Medical treatment and speech therapy for spasmodic dysphonia: a literature review
Tratamento médico e fonoaudiológico da disfonia espasmódica: uma revisão bibliográfica
Eliana Maria Gradim Fabron; Viviane Cristina de Castro Marino; Talyssa de Carvalho Nóbile; Luciana Tavares Sebastião; Suely Mayumi Motonaga Onofri
Abstract
Spasmodic dysphonia (SD) is a voice disorder characterized by a strained-strangled voice, with sound breaks and has implications in one's communication. The purpose of this study is to present a bibliographic review of the speech therapy and medical treatment suggested for SD from 2006 to 2010. The speech therapy and medical treatments described are: botulinum toxin injection, myectomy, neurectomy, denervation and reinnervation selective laryngeal adductor, thyroplasty, radiofrequency thyroarytenoid myothermy, injection of lidocaine, homeopathy and speech therapy. The use of botulinum toxin injection showed results that indicated the satisfaction of the patients who were treated, although some of the articles presented the frequent need of reapplication of the toxin as a disadvantage. The surgical procedures were considered long-lasting and indicated to patients who didn't want to get botulinum toxin injections. The studies, however, presented a restricted contingency of patients, and the outcomes in many studies were based in the patient's own judgment on his/her voice quality. The treatments using lidocaine and homeopathy had positive results in relation to the voice quality of the patients and were suggested as an option for those who wouldn't like to undergo surgical treatment or have botulinum toxin injection. The few studies which discourse on voice therapy presented good results in association with botulinum toxin injection, showing the shortage of information in this field. A study on the literature review pointed out the need of developing researches to help us understand the neurological functioning in spasmodic dysphonia. Future study involving speech therapy in the treatment of ED is still necessary.
Keywords
Resumo
A disfonia espasmódica (DE) é um distúrbio vocal caracterizado por voz tensa-estrangulada, com quebras de sonoridade e que compromete a comunicação do indivíduo. O objetivo deste estudo é apresentar uma revisão bibliográfica dos tratamentos médico e fonoaudiológico proposto para a DE no período entre 2006 e 2010. Os tratamentos descritos foram: injeção de toxina botulínica (TB), miectomia, neurectomia, denervação e reinervação laríngea seletiva adutora, tireoplastia, miotermia tiroaritenóidea com radiofrequência, injeção de lidocaína, homeopatia e tratamento fonoaudiológico (fonoterapia). O uso de injeção de TB mostrou resultados que indicaram a satisfação dos pacientes tratados, embora alguns dos artigos apontassem a necessidade de reaplicação da toxina frequentemente, como desvantagem. Os procedimentos cirúrgicos foram considerados duradouros e indicados para os pacientes que não quiseram se submeter às aplicações de TB. Tais estudos, no entanto, apresentaram contingência de pacientes restrita e os resultados foram baseados, na maioria das investigações, no julgamento dos próprios pacientes sobre a sua qualidade vocal. Os tratamentos, com uso de lidocaína e homeopatia, mostraram resultados positivos em relação à qualidade vocal dos pacientes e foram sugeridos como uma opção, também, para aqueles que não gostariam de ser submetidos ao tratamento cirúrgico ou à aplicação de TB. Os poucos estudos que reportam fonoterapia assinalaram bons resultados quando a mesma foi associada à injeção de TB, mostrando a escassez de informações nesta área. Futuras pesquisas envolvendo a fonoterapia no tratamento da DE são necessárias.
Palavras-chave
References
1. Aronson AE. Adductor Spastic Dysphonia. Clinical voice disorders. New York: Thieme Medical Publishers, 1990, p. 161-83.
2. Siemons-Lurinhg DI, Merman M, Martens J-P, Deuster D, Muller F, Dejonckere, P. Spasmodic dysphonia, perceptual and acoustic analysis: presenting new diagnostic tools. Eur Arch Otorhinolaryngol. 2009; 266(12):1915-22.
3. Grillone GA, Chan T. Laryngeal Dystonia. Otolaryngol Clin North Am. 2006; 39(1):87-100.
4. Watts C, Nye C, Whurr R. Botulinum toxin for treating spasmodic dysphonia (laryngeal dystonia): a systematic Cochrane review. Clin Rehabil. 2006;20(2):112-22.
