Treatment for spasmodic dysphonia: Limitations of current approaches

Current Opinion in Otolaryngology and Head and Neck Surgery

Volumn 17, Issue 3, 2009, Pages 160-165

  Ludlow, Christy L ^a  

^a NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE   (United States)

Author keywords

Botulinum toxin injection; Denervation; Myectomy; Reinnervation; Thyroplasty

Indexed keywords

BOTULINUM TOXIN;

ADDUCTOR SPASMODIC DYSPHONIA; BREATHING DISORDER; DENERVATION; DYSPHAGIA; HUMAN; LARYNGOPLASTY; LARYNX SURGERY; MUSCLE RESECTION; NONHUMAN; PRIORITY JOURNAL; QUALITY OF LIFE; QUESTIONNAIRE; REVIEW; SPASMODIC DYSPHONIA;

BOTULINUM TOXIN TYPE A; DYSPHONIA; HUMANS; INJECTIONS, INTRAMUSCULAR; LARYNGEAL MUSCLES; MICROSURGERY; MUSCLE DENERVATION; OUTCOME AND PROCESS ASSESSMENT (HEALTH CARE); RECURRENT LARYNGEAL NERVE;

EID: 67749089237     PISSN: 10689508     EISSN: None     Source Type: Journal    
DOI: 10.1097/MOO.0b013e32832aef6f     Document Type: Review

References (68)

