Summary
Introduction
Adductor spasmodic dysphonia (ADSD) is one of the most disabling voice disorders with
no permanent cure. Patients with ADSD suffer from poor voice quality and repeated
interruption of phonation that leads to limitations in daily communication. Botox
(BT) injection, considered the gold standard treatment for ADSD, reduces the amount
of voice breaks and improves voice quality for a limited period. In this study, patients
with ADSD were followed after a single BT injection to track the changes in QOL and
perceptual voice quality over a 6-month period.
Method
This is a prospective and longitudinal study. Fifteen patients with ADSD were evaluated
preinjection and 1, 3, and 6 months postinjection. They completed the Voice Activity
and Participation Profile-Persian Version (VAPPP) and read a passage at each recording
period. Perceptual assessment was done by three expert speech-language pathologists
with knowledge of ADSD using the grade, roughness, breathiness, asthenia, strain (GRBAS)
scale. The data were analyzed using Friedman, Wilcoxon, and McNemar tests. The significance
level was set at P < 0.05.
Results
The VAPPP total score and each of the domain scores reached their peak scores at 3
months postinjection. At 6 months postinjection, the VAPPP scores increased significantly
in comparison with the 3-month scores and but were lower than preinjection scores.
GRBAS results also indicated that patients' voices at 1 and 3 months postinjection
were significantly less severe in terms of strain and roughness (P = 0.01; P < 0.001, respectively).
Conclusion
BT injection resulted in improvement of subjects' QOL. The improvement was greatest
at 3 months postinjection but remained above the preinjection values at 6 months after
injection. The voice quality also improved but was not judged as normal.
Key Words
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Article info
Publication history
Published online: June 05, 2018
Accepted:
April 30,
2018
Identification
Copyright
© 2018 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
