Dysphonia (Spastic Dysphonia)

Difficulty and/or pain in PHONATION or speaking.

Also Known As:

Spastic Dysphonia; Hyperkinetic Dysphonia; Neurologic Adducter Spastic Dysphonia; Organic Tremor Dysphonia; Spastic Dysphonia, Neurologic Adducter; Dysphonia, Hyperkinetic; Dysphonia, Organic Tremor; Dysphonia, Spastic; Phonation Disorder; Phonation Disorders

Networked: 1305 relevant articles (140 outcomes, 210 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Tremor (Tremors)
2.	Deglutition Disorders (Dysphagia)
3.	Torticollis (Wryneck)
4.	Dystonia (Limb Dystonia)
5.	Paralysis (Palsy)

Experts

1.	Sataloff, Robert T: 14 articles (06/2022 - 04/2003)
2.	Johns, Michael M: 13 articles (07/2022 - 09/2005)
3.	Hapner, Edie R: 13 articles (02/2021 - 09/2005)
4.	Blitzer, Andrew: 13 articles (01/2021 - 06/2003)
5.	Sanuki, Tetsuji: 12 articles (06/2022 - 12/2007)
6.	Awan, Shaheen N: 11 articles (10/2022 - 01/2006)
7.	Roy, Nelson: 11 articles (10/2016 - 06/2003)
8.	Hu, Amanda: 8 articles (01/2021 - 11/2013)
9.	Yumoto, Eiji: 7 articles (06/2022 - 04/2010)
10.	Murry, Thomas: 7 articles (06/2021 - 10/2002)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Dysphonia:

