• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.23 no.2
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• pp.99-103
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• 2012

Spasmodic dysphonia is a chronic, focal, movement-induced, action-specific dystonia of the laryngeal musculature during speech. It can have a profound effect on quality of life, severely limiting people's communication, especially via telephone and in noisy backgrounds. Spasmodic dysphonia (SD) is usually of the adductor type characterized by glottic contractions causing tightness and voice breaks with forced-strangled voice, but it may also be abductor type or, much less commonly, mixed. Treatment options for adductor spasmodic dysphonia (ADSD) include voice therapy, surgical procedures, and botulinum toxin injections (Botox). The use of Botox injected into the laryngeal muscles remains the "gold standard" treatment for reducing the vocal symptoms of ADSD and Botox induces a temporary paresis of the laryngeal muscles and provides short-term relief of symptoms. Repeated injections of the laryngeal muscles, generally every 3-4 months, are required for continuous relief of symptoms. Improvement in vocal function has been reported after use of Botox injections, though a completely normal voice is rarely achieved. In this hospital, 1,030 patients have been enrolled for Botox injection therapy so far (May, 2012). In this review article, I'd like to present my personal experience of management of spasmodic dysphonia mainly by Botox injection.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.26 no.1
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• pp.16-20
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• 2015

Post-thyroidectomy dysphonia occurs very frequently. Causes of dysphonia include recurrent laryngeal nerve (RLN) or external branch of superior laryngeal nerve (EBSL) injury, intubation, laryngotracheal fixation and other causes. Patients commonly characterized hoarseness or their voice impairment inability to short or sing and loss of loudness. Although complete recovery can be expected mostly in 3 months without obvious nerve injury, dysphonia lowers patients quality of life. The present review discuss the very kinds of causes of post-thyroidectomy dysphonia.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.21 no.1
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• pp.57-60
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• 2010

Spasmodic dysphonia is a focal dystonia of the larynx and breathy voice is a typical sign of abductor spasmodic dysphonia. A group of patients with abductor spasmodic dysphonia have a number of acoustic characteristics including abnormal fundamental frequency fluctuations and abnormally long word duration. We report a abductor spasmodic dysphonia case have enlongated voice onset time voiceless consonants and breathy voice in wide band spectrogram. The patient have the acoustic characteristics only in telephone speaking at work time. We treated the patient with anticholinergic and anticonvulsant drug and supplementary voice therapy. The breathy voice and enlongated VOT were disappeared after those treatment.

• Phonetics and Speech Sciences
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• v.3 no.2
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• pp.99-105
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• 2011

The treatment for patients with mutational dysphonia typically is useful with vegetative phonation, but has not yet been studied. This study attempts to identify the effect of $SKTCLP^{(R)}$ using throat clearing and laughing in patients with mutational dysphonia. The study, which was designed by the author, included 26 patients aged from 14 to 32 years (mean: 18.7 years) who had been diagnosed with mutational dysphonia between January 2007 and June 2010. Voice therapy for these patients included $SKTCLP^{(R)}$, ranging from two to seven sessions (mean: 3.8 sessions). Results were evaluated by videostroboscopy, perceptual evaluation of GRBAS scale, aerodynamic test, and acoustic analysis before and after therapy. Most patients could phonate with low pitch from the beginning and sustain with normal pitch sound in the last session. We had found that glottic gap reduced after therapy and anterior-posterior compression of superior laryngeal part at the first time, and these patients had complete closure of the glottis after treatment. The results of acoustic and aerodynamic measures after treatment indicated significant decreases in Fo, Jitter, Shimmer, SFF, and SPI, and increases in MPT, Psub, and vocal efficiency (p<.05). $SKTCLP^{(R)}$ may be a useful treatment method in managing mutational dysphonia. We can suggest this technique may be useful in improving the voice quality of other functional dysphonia having glottal chink or functional aphonia.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.30 no.1
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• pp.12-14
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• 2019

Functional dysphonia (FD) is a disease entity which includes various voice disorders in the absence of structural or neurologic laryngeal pathology. Muscle tension dysphonia (MTD), psychogenic dysphonia are representative FD with completely different pathogenesis. Therefore there is no standard treatment modality for FD, the first step of treatment of FD is differentiating patient's voice symptoms from other organic voice disorders and other functional voice problems. MTD is a functional voice disorder caused by hyperfunction of intrinsic and extrinsic laryngeal musculature. Symptoms include increased vocal effort, roughness, fatigue and odynophonia. First line for MTD is indirect or direct voice therapy. Unfortunately, many patients with MTD improve with voice therapy alone. For these patients, various modalities tried; lidocaine application, surgical excision of the false vocal folds, and botulinum toxin injection, etc. Botulinum toxin injections are widely used in the field of otolaryngology, especially for spasmodic dysphonia. However, its use in FD or MTD has only been described in few case reports. The aim of this lecture is to evaluate the feasibility of botulinum toxin injection for FD, especially MTD.