5. Ress CJ, Blalock PD, Kemp SE, Halum SL, Koufman JA, Differentiation of adductor-type spasmodic dysphonia from muscle tension dysphonia by spectral analysis. Otolaryngol Head Neck Surg. 2007;137(4):576-81.
6. Behlau M, Pontes P. A evolução do conceito da disfonia espástica. In: Ferreira LP, editor. Um pouco de nós sobre voz. 4ª ed., Carapicuíba: Pró-Fono; 1995. p.101-18.
7. Santos AO. As distintas manifestações fonoaudiológicas e psicológicas na disfonia espasmódica [trabalho de conclusão de curso]. Marília (SP): Universidade Estadual Paulista – UNESP. Curso de Fonoaudiologia. Departamento de Fonoaudiologia; 2010.
8. Zwiner P, Murry T, Swenson M, Woodson GE. Acoustic changes in spasmodic dysphonia after botulinum toxin injection. J Voice. 1991;5(1):78-84.
9. Fisher K, Scherer R, Guo C, Owen A. Longitudinal phonatory characteristics after botulinum toxin type A injection. J Speech Hear Res. 1996;39(5):968-80.
10. Zwiner P, Murry T, Woodson G. Perceptual acoustic relationships in spasmodic dysphonia. J Voice. 1993;7(2):165-71.
11. Viola IC. Atuação terapêutica e análise de um caso de disfonia espástica. In: Ferreira LP. Um pouco de nós sobre voz. 4ª ed., Carapicuíba: Pró-Fono; 1995. p. 95-9.
12. Nakamura K, Muta H, Watanabe Y, Mochizuki R, Yoshida T, Suzuki M. Surgical treatment for adductor spasmodic dysphonia: efficacy of bilateral thyroarytenoid myectomy under microlaryngoscopy. Acta Otolaryngol. 2008;128(12):1348-53.
13. Koufman JA, Rees CJ, Halum SL, Blalock D. Treatment of adductor-type spasmodic dysphonia by surgical myectomy: a preliminary report. Ann Otol Rhinol Laringol. 2006;115 (2):97-102.
14. Tsuji DH, Chrispim FS, Imamura R, Sennes LU, Hachiya A. Impacto na qualidade vocal da miectomia parcial e neurectomia endoscópica do músculo tireoaritenóideo em paciente com disfonia espasmódica de adução. Rev Bras Otorrinolaringol. 2006; 72(2).
15. Chhetri DK, Mendelsohn AB, Blumin JH, Berke GS. Long-term follow-up results of selective laryngeal adductor denervation-reinnervation surgery for adductor spasmodic dysphonia. Laryngoscope. 2006;116(4):635-42.
16. Sanuki T, Isshiki N. Overall evaluation of effectiveness of type II thyroplasty for adductor spasmodic dysphonia. Laryngoscope. 2007;117(12):2255-9.
17. Sanuki T, Isshiki N. Outcomes of type II thyroplasty for adductor spasmodic dysphonia: analysis of revision and unsatisfactory cases. Acta Otolaryngol. 2009; 129(11):1287-93.
18. Isshiki N, Sanuki T. Surgical tips for type II thyroplasty for adductor spasmodic dysphonia: modified technique after review unsatisfactory cases. Acta Otolaryngol. 2010;130(2):275-80.
19. Kim HS, Choi HS, Lim JY, Choi YL, Lim SE. Radiofrequency thyroarytenoid myothermy for treatment of adductor spasmodic dysphonia: how we do it. Clin Otolaryngol. 2008;33(6):621-5.
20. Smith ME, Roy N, Wilson C. Lidocaine block of the recurrent laryngeal nerve in adductor spasmodic dysphonia: a multidimensional assessment. Laryngoscope. 2006;116(4):591-5.
21. Xue S, Schepper L, Hao GJ. Treatment of spasmodic dysphonia with homeopathic medicine: a clinical case report. Homeopathy. 2009;98(1):56-9.
22. Santos VJB, Mattioli JM, Mattioli WM, Daniel RJ, Cruz VPM. Distonia laríngea: relato de caso e tratamento com toxina botulínica. Rev Bras Otorrinolaringol. 2006 Mai/Jun;72(3).
