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European Journal of Physical and... Dec 2022Currently, no evidence exists on specific treatments for post COVID-19 condition (PCC). However, rehabilitation interventions that proved effective for similar symptoms... (Review)
Review
INTRODUCTION
Currently, no evidence exists on specific treatments for post COVID-19 condition (PCC). However, rehabilitation interventions that proved effective for similar symptoms in other health conditions could be applied to people with PCC. With this overview of systematic reviews with mapping, we aimed to describe the Cochrane evidence on rehabilitation interventions proposed for dysphagia, dysphonia and olfactory dysfunction in different health conditions that can be relevant for PCC.
EVIDENCE ACQUISITION
We searched the last five years' Cochrane Systematic Review (CSRs) using the terms "dysphagia," "swallowing disorder," "dysphonia," "voice disorder," "olfactory dysfunction," "smell changes" and "rehabilitation" in the Cochrane Library. We extracted and summarized the available evidence using a map. We grouped the included CSRs for health conditions and interventions, indicating the effect and the quality of evidence.
EVIDENCE SYNTHESIS
We found 170 CSRs published between 2016 and 2021 and 1 was included. It provided data on dysphagia in acute and subacute stroke. Interventions included were acupuncture, neuromuscular electrical stimulation, transcranial magnetic stimulation and behavioral interventions, and swallowing therapy, with very low- to moderate-quality evidence. We did not find any CSR on dysphonia and olfactory disease.
CONCLUSIONS
These results are the first step of indirect evidence able to generate helpful hypotheses for clinical practice and future research. They served as the basis for the three recommendations on treatments for these PCC symptoms published in the current WHO Guidelines for clinical practice.
Topics: Humans; COVID-19; Deglutition Disorders; Dysphonia; Olfaction Disorders; Systematic Reviews as Topic
PubMed: 36534007
DOI: 10.23736/S1973-9087.22.07811-X -
American Family Physician Dec 2017Hoarseness is a common presentation in primary care practices. Combined with other voice-related changes, it falls under the umbrella diagnosis of dysphonia. Hoarseness...
Hoarseness is a common presentation in primary care practices. Combined with other voice-related changes, it falls under the umbrella diagnosis of dysphonia. Hoarseness has a number of causes, ranging from simple inflammatory processes to less common psychiatric disorders to more serious systemic, neurologic, or cancerous conditions. Medication-induced hoarseness is common and should be considered. The initial evaluation begins with a targeted history and physical examination, while also looking for signs of potential systemic etiologies. Treatment should begin with voice rest, especially avoidance of whispering, and conservative management directed toward a presumptive cause. For example, proton pump inhibitors are appropriate for hoarseness due to reflux, and proper vocal hygiene is recommended for vocal abuse-related indications. In the absence of a clear indication, antibiotics, oral corticosteroids, and proton pump inhibitors should not be used for the empiric treatment of hoarseness. Direct visualization of the larynx and vocal folds, commonly mislabeled as vocal cords, should be performed within three months if an etiology has not been determined or if conservative management has been ineffective. Patients who experience symptoms lasting longer than two weeks and who have risk factors for dysplasia (e.g., tobacco use, heavy alcohol use, hemoptysis) may require earlier laryngoscopic evaluation. Voice therapy is effective for improving voice quality in patients with dysphonia if conservative measures are unsuccessful, and it can also be helpful for prophylaxis in high-risk individuals (e.g., vocalists, public speakers). Surgical management is indicated for laryngeal or vocal fold dysplasia or malignancy, airway obstruction, or benign pathology resistant to conservative treatment.
Topics: Adult; Airway Obstruction; Conservative Treatment; Conversion Disorder; Diagnosis, Differential; Dysphonia; Gastroesophageal Reflux; Hoarseness; Humans; Laryngeal Neoplasms; Laryngopharyngeal Reflux; Laryngoscopy; Multiple Sclerosis; Parkinson Disease; Physical Examination; Proton Pump Inhibitors; Rest; Vocal Cord Paralysis; Voice Quality; Voice Training
PubMed: 29431404
DOI: No ID Found -
CoDAS 2023To analyse the relationship between the risk of dysphonia and vocal quality in undergraduate performing arts students. (Observational Study)
Observational Study
PURPOSE
To analyse the relationship between the risk of dysphonia and vocal quality in undergraduate performing arts students.
METHODS
Observational cross-sectional study with 38 undergraduate students in Performing Arts. We applied screening protocols for general and specific risk of dysphonia for actors and made recordings of sustained emission of the vowel /a/, spontaneous speech and reading a text, used for perceptual analysis performed by three evaluators using the GRBASI scale. After intra and inter-rater reliability tests it was obtained final classification of the general degree of vocal deviation parameter for each participant. Comparisons were made considering groups that had or did not have other profession/activity with the use of voice, and the groups were formed from the general grade.
