• Speech Sciences
• /
• v.3
• /
• pp.5-17
• /
• 1998

Botulinum toxin, a neurotoxin derived from Clostridia Botulinum, has been injected into the target muscle(s) for the treatment of several kinds of voice and speech disorders at the Voice Clinic, Yonsei Institute of Logopedics and Phoniatrics since December 1995. Criteria for the diagnosis and method of injection for spasmodic dysphonia, mutational dysphonia, muscle tension dysphonia, dysphonia after total laryngectomy, and stuttering were summarized. Among 144 patients with adductor type spasmodic dysphonia, who were injected one time to maximum 8 times during the 27 months, 90% were recognized as having better than slight improvement. Even though the injected cases were small, not only the abductor type spasmodic dysphonia, but also the intractable mutational dysphonia or muscle tension dysphonia resistant to voice therapy revealed that botulinum toxin injection would be another options for treatment. Patients who cannot phonate after total laryngectomy and some forms of adulthood stutterers can also be candidates for the injection of botulinum toxin.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.25 no.2
• /
• pp.82-85
• /
• 2014

Functional dysphonia is a specific voice disorder refers to dysphonia without abnormal anatomical vocal fold findings at larynx. The proportions of this disorder are estimated up to 40% of dysphonia patients at ENT clinics. In this article, we will discuss about other functional dysphonia and neurological dysphonia except for muslce tension dysphonia and spasmodic dysphonia. For details, will describe about phonatory charateristics and treatment options about paradoxical vocal fold motion disorder, mutational dysphonia, essential vocal tremor, conversion dysphonia, and vocal tremor related with parkinson's disease.

• Phonetics and Speech Sciences
• /
• v.5 no.4
• /
• pp.63-70
• /
• 2013

The purpose of this study is to show the aerodynamic characteristics and differences in muscle tension dysphonia and adductor spasmodic dysphonia to predict factors which will provide additional information while preparing for the objective examination standard to distinguish the two dysphonias. Forty-eight individuals diagnosed with muscle tension dysphonia and adductor spasmodic dysphonia participated in this study. PAS was used in order to find the aerodynamic characteristics for the two dysphonias. The outcomes of this study show that the airflow variation and glottal resistance of the two groups showed noticeable differences. This study concludes that the aerodynamic characteristics may be used as additional information on diverse evaluations to classify muscle tension dysphonia and adductor spasmodic dysphonia.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.28 no.2
• /
• pp.71-78
• /
• 2017

Voice disorder is classified into three categories, structural, neurogenic and functional dysphonia. Neurogenic dysphonia refers to a disruption in the nerves controlling the larynx. Common examples of this include complete or partial vocal cord paralysis, spasmodic dysphonia. Also it occurs as part of an underlying neurologic condition such as Parkinson's disease, myasthenia gravis, Lou Gehrig's disease or disorder of the central nervous system that causes involuntary movement of the vocal folds during voice production. Functional dysphonia is a voice disorder in the absence of structual or neurogenic laryngeal characteristics. A near consensus exist that Muscle tension dysphonia (MTD) is functional voice disorder wherein hyperfunctional laryngeal muscle activity whereas Spasmodic dysphonia (SD) is neurogenic, action-induced focal laryngeal dystonia including several subtype. Both Adductor type spasmodic dysphonia (AdSD) and MTD may be associated with excessive supraglottic contraction and compensation, resulting in a strained voice quality with spastic voice breaks. It makes these two disorders extremely difficult to differentiate based on clinical interpretation alone. Because treatment for AdSD and MTD are quite different, correct diagnosis is important. Clinician should be aware of the specific vocal characteristics of each disease to improve therapeutic outcome.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.10 no.1
• /
• pp.12-16
• /
• 1999

Background and Objectives : The common cause of voice disorders may be bad habits of phonation. faulty vocal habits might aggravate the voice disorder or make the dysphonia. Authors thought the analysis of faulty vocal habits might help to evaluate the causes and to choose the treatment methods in patients with dysphonia. Authors studied to evaluate which vocal habits were used in patients with dysphonia. Materials and Methods : Patients with dysphonia(N= 32) and person without dysphonia(N=20) were evaluated through pre-evaluation test by otolaryngologist and SLP. All subjects were evaluated accordingly Posture of body, expansion of cervical vein, excessive movements of thyroide prominence, position of tongue, tension of lower lip, tension of jaw, breathing pattern related with phonation. Results : In dysphonia group, we found 23 cases with tension of jaw, 15 cases with expansion of cervical vein, 7 cases with bad position of tongue, 3 cases with excessive movement of thyroid prominence and a lot of cases with bad breathing Pattern on Phonation. In control group, only 3 cases with bad position of tongue, 2 cases with tension of lower lip, 1 case with tension of jaw were found. Conclusions : More faulty vocal habits were found in dysphonia group. Authors thought faulty vocal habits could be the cause of dysphonia and aggravate the dysphonia and the control of vocal habits would be very important in patients with dysphonia.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.21 no.1
• /
• pp.17-21
• /
• 2010