23. Thomas JP, Siupsinskiene N. Frozen versus fresh reconstituted botox for laryngeal dystonia. Otolaryngol Head Neck Surg. 2006;135(2):204-8.
24. Cantarella G, Berlusconi A, Maraschi B, Ghio A, Barbieri S. Botulinum toxin injection and airflow stability in spasmodic dysphonia. Otolaryngol Head Neck Surg. 2006;134(3):419-23.
25. Paniello RC, Barlow J, Serna JS. Longitudinal follow-up of adductor spasmodic dysphonia patients after botulinum toxin injection: quality of life results. Laryngoscope. 2008;118(3):564-8.
26. Woodson G, Hochstetler H, Murry T. Botulinum toxin therapy for abductor spasmodic dysphonia. J Voice. 2006;20(1):137-43.
27. Cannito MP, Kahane JC, Chorna L. Vocal aging and adductor spasmodic dysphonia: response to botulinum toxin injection. Clin Interv Aging. 2008;3(1):131-51.
28. Birkent H, Maronian N, Waugh P, Merati AL, Perkel D, Hillel AD. Dosage changes in patients with long-term botulinum toxin use for laryngeal dystonia. Otolaryngol Head Neck Surg. 2009;140(1):43-7.
29. Upile T, Elmiyeh B, Jerjers W, Prasad V, Kafas P, Abiola J, Youl B, Epstein R, HoppeR C, Sudhoff H, Rubin J. Unilateral versus bilateral thyroarytenoid botulinum toxin injections in adductor spasmodic dysphonia: a prospective study. Head Face Med. 2009;5(20).
30. Chang CY, Chabot P, Thomas JP, Warrenton VA, Warnick RI, Portland OR. Relationship of botulinum dosage to duration of side effects and normal voice in adductor spasmodic dysphonia. Otolaryngol Head Neck Surg. 2007;136(6):894-9.
31. Paniello RC, Edgar JD, Perlmutter JS. Vocal exercise versus voice rest following botulinum toxin injections: a randomized crossover trial. Ann Otol Rhinol Laryngol. 2009;118(11):759-63.
32. Braden MN, Johns MM, Klein AM, Delgaudio JM, Gilman M, Hapner ER. Assessing the effectiveness of botulinum toxin injections for adductor spasmodic dysphonia: clinician and patient perception. J Voice. 2010;24(2):242-9.
33. Su CY, Chuang HC, Tsai SS, Chiu JF. Transoral approach to laser thyroarytenoid mioneurectomy for treatment of adductor spasmodic dysphonia: short term results, Ann Otol Rhinol Laryngol. 2007;116(1):11-8.
34. Sanuki T, Yumoto E, Minoda R, Kodama N. Effects of type II tyyroplasty on adductor spasmodic dysphonia. Otolaryngol Head Neck Surg. 2010;142(4):540-6.
35. Haselden K, Powell T, Drinnan MIKE, Carding P. Comparing health locus of control in patients with spasmodic dysphonia, functional dysphonia and nonlaryngeal dystonia. J Voice. 2009;23(6):699-706.
36. Chhetri DK, Berke GS. Treatment of adductor spasmodic dysphonia with selective laryngeal adductor denervation and reinnervation surgery, Otolaryngol Clin North Am. 2006;39(1):101-9.
37. Truong DD, Bhidayasiri R. Botulinum toxin therapy of laryngeal muscle hyperactivity syndromes: comparing different botulinum toxin preparations. Eur J Neurol. 2006;13(1):36-41.
38. Watts CR, Truong DD, Nye C. Evidence for the effectiveness of botulinum toxin for spasmodic dysphonia from high-quality research designs. J Neural Transm. 2008; 115(4):625-30.
39. Ludlow CL. Treatment for spasmodic dysphonia: limitations of current approaches. Curr Opin Otolaryngol Head Neck Surg. 2009;17(3):160-5.
40. Delnooz CCS, Horstink MWIM, Tijssen MA, Bart PC. Paramedical treatment in primary dystonia: a systematic review. Mov Disord. 2009;24(15):2187-98.
Submitted date:
09/29/2011
Accepted date:
05/08/2012
Facebook
Twitter
LinkedIn
Mendeley
Email