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Quality of Life and Voice Changes After a Single Injection in Patients With Adsd Over Time Publisher Pubmed



Faham M1 ; Torabinezhad F1 ; Murry T2 ; Dabirmoghaddam P3 ; Abolghasemi J4 ; Kamali M5 ; Asgari M6
Authors
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Authors Affiliations
  1. 1. Department of Speech and Language Pathology, Iran University of Medical Sciences, Tehran, Iran
  2. 2. Department of Otolaryngology Head and Neck Surgery, Loma Linda Voice and Swallowing Center, Loma Linda Health University, Loma Linda, CA, United States
  3. 3. Otolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Department of Biostatistics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
  5. 5. Department of Basic Sciences in Rehabilitation, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
  6. 6. Center for Spoken Language Understanding (CSLU), Oregon Health & Science University (OHSU), Portland, OR, United States

Source: Journal of Voice Published:2019


Abstract

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. © 2018 The Voice Foundation
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