Dysphonia is a medical terminology for voice disorders characterized by hoarseness, harshness, weakness, or even loss of voice ; any impairment in ability to produce voice sounds using the vocal organs, larynx, The causes of dysphonia can be classified into two groups, organic and functional. Functional dysphonia includes spasmodic dysphonia, muscle tension dysphonia, mutational dysphonia and conversion dysphonia, etc, The findings of laryngoscopy in these dysphonia are almost normal. Therefore, physicians should diagnosis these diseases from careful history taking and abundant understandings about the phonation pattern, Organic dysphonia is caused by anatomical problems in the larynx, especially on the vocal fold, Some lesions, however, are not easily found because these lesions are too small, or located on the lower lip of vibrating vocal fold. Laryngopharyngeal reflux induced laryngitis, vascular lesions, sulcus vocalis, vocal atropy including presbylaryngis, and mucosal tears are common lesions easily missed in laryngoscopy, Therefore, a high index of suspicion is necessary to avoid missing vocal fold mucosal lesions, and the strobovideolaryngoscopy is indispensable in making the diagnosis,

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.14 no.1
• /
• pp.54-56
• /
• 2003

Spasmodic dysphonia is a task-specific dystonia affecting the laryngeal muscles, resulting forced, strained voice. The pathophysiologic mechanism is not fully understood. We experienced a patient with epilepsy developed transient spasmodic dysphonia during valproic acid monotherapy. The spasmodic dysphonia resolved with dose reduction of valproic acid. Change of neurotransmitters, such as GABA in basal ganglia or blockade of sodium channel is possible mechanism in our case of drug-related spasmodic dysphonia.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.27 no.2
• /
• pp.91-94
• /
• 2016

Voice is a physical phenomenon, generated by vocal fold and expiratory airflow. Dysphonia should come from abnormal vocal fold and airflow. Occassionally larynx looks normal in show, but it is actually not. There should be undetected structural or functional abnormalities. So when ENT doctors face dysphonia patients who looks normal larynx, should make a diagnosis through close observation. In this review article we present some dysphonia diseases which looks normal larynx. For example vocal fatigue, vocal fold paresis, posterior glottic diastasis, muscle tension dysphonia and psychogenic dysphonia.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.25 no.2
• /
• pp.75-78
• /
• 2014

Functional dysphonia refers to a voice disturbance that occurs in the absence of structural or neurologic laryngeal pathological characteristics. Poorly regulated activity of the intrinsic and extrinsic laryngeal muscles is cited as the proximal cause of functional dysphonia (FD). Recently, the term functional dysphonia has been replaced in some clinical circles by diagnostic label muscle tension dysphonia (MTD), which serves to highlight excess, dysregulated, or imbalanced activity of the intrinsic and extrinsic laryngeal muscles as proximal cause of the observed dysphonia. And recent research evidence points to specific personality traits as important contributors to its development and maintenance. However, the origin of this dysregulated laryngeal muscle activity has not been fully elucidated. Further research is needed to better understand the pathogenesis of functional dysphonia, and factors contributing to its successful management.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.11 no.1
• /
• pp.98-103
• /
• 2000

Background and Objectives : The etiology and pathophysiology of spasmodic dysphonia is yet unknown. This study was performed to determine if any laryngeal aerodynamic parameter distinguish the voice of patient diagnosed as having adductor spasmodic dysphonia from individuals with normal voice production and to investigate the pathophysiology of spasmodic dysphonia. Materials and Methods : fifteen women diagnosed as having adductor spasmodic dysphonia and fifteen normal control women participitated in this study Maximum phonation time, mean air flow rate, subglottic pressure, vocal efficiency, Vfo, NHR, VTI, FTRI, ATRI, Jitter percent, Shimmer percent were obtained from the participants using 'MDVP(multi-dimensional voice program)' of CSL(Computerized Speech lab, Kay Elemetrics, Co., Model No. 4300), and 'maximum sustained phonation' and 'IPIPI test' of AP II(Aerophone II, Kay Elemetrics, Co., Model 6800). Results : T-test statistical analysis revealed statistically different values for vocal efficiency, Vfo, NHR, MPT, litter percent, Shimmer percent between the spasmodic dysphonia group and the control group. Conclusions : Spasmodic dysphonia affects the ability of the laryngeal mechanism to function effectively. Results from our study demonstrate that certain aerodynamic and acoustic parameters distinguish adductor spasmodic dysphonia from normal voice.