1. Parnes SM, Lavorato AS, Myers EN. Study of spastic dysphonia using videofiberoptic laryngoscopy. Ann Otol 1978; 87:322-326.
2. Edgar JD, Sapienza CM, Bidus K, et al. Acoustic measures of symptoms in abductor spasmodic dysphonia. J Voice 2001; 15:362-372. (Pubitemid 32889296)
3. Aronson AE, Hartman DE. Adductor spastic dysphonia as a sign of essential (voice) tremor. J Speech Hear Disord 1981; 46:52-58.
4. Aronson AE, Brown JR, Litin EM, et al. Spastic dysphonia: II. Comparison with essential (voice) tremor and other neurologic and psychogenic dysphonias. J Speech Hear Disord 1968; 33:219-231.
5. Massey EW, Paulson GW. Essential vocal tremor: clinical characteristics and response to therapy. South Med J 1985; 78:316-317.
6. Dedo HH. Recurrent laryngeal nerve section for spastic dysphonia. Ann Otol Rhinol Laryngol 1976; 85:451-459.
7. Atkins JP. An electromyographic study of recurrent laryngeal nerve conduction and its clinical application. Laryngoscope 1973; 83:796-807.
8. Salassa JR, Desanto LW, Aronson AE. Respiratory distress after recurrent laryngeal nerve section for spastic dysphonia. Laryngoscope 1982; 92:240-245. (Pubitemid 12187093)
9. Aronson AE, DeSanto LW. Adductor spastic dysphonia: 1 1/2 years after recurrent laryngeal nerve resection. Ann Otol Rhinol Laryngol 1981; 90:2-6.
10. Fritzell B, Feuer E, Knutsson E, et al. Experiences with recurrent laryngeal nerve section for spastic dysphonia. Folia Phoniat 1982; 34:160-167. (Pubitemid 12032362)
11. Fritzell B, Hammarberg B, Schiratzki H, et al. Long-term results of recurrent laryngeal nerve resection for adductor spasmodic dysphonia. J Voice 1993; 7:172-178. (Pubitemid 23146574)
12. Genack SH, Woo P, Colton RH, et al. Partial thyroarytenoid myectomy: an animal study investigating a proposed new treatment for adductor spasmodic dysphonia. Otolaryngol Head Neck Surg 1993; 108:256-264. (Pubitemid 23105780)
13. Goding GSJ, Pernell KJ. Doxorubicin chemomyectomy: effects on evoked vocal fold tension and mucosal wave. Ann Otol Rhinol Laryngol 2000; 109:294-300.
14. Woo P. Carbon dioxide laser-assisted thyroarytenoid myomectomy. Lasers Surg Med 1990; 10:438-443. (Pubitemid 20366412)
15. Shaw GY, Sechtem PR, Rideout B. Posterior cricoarytenoid myoplasty with medialization thyroplasty in the management of refractory abductor spasmodic dysphonia. Ann Otol Rhinol Laryngol 2003; 112:303-306. (Pubitemid 36438025)
16. Netterville JL, Stone RE, Rainey C, et al. Recurrent laryngeal nerve avulsion for treatment of spastic dysphonia. Ann Otol Rhinol Laryngol 1991; 100: 10-14.
17. Weed DT, Jewett BS, Rainey C, et al. Long-term follow-up of recurrent laryngeal nerve avulsion for the treatment of spastic dysphonia. Ann Otol Rhinol Laryngol 1996; 105:592-601. (Pubitemid 26272265)
18. Berke GS, Blackwell KE, Gerratt RR, et al. Selective laryngeal adductor denervation-reinnervation: a new surgical treatment for adductor spasmodic dysphonia. Ann Otol Rhinol Laryngol 1999; 108:227-231. (Pubitemid 29135927)
19. Allegretto M, Morrison M, Rammage L, et al. Selective denervation: reinnervation for the control of adductor spasmodic dysphonia. J Otolaryngol 2003; 32:185-189. (Pubitemid 37064175)
20. Tucker HM. Laryngeal framework surgery in the management of spasmodic dysphonia: preliminary report. Ann Otol Rhinol Laryngol 1989; 98:52-54.
21. Isshiki N. Recent advances in phonosurgery. Folia Phoniat 1980; 32:119-154.
22. Isshiki N, Haji T, Yamamoto Y, et al. Thyroplasty for adductor spasmodic dysphonia: Further experiences. Laryngoscope 2001; 111:615-621. (Pubitemid 32295273)
23. Isshiki N, Tsuji DH, Yamamoto Y, et al. Midline lateralization thyroplasty for adductor spasmodic dysphonia. Ann Otol Rhinol Laryngol 2000; 109:187-193. (Pubitemid 30108211)
24. Chan SW, Baxter M, Oates J, et al. Long-term results of type II thyroplasty for adductor spasmodic dysphonia. Laryngoscope 2004; 114:1604-1608. (Pubitemid 39278879)
25. Chhetri DK, Mendelsohn AH, Blumin JH, et al. Long-term follow-up results of selective laryngeal adductor denervation-reinnervation surgery for adductor spasmodic dysphonia. Laryngoscope 2006; 116:635-642. (Pubitemid 44318078)
