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Long-term Therapy for Spasmodic Dysphonia
Acoustic and Aerodynamic Outcomes
Ritvik P. Mehta, BS;
Stephen N. Goldman, MA;
Lisa A. Orloff, MD
Arch Otolaryngol Head Neck Surg. 2001;127:393-399.
Objective To evaluate the long-term aerodynamic, acoustic, and electromyographic
effects of serial botulinum toxin (BT) injections in patients with adductor
spasmodic dysphonia.
Design Two-year, nonrandomized, controlled, before-after study.
Setting Ambulatory care clinic at a single academic medical center.
Patients A convenience sample of 91 patients with adductor spasmodic dysphonia
evaluated and treated during 2 years and 64 age- and sex-matched controls.
Interventions Injections of BT into the thyroarytenoid muscles in conjunction with
electromyographic evaluation and acoustic and aerodynamic evaluation before
and after serial BT injections.
Main Outcome Measures Translaryngeal airflow, jitter, shimmer, signal-to-noise ratio, fundamental
frequency, standard deviation of fundamental frequency, maximum phonation
time, and inappropriate muscle activity by electromyography.
Results Translaryngeal airflow, jitter, and shimmer improved significantly after
serial BT treatments and showed sustained improvement over time. Fundamental
frequency, standard deviation of fundamental frequency, and signal-to-noise
ratio did not change significantly after BT treatment. Electromyographic data
suggested decreased inappropriate muscle activity with repeated BT injections.
Conclusion Treatment with BT provides ongoing relief of voice perturbations in
patients with adductor spasmodic dysphonia who undergo long-term cumulative
therapy.
From the Division of Otolaryngology, University of California, San
Diego, School of Medicine.
Corresponding author and reprints: Lisa A. Orloff, MD, Division of
Otolaryngology, University of California, San Diego School of Medicine, 200
W Arbor Dr, San Diego, CA 92103-8891 (e-mail: lorloff{at}ucsd.edu).
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