Effects and Differences of Voice Therapy on Spasmodic Dysphonia and Muscle tension dysphonia: A Retrospective Pilot Study.

OBJECTIVES: Laryngeal and voice findings of adductor spasmodic dysphonia (AdSD) and muscle tension dysphonia (MTD) are similar, and it is difficult to distinguish between both disorders. The purpose of this study is to ascertain the effect of voice therapy on MTD and AdSD and clarify their difference. METHODS: A total of 49 patients, including 22 patients with MTD (MTD group) and 27 patients with AdSD (SD group), were included in the study. The MTD scores were evaluated, and aerodynamic analysis (maximum phonation time [MPT], mean airflow rate [MFR], highest pitch, lowest pitch, and pitch range), perceptual evaluation (Strangulation, Interruption, and Tremor), acoustic analysis (PPQ, APQ, NHR, and DVB), and subjective assessment (voice handicap index-10 [VHI-10]) were performed before and after voice therapy. RESULTS: The MTD score, highest pitch, pitch range, strangulation, PPQ, APQ, NHR, and VHI-10 showed significant improvement after treatment in the MTD groups. On the other hand, the effect of voice treatment on AdSD was poor despite the improvement in the MTD score. CONCLUSIONS: This study could serve as a basis for conducting prospective studies to verify the effects of voice therapy on MTD and AdSD.

Optimal Management of the Unilateral Recurrent Laryngeal Nerve Involvement in Patients with Thyroid Cancer.

We aimed to determine the optimal management of recurrent laryngeal nerve (RLN) involvement in thyroid cancer. We enrolled 80 patients with unilateral RLN involvement in thyroid cancer between 2000 and 2016. Eleven patients with preoperatively functional vocal folds (VFs) underwent sharp tumor resection to preserve the RLN (shaving group). Thirty-three patients underwent RLN reconstruction with RLN resection (reconstruction group). We divided the reconstruction group into two subgroups based on preoperative VF mobility (normal-reconstruction and paralyzed-reconstruction subgroups). In the cases where RLN reconstruction was difficult, phonosurgeries including arytenoid adduction (AA), with or without thyroplasty type I, or nerve muscle pedicle implantation with AA were performed later (phonosurgery group). We evaluated and compared vocal function among the evaluated periods and different groups. Postoperative vocal function in the shaving and normal-reconstruction subgroups was favorable. There were no significant differences between the two groups. In the paralyzed-reconstruction and phonosurgery groups, postoperative vocal function was significantly improved, and vocal function in the paralyzed-reconstruction subgroup was significantly better than that in the phonosurgery group. For optimal management of unilateral RLN involvement in thyroid cancer, first, sharp dissection should be performed, and if this is impossible, a simultaneous RLN reconstruction procedure should be adopted whenever possible.