26. Troung DD, Rontal M, Rolnick M, et al. Double-blind controlled study of botulinum toxin in adductor spasmodic dysphonia. Laryngoscope 1991; 101:630-634.
27. Ludlow CL. Impact of botulinum toxin in laryngeal physiology. In: Brin MF, Hallett M, editors. Scientific and Therapeutic Aspects of Botulinum Toxin. Philadelphia: Lippincott Williams & Wilkins; 2002. pp. 179-188.
28. Blitzer A, Brin MF, Stewart CF. Botulinum toxin management of spasmodic dysphonia (laryngeal dystonia): a 12-year experience in more than 900 patients. Laryngoscope 1998; 108:1435-1441. (Pubitemid 28465236)
29. Bielamowicz S, Ludlow CL. Effects of botulinum toxin on pathophysiology in spasmodic dysphonia. Ann Otol Rhinol Laryngol 2000; 109:194-203. (Pubitemid 30108212)
30. Willinger U, Volkl-Kernstock S, Aschauer HN. Marked depression and anxiety in patients with functional dysphonia. Psychiatry Res 2005; 134:85-91. (Pubitemid 40460976)
31. MacKenzie K, Millar A, Wilson JA, et al. Is voice therapy an effective treatment for dysphonia? A randomised controlled trial. BMJ 2001; 323:658-661. (Pubitemid 32897005)
32. Ludlow CL, Adler CH, Berke GS, et al. Research priorities in spasmodic dysphonia. Otolaryngol Head Neck Surg 2008; 139:495-505. This was the report of a panel of experts that reviewed the state of knowledge on spasmodic dysphonia and made recommendations for future approaches to developing a consensus for diagnosis of spasmodic dysphonia, for determining risk factors for the disorder and for developing and evaluating new treatments for the disorder. Considerable attention was given to the need to conduct systematic and quantitative studies of the outcome of surgical treatments for the disorder.
33. Shipp T, Izdebski K, Reed C, et al. Intrinsic laryngeal muscle activity in a spastic dysphonic patient. J Speech Hear Disord 1985; 50:54-59. (Pubitemid 15141722)
34. Nash EA, Ludlow CL. Laryngeal muscle activity during speech breaks in adductor spasmodic dysphonia. Laryngoscope 1996; 106:484-489. (Pubitemid 26120135)
35. Koda J, Ludlow CL. An evaluation of laryngeal muscle activation in patients with voice tremor. Otolaryngol Head Neck Surg 1992; 107:684-696.
36. Warrick P, Dromey C, Irish JC, et al. Botulinum toxin for essential tremor of the voice with multiple anatomical sites of tremor: a crossover design study of unilateral versus bilateral injection. Laryngoscope 2000; 110:1366-1374. (Pubitemid 30626109)
37. Warrick P, Dromey C, Irish J, et al. The treatment of essential voice tremor with botulinum toxin A: a longitudinal case report. J Voice 2000; 14:410-421.
38. Adler CH, Bansberg SF, Hentz JG, et al. Botulinum toxin type A for treating voice tremor. Arch Neurol 2004; 61:1416-1420. (Pubitemid 39202225)
39. Blitzer A, Brin M, Stewart C, et al. Abductor laryngeal dystonia: a series treated with botulinum toxin. Laryngoscope 1992; 102:163-167.
40. Cyrus CB, Bielamowicz S, Evans FJ, et al. Adductor muscle activity abnormalities in abductor spasmodic dysphonia. Otolaryngol Head Neck Surg 2001; 124:23-30. (Pubitemid 32096774)
41. Bielamowicz S, Squire S, Bidus K, et al. Assessment of posterior cricoarytenoid botulinum toxin injections in patients with abductor spasmodic dysphonia. Ann Otol Rhinol Laryngol 2001; 110:406-412. (Pubitemid 32433850)
42. Remacle M, Plouin-Gaudon I, Lawson G, et al. Bipolar radiofrequency- induced thermotherapy (rfitt) for the treatment of spasmodic dysphonia. A report of three cases. Eur Arch Otorhinolaryngol 2005; 262:871-874.
43. Kim HS, Choi HS, Lim JY, et al. Radiofrequency thyroarytenoid myothermy for treatment of adductor spasmodic dysphonia: how we do it. Clin Otolaryngol 2008; 33:621-625. A study of partial thyroarytenoid myectomy using radiofrequency induced thermotherapy in ADSD patients showed although there was an initial benefit that by 1 year post surgery most patients once again needed to receive botulinum toxin injections to control their symptoms.