1.	Botulinum Toxins (Botulinum Toxin)IBA 01/01/2022 - "Botulinum toxin injection into to the laryngeal muscles is the most common and effective treatment of choice for symptoms of spasmodic dysphonia. " 06/01/1999 - "Botulinum toxin has been demonstrated clinically to be an effective treatment for a variety of laryngeal problems, most notably spasmodic dysphonia. " 01/01/2008 - "Based on the quality of evidence scale used, botulinum toxin can be considered an effective treatment for adductor spasmodic dysphonia." 09/01/2004 - "Injection of botulinum toxin (BT) into the muscles of the larynx is an effective treatment for the symptoms of spasmodic dysphonia (SD). " 03/01/2002 - "Botulinum toxin has been used effectively to treat spasmodic dysphonia. "
2.	Type A Botulinum Toxins (Botox)FDA Link 01/14/2020 - "Botulinum toxin A (BT) is the gold standard treatment for adductor spasmodic dysphonia (AdSD) with established use for greater than thirty years. " 06/01/1991 - "Botulinum toxin A proved to be an effective and safe treatment of adductor spasmodic dysphonia." 04/01/2004 - "This study demonstrates the efficacy of Botox for treating patients with adductory spasmodic dysphonia and further illustrates the usefulness and validity of the V-RQOL Measure in evaluating patients with dysphonia." 01/01/1993 - "To assess the efficacy of bilateral or unilateral botulinum treatments for spasmodic dysphonia we injected botulinum toxin (type A) into the thyroarytenoid muscle of 24 patients with adductor type spasmodic dysphonia. " 03/01/2021 - "The purpose of this study was to evaluate the outcomes of long-term botulinum toxin type A (BoNTA) treatment for adductor spasmodic dysphonia (AdSD) and to determine the factors predictive of treatment response by investigating dose stability and average intervals. "
3.	Polytetrafluoroethylene (Teflon)FDA Link 06/01/1985 - "Such difficulties in patients who have paralytic dysphonia may also make it impossible to effect improved vocal cord closure by the usual techniques of Teflon injection. " 04/01/1998 - "In certain cases in which formation of granulomatous reaction to the Teflon occurs, patients may have significant dysphonia or airway compromise. " 07/01/1995 - "We conclude that dysphonia, secondary to Teflon injection, can be either from overinjection of Teflon or inappropriate injection, or from the proliferative granulomatous response of the larynx to the Teflon. " 07/01/1995 - "In our practice, we have seen increasing numbers of patients who had developed dysphonia related to Teflon injection. " 10/01/1991 - "Injection techniques for the rehabilitation of paralytic dysphonia (e.g., Teflon) remain popular in the United States. "
4.	6-chloro-2-(1-piperazinyl)pyrazine (CPP)IBA 01/01/2023 - "It shows significant improvement in CPP, translating to decreased breathiness and dysphonia and increased VE, leading to easier and more sustainable phonation. " 03/01/2017 - "A combination of measures of the CPP distribution was effective for a linear prediction of percent dysphonia duration for the speech samples (r = 0.825; rho = 0.81). " 03/01/2017 - "However, dysphonia duration may be effectively predicted via measures of the CPP distribution, and acoustic classification of dysphonic voice types via cepstral methods may be improved with an analysis of the CPP distribution across an utterance." 11/01/2022 - "The current study demonstrated the validity of CPP and CSID as indicators of dysphonia and indices of dysphonia severity in the Japanese language." 01/01/2021 - "The aims of study were (1) to determine the cut-off values of parameters related to auditory perceptual assessment (visual analog scale [VAS]) and acoustic analysis (cepstral peak prominence [CPP], low-frequency/high-frequency [L/H] ratio, CPP SD, L/H ratio SD, acoustic voice quality index [AVQI], and cepstral spectral index of dysphonia [CSID]) for predicting voice problems within a Korean population, and (2) to verify the discriminative power of these cut-off values. "
5.	SteroidsIBA 03/01/2018 - "This study investigated the histopathological aspects of steroid-induced dysphonia. " 05/01/2000 - "Seventy-two patients reporting dysphonia and taking inhaled steroids from a pMDI entered a 12-week, open, parallel group study. " 12/01/2022 - "Examination should be repeated when dysphonia persists, recurs swiftly, or when patients seek repeated treatment, as there may be increased risk of adverse outcomes, and continued steroid use may mask underlying chronic pathology that is best treated by other means. " 09/01/2017 - "Nevertheless, adjunctive steroid injection was associated with a 0.3-fold (OR = 0.345, 95% CI: 0.152-0.784, P = 0.011) lower risk of persistent dysphonia. " 12/01/2015 - "The present case is a 28-year-old asthmatic female who was on inhalational steroid for 8 years, presented with sudden onset of severe dysphonia for 5 days. "
6.	rimabotulinumtoxinB FDA Link 09/01/2004 - "This single-site, open-label, dose-finding study evaluated the safety and efficacy of botulinum toxin type B (BoNT-B; Myobloc) for the treatment of adductor spasmodic dysphonia (AdSD) in 13 patients. " 09/01/2004 - "Safety and efficacy of botulinum toxin type B (Myobloc) in adductor spasmodic dysphonia." 02/01/2005 - "[The dosage of botulinum toxin type B in adductor type spasmodic dysphonia]." 09/01/2002 - "Botulinum toxin type B for treatment of spasmodic dysphonia: a case report." 09/01/2002 - "Botulinum toxin type B (BTXB) has been found to be safe and effective in the treatment of cervical dystonia, but it has not been used previously to treat spasmodic dysphonia. "
