0.05). Conclusion: The MLMT can remarkably improve the supraglottic activity and perceptual characteristics of voice in primary MTD after a therapeutic course. Further studies are recommended to confirm the effectiveness of MLMT on decreasing VTD sensations.

Results of Fascial Augmentation in Unilateral Vocal Fold Paralysis

2002 ◽  
Vol 111 (6) ◽  
pp. 523-529 ◽  
Author(s):  
Petri Reijonen ◽  
Sari Lehikoinen-Söderlund ◽  
Heikki Rihkanen
Keyword(s):  
Vocal Fold ◽  
Acoustic Analysis ◽  
Voice Quality ◽  
Vocal Fold Paralysis ◽  
Unilateral Vocal Fold Paralysis ◽  
Inexpensive Method ◽  
Maximum Phonation Time ◽  
Perceptual Evaluation

The objective of this study was to evaluate the effects on voice quality of augmentation by injection of minced fascia in patients with unilateral vocal fold paralysis. Preoperative and postoperative voice samples from 14 patients (6 men and 8 women; mean age, 59 years) were analyzed by computerized acoustic analysis and blinded perceptual evaluation. Statistically significant improvements were seen in perturbation measurements (jitter and shimmer), noise-to-harmonics ratio, and maximum phonation time. A panel of evaluators rated 10 of the 14 postoperative voices as normal or near-normal. Injection laryngoplasty with minced fascia offers a new, effective, well-tolerated, and inexpensive method to medialize a paralyzed vocal fold. The graft seems to survive well, as indicated by good vocal results with a follow-up ranging from 5 to 32 months.

Medialization thyroplasty in glottis insufficiency due to unilateral vocal fold paralysis and after laser cordectomies – preliminary report

2017 ◽  
Vol 71 (1) ◽  
pp. 22-29
Author(s):  
Anna Rzepakowska ◽  
Ewa Osuch-Wójcikiewicz ◽  
Ewelina Sielska-Badurek ◽  
Kazimierz Niemczyk
Keyword(s):  
Vocal Fold ◽  
Acoustic Analysis ◽  
Standard Procedure ◽  
Thyroid Cartilage ◽  
Voice Quality ◽  
Type I ◽  
Vocal Fold Paresis ◽  
Maximum Phonation Time ◽  
Perceptual Evaluation ◽  
Medialization Thyroplasty

Medialization thyroplasty (type I) is surgical procedure performed on the thyroid cartilage. The major indication for this surgery is significant glottis insufficiency due to unilateral vocal fold paresis. However the proce¬dure is also performed after vocal fold resections during cordectomy. The aim: The evaluation of voice results in patients after medialisation throplasty. Material and methods: In Otolaryngology Department of Medical University of Warsaw there were performed so far 8 thyroplasty procedures under local anaesthesia with implantation of medical silicon protesis. 6 patients had unilat¬eral vocal fold paresis and the rest two underwent in the past laser cordectomy due to T1a vocal carcinoma. Results: There were no complications during and post the surgery. The follow up examination in 1st , 3rd, 6th i 12th months postoperatively revealed for all patients significant improvement of glottal closure in laryngeal videostrobos¬copy. The voice quality improved both in perceptual evaluation (GRBAS scale) and acoustic analysis (F0, jitter, shim¬mer, NHR) in both patients groups. However the rate of improvement was much more significant in group with uni¬lateral vocal fold paresis. In all patients the maximum phonation time (MPT) increased. The self-evaluation of voice quality with Voice Handicap Index questionnaire confirmed also individual improvement. Conclusions: The speech rehabilitations is not successful in each patient with glottis insufficiency. The medialisation thyroplasty remains the standard procedure for permanent improvement of voice quality in those cases.

scholarly journals Self-perception, complaints and vocal quality among undergraduate students enrolled in a Pedagogy course

CoDAS ◽  
2015 ◽  
Vol 27 (3) ◽  
pp. 285-291 ◽  
Author(s):  
Eliana Maria Gradim Fabron ◽  
Simone Fiuza Regaçone ◽  
Viviane Cristina de Castro Marino ◽  
Marina Ludovico Mastria ◽  
Suely Mayumi Motonaga ◽  
...  
Keyword(s):  
Undergraduate Students ◽  
Acoustic Analysis ◽  
Voice Quality ◽  
Second Phase ◽  
Self Perception ◽  
Self Assessment ◽  
Perceptual Evaluation ◽  
Vocal Quality ◽  
The Voice

PURPOSE: To compare the vocal self-perception and vocal complaints reported by two groups of students of the pedagogy course (freshmen and graduates); to relate the vocal self-perception to the vocal complaints for these groups; and to compare the voice quality of the students from these groups through perceptual auditory assessment and acoustic analysis. METHODS: Initially, 89 students from the pedagogy course answered a questionnaire about self-perceived voice quality and vocal complaints. In a second phase, auditory-perceptual evaluation and acoustic analyses of 48 participants were made through voice recordings of sustained vowel emission and poem reading. RESULTS: The most reported vocal complaints were fatigue while using the voice, sore throat, effort to speak, irritation or burning in the throat, hoarseness, tightness in the neck, and variations of voice throughout the day. There was a higher occurrence of complaints from graduates than from freshmen, with significant differences for four of the nine complaints. It was also possible to observe the relationship between vocal self-perception and complaints reported by these students. No significant differences were observed in the results of auditory-perceptual evaluation; however, some graduates had their voices evaluated with higher severity of deviation of normalcy. During acoustic analysis no difference was observed between groups. CONCLUSION: The increase in vocal demand by the graduates may have caused the greatest number and diversity of vocal complaints, and several of them are related to the self-assessment of voice quality. The auditory-perceptual evaluation and acoustic analysis showed no deviations in their voice.

