Longitudinal variations of laryngeal overpressure and voice-related quality of life in spasmodic dysphonia

• Published in: The Laryngoscope Vol. 125; no. 3; p. 661
• Main Authors: Yeung, Jeffrey C, Fung, Kevin, Davis, Eric, Rai, Sunita K, Day, Adam M B, Dzioba, Agnieszka, Bornbaum, Catherine, Doyle, Philip C
• Format: Journal Article
• Language: English
• Published: United States 01.03.2015
• Subjects: Adult; Aged; Dysphonia - diagnosis; Dysphonia - physiopathology; Dysphonia - psychology; Female; Follow-Up Studies; Humans; Larynx - physiopathology; Male; Middle Aged; Pressure; Quality of Life; Self-Assessment; Severity of Illness Index; Speech Production Measurement - methods; Voice Quality - physiology; laryngology; laryngeal overpressure; voice-related quality of life; voice/dysphonia; spasmodic dysphonia
• ISSN: 1531-4995
• DOI: 10.1002/lary.24953

Adductor spasmodic dysphonia (AdSD) is a voice disorder characterized by variable symptom severity and voice disability. Those with the disorder experience a wide spectrum of symptom severity over time, resulting in varied degrees of perceived voice disability. This study investigated the longitudinal variability of AdSD, with a focus on auditory-perceptual judgments of a dimension termed laryngeal overpressure (LO) and patient self-assessments of voice-related quality of life (V-RQOL). Longitudinal, correlational study. Ten adults with AdSD were followed over three time periods. At each, both voice samples and self-ratings of V-RQOL were gathered prior to their scheduled Botox injection. Voice recordings subsequently were perceptually evaluated by eight listeners for LO using a visual analog scale. LO ratings for all-voiced and Rainbow Passage sentence stimuli were found to be highly correlated. However, only the LO ratings obtained from judgments of AV stimuli were found to correlate moderately with self-ratings of voice disability for both the physical functioning and social-emotional subscores, as well as the total V-RQOL score. Based on perceptual judgments, LO appears to provide a reliable means of quantifying the severity of voice abnormalities in AdSD. Variability in self-ratings of the V-RQOL suggest that perceived disability related to AdSD should be actively monitored. Further, auditory-perceptual judgments may provide an accurate index of the potential impact of the disorder on the speaker. Similarly, LO was supported as a simple clinical measure that serves as a reliable index of voice change over time.