7.	CollagenIBA 03/01/2008 - "As an outpatient office procedure, collagen injection offers a simple, efficient and effective treatment for dysphonia. " 01/01/1986 - "Postoperatively, all of our patients showed improved dysphonia without secondary effects occurring from the collagen. " 08/01/2008 - "Findings of collagen disarrangement were categorized semiquantitatively and correlated with RE severity, age, cigarette smoking and duration of dysphonia. " 06/01/2007 - "Collagen injection for Parkinson-related dysphonia is an effective temporary method of subjectively improving voice and speech in selected patients. " 09/01/2004 - "Two patients in whom collagen was injected formed firm submucosal deposits that interrupted the normal mucosal wave and produced significant dysphonia. "
8.	Axitinib (AG 013736)IBA 05/01/2019 - "Overall, toxicity by Axitinib was very common, diarrhea 87.5%, asthenia 75%, dysphonia 56.25%, hypertension 37.5% and anorexia 37.5%, although most are grade 1-2 toxicities controlled with hygiene-diet measures and treatment recommendations. CONCLUSIONS: Axitinib is a drug that has been shown to increase PFS after 1st line progression, with a tolerable toxic profile. " 02/01/2015 - "The most common treatment-related adverse events associated with axitinib included diarrhea, hypertension, fatigue, nausea, decreased appetite, dysphonia, and palmar-plantar erythrodysesthesia. " 11/01/2015 - "Axitinib had a manageable tolerability profile in the AXIS trial, with the most commonly reported treatment-related adverse events including diarrhoea, hypertension, fatigue, decreased appetite, nausea, dysphonia, hand-foot syndrome and hypothyroidism. " 04/01/2014 - "Axitinib has demonstrated a predictable and manageable AE profile in clinical trials; most commonly reported treatment-related events are diarrhea, hypertension, fatigue, nausea, vomiting and dysphonia. " 05/01/2015 - "Common adverse events with axitinib/gemcitabine in Japanese patients were fatigue, anorexia, dysphonia, nausea and decreased platelet count. "
9.	Proton Pump InhibitorsIBA 05/01/2007 - "[Three cases of muscle tension dysphonia improved using proton pump inhibitors]." 05/01/2007 - "We report 3 cases of muscle tension dysphonia (MTD), all involving women 44 to 68 years old, recovered using proton pump inhibitors (PPI). " 03/01/2020 - "Vocal Tract Discomfort and Dysphonia in Patients Undergoing Empiric Therapeutic Trial with Proton Pump Inhibitor for Suspected Laryngopharyngeal Reflux." 12/01/2022 - "To Compare and Evaluate Laryngeal Changes in Patients with Dysphonia in Laryngopharyngeal Reflux (LPR) before and after Treatment with Proton Pump Inhibitors (PPI) and Prokinetic Drugs." 05/01/2022 - "A retrospective chart review was performed of patients with LPR-associated dysphonia in the absence of subjective dysphagia who presented between January 1, 2007 and June 30, 2019 and underwent 24 pH impedance and esophageal manometry studies after inadequate response to lifestyle modifications, high dose of Proton Pump Inhibitor (PPIs), H2 blockers, alkaline water, and Gaviscon (GlaxoSmithKline, Warren, NJ, USA). "
10.	Levodopa (L Dopa)FDA LinkGeneric 06/16/1973 - "Blind evaluations of transient attacks of dysphonia revealed an association between episodes of neurological deterioration and exceptionally high plasma concentrations of levodopa shortly after ingestion. " 12/01/2020 - "From January 2014 to April 2019, patients with early IPD and healthy individuals were recruited and evaluated for clinical findings (Hoehn and Yahr scale; Unified Parkinson's Disease Rating Scale); Voice Handicap Index (VHI); grade of dysphonia, roughness, breathiness, asthenia, and strain and instability (GRBASI); maximal phonation time; phonation quotient; acoustic parameters; and orofacial muscle strength Oral Performance Instrument (IOPI; IOPI Medical, Woodinville, WA, USA) t) at baseline and 45 minutes after the levodopa intake (LCT). " 01/01/1976 - "Two sporadic cases of striato-nigral degeneration were characterized by the onset at the age of 61 of an akinetic-hypertonic syndrome and of a minimal or absent rest tremor, with a pyramidal syndrome, sphincter disorders, dysphonia, difficulty in swallowing and an unfavorable development in the space of two or three years not affected by L-Dopa. " 10/04/2018 - "A systematic review and meta-analysis was performed using the following keywords: Parkinson's disease; levodopa; L-dopa; voice; speech disorders; dysphonia; dysarthria. " 03/01/2013 - "From the therapeutic perspective, magnetic stimulation applied repetitively has been found useful, with different degrees of efficacy, in treating resistant depression, tinnitus, psychogenic dysphonia, Alzheimer disease, autism, Parkinson disease, dystonia, stroke, epilepsy, generalized anxiety as well as post traumatic stress disorder, auditory hallucinations, chronic pain, aphasias, obsessive-compulsive disorders, L-dopa induced dyskynesia, mania and Rasmussen syndrome, among others. "

