Improved Outcome Measures Selection for Rating Spasmodic Dysphonia

Introduction Spasmodic Dysphonia (SD) is a rare disease, for which there is no consensus on the outcome measures to be used for the diagnosis as well as the treatment evaluation. This study aims to evaluate different possibilities for SD rating.

Method evaluation of the Voice Range Profile, Roughness-Breathiness-Hoarseness, Voice Handicap Index 9 (VHI-9), spasm count, and voice strain before and one month after Botulinum toxin injection in 7 SD (without voice tremor) patients successfully undergoing this treatment for a minimum of 1 year. Statistical significance was measured using the Wilcoxon signed-rank test (p≤0.05).

Results spasm count, voice strain (p = 0.018) and Jitter (p = 0.046) significantly decreased upon Botulin injection, while the range of the Sound Pressure Level (SPL) improved significantly (p = 0.028). The Dysphonia Severity Index and VHI-9 showed a trend toward improvement (p = 0.075 and 0.078, respectively).

The Maximum Phonation Time did not change. Roughness improved significantly (p = 0.038) while Breathiness and Hoarseness merely showed a trend to improvement (p = 0.083 and 0.063 respectively). An initial evaluation of reading vowel-rich sentences that likely trigger the spasms in SD patients shows that upon Botulinum toxin injection, the patient’s fundamental frequency variation of the speaking voice increases while the time necessary to speak each sentence decreases.

Conclusions the majority of the standard voice assessment parameters is abnormal in non-treated SD patients and improves within 1m after Botulin injection. On-going multicentric data collection (Austria, Germany, Ukraine) will be used to confirm these preliminary data.

Poster-PDF A-1513.PDF

Publication History

Article published online:
10 June 2020