• Proceedings of the KSPS conference
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• 2007.05a
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• pp.143-145
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• 2007

Muscle groups that are located in and around the vocal tract can produce audible changes in frequency and/or intensity of the voice. Vocal vibrato is a characteristic feature in the singing of performers trained in the western classical tradition and vibrato is generally considered to result from modulation in frequency amplitude and timbre. Vocal tremor is also characterized by periodic fluctuations in the voice frequency or intensity and vocal tremor is symptom of a neurological disease as Spasmodic dysphonia , Parkinson's disease. Vocal vibrato and Vocal tremor may have many of the same origins and mechanisms in the voice production systems. The purpose of this study is to find acostic character of Korean traditional song Pansori singer's vibrato and Spasmodic dysphonia patient's vocal tremor. twelve Pansori singers and seven Spasmodic dysponia patients participated to this study. Power spectrum and Real time Spectrogram are used to analyze the acoustic characteristics of Pansori singing and Spasmodic dysphonia patient's voice The results are as follows; First, vowel formant differences between Pansori singing and Spasmodic dysphonia patient's voice are higher F1, F3. Second, The vibrato rate show differences between Pansori singing and Spasmodic dysphonia patients;$4^{\sim}6/sec$ and $5{\sim}6/sec$ Vibrato rate of pitch is 5.7 Hz ${\sim}$ 42.4 Hz for Pansori singing , 3.8 Hz ${\sim}$ 27.9 Hz for Spasmodic dysphonia patients ;Vibrato rate of intensity range is 0.07 dB ${\sim}$ 8.26 dB for Pansori singing and 0.07 dB ${\sim}$ 4.81 dB for Spasmodic dysphonia patients

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.17 no.2
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• pp.127-132
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• 2006

Background and Objectives : Functional dysphonia is a voice disturbance in the absence of structural or neurologic laryngeal pathology characterized by voluntary misuse of laryngeal muscles. The present report reviews clinical characteristics of 25 patients with functional dysphonia. Materials and Method : We analyzed medical records, perceptual and acoustic analysis of voice samples, aerodynamic studies and laryngoscopy. Results : There was no sex or age predilection. Eighty four percent of patients presented sudden onset of symptoms and 76% had specific events at the onset. Most patients showed breathy or strained voice and various degree of vocal fold insufficiency with supraglottic compensatory contractions. Acoustic analysis revealed non-diagnostic, but mean flow rate was lower than normal in all cases. All patients responded to voice therapy except for 4 patients who were tort to follow up. Mean number of voice therapy sessions required to get responses is 1.9 sessions. Conclusion : We concluded that patients with functional dysphonia responded very well to short-term voice therapy and should be included in differential diagnosis in patients with dysphonia cannot be explained by structural or neurologic etiology.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.8 no.1
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• pp.54-58
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• 1997

Spasmodic dysphonia is an uncommon and poorly understood disorder of motor control of laryngeal speech. We analysed 88 patients with spasmodic dysphonia, using chart review. These patients had historical information evaluated for age of onset(mean 39.2 years), duration of symptoms(mean 8.8 years), sex(4.2 : 1 female to male) family history(positive in 16.7%), and primary(84.8%) and secondary(15.2%) etiology : neurological evaluation for other dystonic involvement(40.7%). Eighty-three patients(94.3%) had adductor type of spasmodic dysphonia and 4 patients were abductor type and 1 patient was mixed type. All patients had normal thyroid and parathyroid functions and among 46cases, 8 patients had abnormal brain MRI finding. seventeen patients were evaluated by auditory brainstem response parameters. four out of the 17 patiemts had prolonged wave Ⅰ-Ⅴ interpeak latency.

• Speech Sciences
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• v.9 no.4
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• pp.39-47
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• 2002

The purpose of this study was to investigate the effects of Seo Dongil's voice technique on voice quality in patient with adductor spasmodic dysphonia. One patient participated in the study. The subject was assessed acoustically (Ave Fo, Ave Int, percent speech time, percent silence time, percent voice time, percent voiceless time) and perceptually (GRBAS scales) in the first and last session. Dr. Speech (version 4.0, Tiger-DRS) was used to compare acoustic parameters of pre-and post-treatment. Seo Dongil's voice technique consisted of relaxation, breathing exercise and phonation exercise. The results were as follows: First, Seo Dongil's voice technique tented to be effective on decreasing voice break and voice stoppage in patient with adductor spasmodic dysphonia. Second, GRBAS scales showed that Seo Dongil's voice technique was effective on improving voice quality of patient with adductor spasmodic dysphonia.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.25 no.2
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• pp.79-81
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• 2014

Spasmodic dysphonia (SD) is a chronic, focal, speech-induced, action-specific dystonia, resulting strained voice. Muscle tension dysphonia (MTD) may also result in a strangled, strained voice quality, usually as a result of compensation for underlying laryngeal disease such as glottal insufficiency. Patients with SD and MTD were suffered from the severely limiting people's communication, especially via telephone and in noisy backgrounds. SD is usually of the adductor type characterized by glottic contractions causing tightness and voice breaks, which is difficult to distinguish from MTD. In this review article, we present the characteritics and management of SD and MTD.