Therapies and Procedures

1.	Therapeutics 09/01/2020 - "Group voice therapy was effective for a significant reduction of vocal symptoms and anxiety - common conditions in patients with dysphonia. " 05/01/2019 - "Significantly improved subjective and perceptual findings verify positive combined voice therapy effects in patients with functional dysphonia. " 12/01/2017 - "Voice therapy is effective for improving voice quality in patients with dysphonia if conservative measures are unsuccessful, and it can also be helpful for prophylaxis in high-risk individuals (e.g., vocalists, public speakers). " 01/01/2008 - "Voice therapy leads to statistically significant improvement in the VRQOL life in elderly patients with age-related dysphonia. " 10/01/2023 - "Although voice therapy (VT) has been known effective in muscle tension dysphonia (MTD), it is not obviously clear which VT approach is more effective. "
2.	Injections 03/01/2021 - "A total of 470 patients with adductor spasmodic dysphonia, who received electromyography-guided BoNTA injections over 12 years, were retrospectively enrolled in this study. " 03/01/2021 - "We identified randomized controlled trials, controlled trials, and observational studies of the effects of BT injections on the QOL in patients with adductor spasmodic dysphonia. " 07/06/2023 - "Adult patients with adductor spasmodic dysphonia that presented to a tertiary laryngology practice for BTX injections were recruited from March to July 2022. " 06/01/2019 - "In ENT, adductor and abductor (ABSD) spasmodic dysphonia are often treated with BTX-A injections into the respective overacting vocal cord muscles. " 01/01/2017 - "Of 149 patients who received a total of 2484 BTX injections for the treatment of spasmodic dysphonia in 1993-2013, 49 patients received at least 20 injections. "
3.	Aftercare (After-Treatment) 01/01/2021 - "This case series study found that employed patients with spasmodic dysphonia reported voice-related work productivity impairment, which improved significantly 1 month after treatment with BoNT injection. " 07/01/2023 - "The findings of the between-group comparison after treatment revealed a significantly greater increase in the Dysphonia Severity Index in the experimental group compared with the control group (P = 0.037). " 10/01/2001 - "After treatment, all symptoms and endoscopic abnormalities improved significantly except for intermittent dysphonia and laryngeal mucosal redness. " 05/01/2013 - "Although assessment was necessarily subjective, our study indicated that vocal folds showed decreased stiffness and improved mucosal wave properties after treatment, resulting in improved vibration and dysphonia. " 06/01/1990 - "After treatment, dysphonia had improved in all of these fifteen patients, and aspiration had disappeared in thirteen patients. "
4.	Speech Therapy (Therapy, Speech) 04/01/2012 - "These results confirm that in subjects with dysfunctional dysphonia, the greater proprioceptive awareness acquired through speech therapy permits improvement in postural performance. " 08/06/2018 - "The use of CVRP for the treatment of behavioral dysphonia presented positive results in the pre- and post-speech therapy evaluation. " 03/01/2010 - "Subjective evaluation of the long-term efficacy of speech therapy on dysfunctional dysphonia." 05/01/2020 - "The aim of this study was the evaluation of the possible role of KT in supporting speech therapy in singers complaining of dysphonia using singing voice handicap index (SVHI), fundamental frequency (F0), shimmer, jitter and harmonic to noise ratio (mean H/N). " 06/01/2019 - "A larger-scale study would be necessary to analyze the continuum between vocal effort and vocal forcing, to improve speech therapy for dysfunctional dysphonia."
5.	Laryngoplasty 07/01/2000 - "With the improved glottic vibration, thyroplasty type I provides more efficient phonation in patients with glottic incompetence dysphonia." 02/01/2000 - "Although a longer follow-up is needed, this case indicates that midline type II thyroplasty could be a useful treatment for adductor spasmodic dysphonia." 07/01/2015 - "Of 12 children treated by thyroplasty (5 studies), 2 experienced resolution of dysphonia, 4 had some improvement, and 4 had no improvement (2 patients had undocumented outcomes). " 06/01/2021 - "Voice assessment of fat injection vs medialization laryngoplasty in nonparalytic dysphonia." 12/01/2020 - "Injection laryngoplasty with fat grafts processed through centrifugation and emulsification is an effective technique for the treatment of dysphonia caused by glottic insufficiency related to scarred vocal folds, with minimal complication rates."