44. Nakamura K, Muta H, Watanabe Y, et al. Surgical treatment for adductor spasmodic dysphonia: efficacy of bilateral thyroarytenoid myectomy under microlaryngoscopy. Acta Otolaryngol 2008; 128:1348-1353. Bilateral total thyroarytenoid myectomy initially produced 3 to 6 months of breathiness, one patient needed adductor surgery, but a benefit remained in the others between 2.5 and 8 years later. The patients chose myectomy without a cervical scar over thyroplasty.
45. Tsuji DH, Chrispim FS, Imamura R, et al. Impact in vocal quality in partial myectomy and neurectomy endoscopic of thyroarytenoid muscle in patients with adductor spasmodic dysphonia. Braz J Otorhinolaryngol 2006; 72:261-266. (Pubitemid 44298460)
46. Sanuki T, Isshiki N. Outcomes of type II thyroplasty for adductor spasmodic dysphonia: analysis of revision and unsatisfactory cases. Acta Otolaryngol 2008 Dec:1-7. [Epub ahead of print] A third retrospective study of a series of 41 cases by Isshiki on the use of Type II thyroplasty in adductor spasmodic dysphonia. Unfortunately the follow-up period was too short, only one year, and symptoms were only rated in prolonged vowels, which are less likely to show symptoms in adductor spasmodic dysphonia. In addition, voice breaks, the symptoms specific to this disorder were not measured. Others have not been able to replicate benefits with this procedure.
47. Sapienza CM, Walton S, Murry T. Acoustic variations in adductor spasmodic dysphonia as a function of speech task. J Speech Lang Hear Res 1999; 42:127-140. (Pubitemid 29066473)
48. Barkmeier JM, Case JL, Ludlow CL. Identification of symptoms for spasmodic dysphonia and vocal tremor: a comparison of expert and nonexpert judges. J Commun Disord 2001; 34:21-37.
49. Goodin DS, Frohman EM, Garmany GP Jr, et al. Disease modifying therapies in multiple sclerosis: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology and the MS Council for Clinical Practice Guidelines. Neurology 2002; 58:169-178.
50. 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; 115:625-630. An evidence-based analysis of the results of botulinum toxin injection in spasmodic dysphonia which concluded that this treatment is effective in addutor spasmodic dysphonia.
51. Simpson DM, Blitzer A, Brashear A, et al. Assessment: Botulinum neurotoxin for the treatment of movement disorders (an evidence-based review): report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology 2008; 70:1699-1706. A large multidisciplinary panel reviewed the evidence regarding treatment with botulinum toxin in movement disorders including spasmodic dysphonia. These authors only concluded that botulinum toxin injections for adductor spasmodic dysphonia are probably effective and that no evidence is available on abductor spasmodic dysphonia. This panel concluded that botulinum toxin should be considered as a treatment option for adductor spasmodic dysphonia. (Pubitemid 351644138)
52. Klein AM, Stong BC, Wise J, et al. Vocal outcome measures after bilateral posterior cricoarytenoid muscle botulinum toxin injections for abductor spasmodic dysphonia. Otolaryngol Head Neck Surg 2008; 139:421-423. An uncontrolled case series of bilateral 2.5U injections into the posterior crico-arytenoid muscles for patients with abductor spasmodic dysphonia suggesting benefit.
53. Hogikyan ND, Sethuraman G. Validation of an instrument to measure voice-related quality of life (V-RQOL). J Voice 1999; 13:557-569. (Pubitemid 30007814)
54. Morrison MD, Rammage LA, Belisle GM, et al. Muscular tension dysphonia. J Otolaryngol 1983; 12:302-306.
55. Koufman JA, Blalock PD. Classification and approach to patients with functional voice disorders. Ann Otol Rhinol Laryngol 1982; 91:372-377.
56. Young N, Blitzer A. Management of supraglottic squeeze in adductor spasmodic dysphonia: a new technique. Laryngoscope 2007; 117:2082-2084. A new approach to treatment of patients with adductor spasmodic dysphonia who also have constant hyperadductive squeeze that is not benefited by voice therapy. Only four cases were included with some benefit based on unblinded assessment by the treating physicians. Such patients are difficult to treat and a controlled study comparing the addition of this procedure to the usual approach is needed with blinded assessment. (Pubitemid 350059396)
