AI Article Synopsis
- The study underscores the effectiveness of electromyography (EMG) in diagnosing and treating treatment-resistant dysphonia, particularly when traditional voice therapy fails.
- A 43-year-old woman experienced persistent hoarseness for 9 months, with her voice assessment indicating significant issues; EMG identified isolated cricothyroid (CT) dystonia as the underlying cause.
- After receiving botulinum toxin injections, her voice quality significantly improved, demonstrating that EMG can be a critical tool in managing dysphonia without apparent structural causes.
Article Abstract
Objective: To demonstrate the utility of electromyography (EMG) in the evaluation and management of treatment-resistant dysphonia.
Method: We report a case of refractory dysphonia in which EMG was used to identify and treat isolated cricothyroid (CT) dystonia.
Results: The patient, a healthy 43-year-old woman, presented with 9 months of progressive hoarseness. Her symptoms were present across vocal tasks but were particularly bothersome while dictating. On presentation, her voice was rated grade 3, roughness 3, breathiness 1, asthenia 0, and strain 3 (G3R3B1A0S3). Videostroboscopy was remarkable for hyperfunction. Voice therapy was not beneficial despite appropriate effort. Microdirect laryngoscopy revealed no evidence of structural pathology. The patient was referred for EMG because of her normal examination and failure to improve with therapy. The CT muscle demonstrated an increased latency of 750 ms in all vocal tasks. One month after CT injection with 3 units of botulinum toxin (BTX), her voice was improved. Perceptual voice evaluation was rated G1R1B0A0S1. Voice Handicap Index improved from 87 to 35.
Conclusions: In the absence of structural pathology, EMG can be a useful adjunct in the diagnosis of dysphonia that persists despite adequate trials of voice therapy. To our knowledge, this is the only report of laryngeal dystonia due to isolated CT dysfunction successfully treated with BTX.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.jvoice.2015.06.005 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Wilson's disease manifesting as refractory rickets.
BMJ Case Rep
January 2025
Neurology, King George's Medical University, Lucknow, Uttar Pradesh, India
Wilson's disease is a metabolic disorder affecting the liver, brain, skin and osteo-muscular organs. Refractory rickets is an unusual phenomenon in Wilson's disease. This 27-year-old man was primarily treated for rickets for 20 years without success and later developed features of tremulousness of limbs and dysphonia when he was evaluated for Wilson's disease.
View Article and Find Full Text PDFPrompt response to rituximab in a patient with resistant polymyositis with complications of dysphagia and dysphonia: a case report.
Ann Med Surg (Lond)
October 2024
Department of Internal Medicine, Al-Ahli Hospital, West Bank, Palestine.
Introduction And Importance: Polymyositis is an inflammatory process, primarily affecting proximal muscles, characterized by elevated muscle enzymes and distinctive electromyography patterns.
Case Presentation: The authors present a case of a 33-year-old male patient experiencing complications of polymyositis, including pharyngeal and laryngeal involvement leading to dysphagia and dysphonia. Steroids and intravenous immunoglobulin (IVIG) therapy proved ineffective.
Stimulated Vocal Fold Immobility After Vagal Nerve Stimulator Placement: A Case Series.
Ann Otol Rhinol Laryngol
November 2024
Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, Houston, TX, USA.
Introduction: Vagal nerve stimulator (VNS) implantation is a vital therapy for epilepsy refractory to other treatments; however, it is associated with a very high rate of voice changes. Relatively few of these patients are evaluated for vocal fold motion impairments. In this series, we evaluate 5 such patients with a novel phenotype of forced abduction with VNS stimulation.
View Article and Find Full Text PDFAmikacin Liposome Inhalation Suspension in the Real-World Management of Refractory Mycobacterium avium Complex Pulmonary Disease.
Cureus
March 2024
Respiratory Medicine, National Hospital Organization Fukuoka National Hospital, Fukuoka, JPN.
The increasing prevalence of complex (MAC) pulmonary disease poses a significant therapeutic challenge, particularly due to the limited efficacy and systemic toxicity associated with conventional guideline-based therapy. Amikacin liposome inhalation suspension (ALIS) has been developed, yet its real-world application remains underreported. This retrospective analysis, conducted from March 2021 to February 2024, examined ALIS's clinical use in patients aged 20 years or older with refractory MAC pulmonary disease at our institution.
View Article and Find Full Text PDFLaryngeal Dysfunction Manifesting as Chronic Refractory Cough and Dyspnea: Laryngeal Physiology in Respiratory Health and Disease.
Chest
July 2024
Pulmonary & Critical Care Service, Brooke Army Medical Center, JBSA Fort Sam Houston, TX.
Topic Importance: Laryngeal dysfunction as a cause of chronic refractory cough and episodic dyspnea is often missed, which results in unnecessary testing and delays in diagnosis. Understanding laryngeal roles in breathing and airway protection can help to appreciate the propensity to laryngeal dysfunction with aging, chronic lung disease, and sleep apnea.
Review Findings: The human larynx is a complex muscular structure that is responsible for multiple roles of breathing, vocalization, coughing, and swallowing.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!