Review of differential diagnosis and management of spasmodic dysphonia

Whurr, Renata; Lorch, Marjorie Perlman

doi:10.1097/moo.0000000000000253

Cited by 23 publications

(14 citation statements)

References 45 publications

(18 reference statements)

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“…This result was compatible with our clinical observation that adductor spasmodic dysphonia could markedly interfere with communication and socialization during the daily lives of patients. Although adductor spasmodic dysphonia is a rare disease with a prevalence of 14 out of 100,000 [35], it is worthwhile to offer a model for rapid screening because the symptoms can be treated easily and effectively by regular intralaryngeal botulinum toxin type A injections or surgery [35].…”

Section: Comparison With Prior Workmentioning

confidence: 99%

Deep Learning Application for Vocal Fold Disease Prediction Through Voice Recognition: Preliminary Development Study

Hu¹,

Chang²,

Wang³

et al. 2021

J Med Internet Res

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Background Dysphonia influences the quality of life by interfering with communication. However, a 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 189 normal voice samples and 552 samples of individuals with voice disorders, including vocal atrophy (n=224), unilateral vocal paralysis (n=50), organic vocal fold lesions (n=248), and adductor spasmodic dysphonia (n=30). The 741 samples were divided into 2 sets: 593 samples as the training set and 148 samples as the testing set. A convolutional neural network approach was applied to train the model, and findings were compared with those of human specialists. Results The convolutional neural network model achieved a sensitivity of 0.66, a specificity of 0.91, and an overall accuracy of 66.9% for distinguishing normal voice, vocal atrophy, unilateral vocal paralysis, organic vocal fold lesions, and adductor spasmodic dysphonia. Compared with the accuracy of human specialists, the overall accuracy rates were 60.1% and 56.1% for the 2 laryngologists and 51.4% and 43.2% for the 2 general ear, nose, and throat doctors. Conclusions Voice alone could be used for common vocal fold disease recognition through a deep learning approach after training with our Mandarin pathological voice database. This approach involving artificial intelligence could be clinically useful for screening general vocal fold disease using the voice. The approach includes a quick survey and a general health examination. It can be applied during telemedicine in areas with primary care units lacking laryngoscopic abilities. It could support physicians when prescreening cases by allowing for invasive examinations to be performed only for cases involving problems with automatic recognition or listening and for professional analyses of other clinical examination results that reveal doubts about the presence of pathologies.

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Section: Comparison With Prior Workmentioning

confidence: 99%

Deep Learning Application for Vocal Fold Disease Prediction Through Voice Recognition: Preliminary Development Study

Hu¹,

Chang²,

Wang³

et al. 2021

J Med Internet Res

View full text Add to dashboard Cite

show abstract

“…A correct diagnosis requires a specialized multidisciplinary team [8] that can manage to set the diagnosis and start the treatment plan on time. Future research is needed in order to better understand the etiology, treatment, and other factors that may contribute to optimal treatment effects, as well as the possibility of recovery from AdSD.…”

Section: Discussionmentioning

confidence: 99%

“…For this reason, AdSD is sometimes mistakenly interpreted as a psychogenic disorder or muscle tension dysphonia [8]. Indeed, the voice characteristics of a psychological voice disorder are sometimes similar.…”

Section: Introductionmentioning

confidence: 99%

Long-Term Follow-Up of Patients with Spasmodic Dysphonia and Improved Voice despite Discontinuation of Treatment

Geneid

Lindestad

Granqvist

et al. 2016

Folia Phoniatr Logop

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Objective: To evaluate voice function in patients with adductor spasmodic dysphonia (AdSD) who discontinued botulinum toxin (BTX) treatment because they felt that their voice had improved sufficiently. Patients and Methods: Twenty-eight patients quit treatment in 2004, of whom 20 fulfilled the inclusion criteria for the study, with 3 subsequently excluded because of return of symptoms, leaving 17 patients (11 males, 6 females) included in this follow-up study. A questionnaire concerning current voice function and the Voice Handicap Index were completed. Audio-perceptual voice assessments were done by 3 listeners. The inter- and intrarater reliabilities were r > 0.80. Results: All patients had a subjectively good stable voice, but with differences in their audio-perceptual voice assessment scores. Based on the pre-/posttreatment auditory scores on the overall degree of AdSD, patients were divided into 2 subgroups showing more and less improvement, with 10 and 7 patients, respectively. The subgroup with more improvement had shorter duration from the onset of symptoms until the start of BTX treatment, and included 7 males compared to only 4 males in the subgroup with less improvement. Conclusion: It seems plausible that the symptoms of spasmodic dysphonia may decrease over time. Early intervention and male gender seem to be important factors for long-term reduction of the voice symptoms of AdSD.

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“…With a prevalence rate of 14 per 100,000 it predominantly affects women in the ratio of 2.5:1, with the peak of onset being between 30-50 years. It is classified mainly into Adductor Spastic Dysphonia (ADSD), Abductor Spastic Dysphonia and the mixed variant [5]. ADSD is characterized by involuntary spasms of laryngeal muscles during adduction, producing tense vocal cords and a strained voice.…”

Section: Introductionmentioning

confidence: 99%

Retrospective Analysis of Phonatory Outcomes after CO2 Laser Thyroarytenoid Myoneurectomy in Patients with Adductor Spasmodic Dysphonia

Bidaye

2020

GJO

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Introduction: Adductor spasmodic dysphonia (ADSD) is a focal laryngeal dystonia characterized by spasms of laryngeal muscles during speech. Botulinum toxin injection in the Thyroarytenoid muscle remains the gold-standard treatment for ADSD. However, as Botulinum toxin injections need to be repeated periodically, the voice quality fluctuates over a longer period. A Microlaryngoscopic Transoral approach to CO2 laser Thyroarytenoid myoneurectomy (TAM) has been reported as an effective technique for treatment of ADSD. It provides sustained improvement in the voice over a longer duration.Methods: Trans oral Microlaryngoscopic CO2 laser TAM was performed in 14 patients (5 females and 9 males), aged between 19 and 64 years who were diagnosed with ADSD. Data was collected from over 3 years starting from Jan 2014 -Dec 2016. GRBAS scale along with Multidimensional voice programme (MDVP) analysis of the voice and Video laryngo-stroboscopic (VLS) samples at the end of 3 and 12 months of surgery would be compared with the pre-operative readings.Results: A total of 9 (64.2%) patients showed an improvement in grade after 3 months as well as 12 months after the surgery. While 12 (85.7%) patients showed an improvement in strain after 12 months of surgery. The spasms on VLS showed an improvement in 9 (64.3%) out of 14 cases after 3 months of surgery which was proven to be statistically significant. Conclusion:This innovative surgical technique is a good alternative treatment for ADSD patients who seek a definite improvement of their condition.

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Review of differential diagnosis and management of spasmodic dysphonia

Cited by 23 publications

References 45 publications

Deep Learning Application for Vocal Fold Disease Prediction Through Voice Recognition: Preliminary Development Study

Deep Learning Application for Vocal Fold Disease Prediction Through Voice Recognition: Preliminary Development Study

Long-Term Follow-Up of Patients with Spasmodic Dysphonia and Improved Voice despite Discontinuation of Treatment

Retrospective Analysis of Phonatory Outcomes after CO2 Laser Thyroarytenoid Myoneurectomy in Patients with Adductor Spasmodic Dysphonia

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