Responsiveness of Persian Version of Consensus Auditory Perceptual Evaluation of Voice (CAPE-V), Persian Version of Voice Handicap Index (VHI), and Praat in Vocal Mass Lesions with Muscle Tension Dysphonia

2018 ◽  
Vol 32 (6) ◽  
pp. 770.e21-770.e30 ◽  
Author(s):  
Hassan Khoramshahi ◽  
Ahmad Reza Khatoonabadi ◽  
Seyyedeh Maryam Khoddami ◽  
Peyman Dabirmoghaddam ◽  
Noureddin Nakhostin Ansari
Keyword(s):  
Muscle Tension ◽  
Voice Handicap Index ◽  
Perceptual Evaluation ◽  
Muscle Tension Dysphonia ◽  
Persian Version ◽  
Mass Lesions

scholarly journals Long-term Follow-up of Patients with Spasmodic Dysphonia Repeatedly Treated with Botulinum Toxin Injections

2011 ◽  
Vol 1 (2) ◽  
pp. 57-60 ◽  
Author(s):  
PH Dejonckere ◽  
C Manfredi
Keyword(s):  
Botulinum Toxin ◽  
Acoustic Analysis ◽  
Botulinum Toxin Injection ◽  
Muscle Tension ◽  
Voice Quality ◽  
Spasmodic Dysphonia ◽  
Long Term Effects ◽  
Adductor Spasmodic Dysphonia ◽  
Over Time

ABSTRACT Adductor spasmodic dysphonia (SD) is a focal laryngeal dystonia mainly resulting in a strained voice quality with spastic voice breaks and frequency shifts, perturbing fluency and intelligibility. SD-patients report unusually high impairment of their quality of life. The standard treatment is botulinum toxin injection in the thyroarytenoid muscles, in order to interfere with the perturbed sensory feedback loop of kinetic muscle tension regulation. The globally favorable effects are temporary, but the botulinum injections can be repeated. There is a lack of information about long-term effects. This is the first study investigating effects over several years, and comparing self-evaluation of patients with objective multimodal acoustic analysis. Results show that 72% of the individual injections are successful. The effects of botulinum are not reduced after repeated injections. In contrary, the self-perceived improvement increases in average over time. When self-evaluations preinjection are considered, patients tend to evaluate their voice and their handicap as worsening over time. This contrasts with the results of multimodal acoustic analysis. Objective data reveal a relative stability over time for as well pre- as postinjection. This seems to indicate that there is no shift over time in the objective severity of deviance in voice quality.

Intervention Outcomes of Two Treatments for Muscle Tension Dysphonia: A Randomized Controlled Trial

2019 ◽  
Vol 62 (2) ◽  
pp. 272-282 ◽  
Author(s):  
Christopher R. Watts ◽  
Amy Hamilton ◽  
Laura Toles ◽  
Lesley Childs ◽  
Ted Mau
Keyword(s):  
Outcome Measures ◽  
Primary Outcome ◽  
Outcome Measure ◽  
Muscle Tension ◽  
Primary Outcome Measure ◽  
Voice Therapy ◽  
Secondary Outcome ◽  
Treatment Groups ◽  
Perceptual Evaluation ◽  
Muscle Tension Dysphonia

Purpose The aim of this study was to test the hypothesis that stretch-and-flow voice therapy (SnF) is noninferior to resonant voice therapy (RVT) for speakers with muscle tension dysphonia. Method Participants with primary muscle tension dysphonia were randomly assigned to 1 of 2 treatment groups. Participants received 6 sessions of either SnF or RVT for 6 weeks (1 session per week). Pretreatment and posttreatment audio recordings of sustained vowels and connected speech were acquired. Response to treatment was assessed using the voice handicap index (VHI) as the primary outcome measure. Secondary outcome measures included the acoustic voice quality index, the smoothed cepstral peak prominence, and scales from the Consensus Auditory-Perceptual Evaluation of Voice instrument. Data were analyzed for 21 participants who completed the study (12 in the SnF group, 9 in the RVT group). Results Direction of change for the primary outcome measure and all 3 secondary outcome measures at posttreatment was in the direction of improvement for both SnF and RVT. Confidence intervals for VHI measures did not cross the null effect line on forest plots, suggesting significant effects for both treatments on the primary outcome measure. The effect sizes for pretreatment to posttreatment changes in VHI were large for both treatment groups. Similar results were found for the secondary acoustic outcome measures. There were statistically significant pretreatment to posttreatment changes in the primary and secondary outcome measures for patients receiving both treatments, indicating significant improvement in response to both RVT and SnF. There were no statistically significant differences in pretreatment to posttreatment changes in the primary outcome measure or any secondary outcome measure between the two groups. The within-group pretreatment to posttreatment changes in Consensus Auditory-Perceptual Evaluation of Voice scales did not reach statistical significance for either RVT or SnF. Conclusions Both SnF and RVT produced positive treatment response in speakers with muscle tension dysphonia, with no statistically significant difference in the outcome measures between the two treatments. This suggests that SnF is noninferior to RVT and that both are effective options for treating vocal hyperfunction. Results from this study also support previous findings documenting the sensitivity of multidimensional acoustic measurements to treatment response.

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