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

Laryngoscope. 2015 Mar;125(3):661-6. doi: 10.1002/lary.24953. Epub 2014 Oct 7.


Objectives/hypothesis: 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).

Study design: Longitudinal, correlational study.

Methods: 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.

Results: 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.

Conclusions: 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.

Keywords: laryngeal overpressure; laryngology; spasmodic dysphonia; voice-related quality of life; voice/dysphonia.

MeSH terms

  • 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*