Differentiating between adductor and abductor spasmodic dysphonia using airflow interruption

Laryngoscope. 2009 Sep;119(9):1851-5. doi: 10.1002/lary.20572.

Abstract

Objectives/hypothesis: To measure the laryngeal resistance (R(L)), subglottal pressure (P(s)), and mean flow rate (MFR) of adductor (ADSD) and abductor (ABSD) spasmodic dysphonia patients using the airflow interrupter.

Methods: The R(L) of six ABSD and seven ADSD patients was measured using the airflow interrupter, a noninvasive device designed to measure MFR and P(s) via mechanical balloon valve interruption. Subjects performed 10 trials at each of two intensity levels, with each trial consisting of a sustained /a/ during which phonation was interrupted for 500 ms. Laryngeal resistance was calculated as subglottal pressure divided by airflow.

Results: Mean R(L) for the ADSD and ABSD subtypes at 65 dB were 24.78 cmH(2)O/L/s and 14.51 cmH(2)O/L/s, respectively (P = .04). Mean R(L) at 70 dB were 40.02 cmH(2)O/L/s and 15.84 cmH(2)O/L/s (P = .014). P(s) for the ADSD and ABSD subtypes at 65 dB were 10.23 cmH(2)O and 8.32 cmH(2)O, respectively (P = .582). At the 70 dB level, P(s) were 12.39 cmH(2)O and 11.78 cmH(2)O (P = .886). MFR for the ADSD and ABSD subtypes at 65 dB were 435 mL/s and 746 mL/s (P = .205). Mean MFR at 70 dB were 518 mL/s and 848 mL/s (P = .198).

Conclusions: Noninvasive measurements of R(L) may be useful for differentiating between ADSD and ABSD. This simple objective test, which produces a quantitative output, could be used to evaluate laryngeal function in patients with spasmodic dysphonia.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Acoustics
  • Dysphonia / diagnosis*
  • Dysphonia / physiopathology
  • Glottis / physiology
  • Humans
  • Larynx / physiopathology
  • Otolaryngology / methods
  • Phonation / physiology