57. Casserly P, Timon C. Botulinum toxin A injection under electromyographic guidance for treatment of spasmodic dysphonia. J Laryngol Otol 2008; 122:52-56. An uncontrolled case series suggesting that EMG is beneficial and EMG indications of accuracy of placement is prognostic of degree of patient benefit. (Pubitemid 351650704)
58. Jeffcoat BT, Schweinfurth JM. Efficacy of a portable, audible-only electromyography device in the treatment of spasmodic dysphonia. Laryngoscope 2008; 118:942-943. An inexpensive portable speaker for listening to EMG while injecting the thyro-arytenoid muscle is described.
59. Birkent H, Maronian N, Waugh P, et al. Dosage changes in patients with long-term botulinum toxin use for laryngeal dystonia. Otolaryngol Head Neck Surg 2009; 140:43-47. A retrospective analysis of bilateral injection dosage of botulinum toxin into the thyroarytenoid muscles in adductor spasmodic dysphonia, reports that dosage titration is not usually reached until after 5 injections and that a significant reduction in dosage occurs by the 13th injection and continue until 20 injections without reduction in benefit duration. Suggests that a bilateral injection of 2.0U is usual.
60. Davidson B, Ludlow CL. Long term effects of botulinum toxin injections in spasmodic dysphonia. Otolaryngol Head Neck Surg 1996; 105:33-42. (Pubitemid 26015364)
61. Holden PK, Vokes DE, Taylor MB, et al. Long-term botulinum toxin dose consistency for treatment of adductor spasmodic dysphonia. Ann Otol Rhinol Laryngol 2007; 116:891-896. Another retrospective series on dosage for bilateral thyroarytenoid injections in patients with adductor spasmodic dysphonia. The authors suggest that a starting dosage of 1.5U is often adequate and a 2.5U dosage is unnecessary.
62. Pastor AM, Moreno-Lopez B, De la Cruz RR, et al. Effects of botulinum neurotoxin type A on abducens motoneurons in the cat: ultrastructural and synaptic alterations. Neuroscience 1997; 81:457-478. (Pubitemid 27382000)
63. Moreno-Lopez B, De la Cruz RR, Pastor AM, et al. Effects of botulinum neurotoxin type A on abducens motoneurons in the cat: alterations of the discharge pattern. Neuroscience 1997; 81:437-455. (Pubitemid 27381999)
64. Antonucci F, Rossi C, Gianfranceschi L, et al. Long-distance retrograde effects of botulinum neurotoxin A. J Neurosci 2008; 28:3689-3696. An important basic study in mice and rats showing central changes due retrograde transport of botulinum toxin producing reductions in sensory inputs in the hemisphere contralateral to injection. They also showed reduced motor neuron excitation by descending corticobulbar inputs to the facial nucleus in the brainstem. These findings may explain why there may be a reduction in spasms in noninjected muscles in dystonia and that the benefits of this treatment may include central changes.
65. Cannito MP, Kahane JC, Chorna L. Vocal aging and adductor spasmodic dysphonia: response to botulinum toxin injection. Clin Interv Aging 2008; 3:131-151. (Pubitemid 351559809)
66. Paniello RC, Barlow J, Serna JS. Longitudinal follow-up of adductor spasmodic dysphonia patients after botulinum toxin injection: quality of life results. Laryngoscope 2008; 118:564-568. (Pubitemid 351640641)
67. Hogikyan ND, Wodchis WP, Terrell JE, et al. Voice-related quality of life (V-RQOL) following type I thyroplasty for unilateral vocal fold paralysis. J Voice 2000; 14:378-386.
68. Simonyan K, Tovar-Moll F, Ostuni J, et al. Focal white matter changes in spasmodic dysphonia: a combined diffusion tensor imaging and neuropathological study. Brain 2008; 131:447-459. The first neuropathological study of spasmodic dysphonia showing axonal thinning in the internal capsule and mineral deposits in the basal ganglia and cerebellum. (Pubitemid 351197613)