RESULTS
Most students were at high risk for dysphonia. All had vocal alteration, with a predominance of mild degree. Students who had another profession/activity with voice use scored higher in the specific protocol for actors, and in the sum of this protocol with the general screening protocol. There was no relationship between the degree of vocal alteration and the risk of dysphonia. Students who did not yet work professionally had more moderate or severe vocal alterations, and those who did work professionally had a higher frequency of mild vocal alterations.
CONCLUSION
Most students were at high risk for dysphonia. All had vocal alteration, with a predominance of mild alteration. There was no relationship between the risk of dysphonia and the degree of vocal alteration.
Topics: Humans; Dysphonia; Voice Quality; Cross-Sectional Studies; Reproducibility of Results; Students
PubMed: 37610967
DOI: 10.1590/2317-1782/20232022036pt -
Acta Otorhinolaryngologica Italica :... Oct 2022Considering the impact of dysphonia on public health and the increasing attention to patient-centred care, we evaluated sex-related differences in the prevalence of...
OBJECTIVE
Considering the impact of dysphonia on public health and the increasing attention to patient-centred care, we evaluated sex-related differences in the prevalence of benign voice disorders, awareness of dysphonia and voice therapy (VT) results.
METHODS
One hundred and seventy-one patients, 129 females and 42 males, with functional or organic benign dysphonia underwent Voice Handicap Index (VHI), auditory-perceptual dysphonia severity scoring (GRBAS) and acoustic analysis (Jitter%, Shimmer%, NHR) before and after VT.
RESULTS
Prevalence of each voice disorder was significantly higher among females. Mean time-to-diagnosis (time elapsed until medical consultation) was not different between males and females. The refusal of therapy and VT adherence (mean number of absences and premature dropout) were similar in the two groups. Pre-VT VHI and "G" parameter were worse in women. The percentage of women with abnormal acoustic analysis was significantly higher. Post-VT VHI gain was higher in women, whereas "G" parameter improvement did not differ by sex.
CONCLUSIONS
Our study showed a higher prevalence of voice disorders in females. Awareness of dysphonia was not gender related. Females started with worse voice subjective perception and acoustic analysis, but they perceived greater improvement after therapy.
Topics: Male; Humans; Female; Prevalence; Voice Quality; Dysphonia; Voice Disorders; Acoustics; Patient Compliance; Severity of Illness Index
PubMed: 36541384
DOI: 10.14639/0392-100X-N2018 -
Toxins Dec 2022Laryngeal dystonia (LD), or spasmodic dysphonia (SD), is a chronic, task-specific, focal movement disorder affecting the larynx. It interferes primarily with the... (Review)
Review
Laryngeal dystonia (LD), or spasmodic dysphonia (SD), is a chronic, task-specific, focal movement disorder affecting the larynx. It interferes primarily with the essential functions of phonation and speech. LD affects patients' ability to communicate effectively and significantly diminishes their quality of life. Botulinum neurotoxin was first used as a therapeutic agent in the treatment of LD four decades ago and remains the standard of care for the treatment of LD. This article provides an overview of the clinical application of botulinum neurotoxin in the management of LD, focusing on the classification for this disorder, its pathophysiology, clinical assessment and diagnosis, the role of laryngeal electromyography and a summary of therapeutic injection techniques, including a comprehensive description of various procedural approaches, recommendations for injection sites and dosage considerations.
Topics: Humans; Dysphonia; Botulinum Toxins; Dystonia; Quality of Life; Larynx
PubMed: 36548741
DOI: 10.3390/toxins14120844 -
Clinics (Sao Paulo, Brazil) Mar 2016To propose and test the applicability of a dysphonia risk screening protocol with score calculation in individuals with and without dysphonia.
OBJECTIVE
To propose and test the applicability of a dysphonia risk screening protocol with score calculation in individuals with and without dysphonia.
METHOD
This descriptive cross-sectional study included 365 individuals (41 children, 142 adult women, 91 adult men and 91 seniors) divided into a dysphonic group and a non-dysphonic group. The protocol consisted of 18 questions and a score was calculated using a 10-cm visual analog scale. The measured value on the visual analog scale was added to the overall score, along with other partial scores. Speech samples allowed for analysis/assessment of the overall degree of vocal deviation and initial definition of the respective groups and after six months, the separation of the groups was confirmed using an acoustic analysis.
RESULTS
The mean total scores were different between the groups in all samples. Values ranged between 37.0 and 57.85 in the dysphonic group and between 12.95 and 19.28 in the non-dysphonic group, with overall means of 46.09 and 15.55, respectively. High sensitivity and specificity were demonstrated when discriminating between the groups with the following cut-off points: 22.50 (children), 29.25 (adult women), 22.75 (adult men), and 27.10 (seniors).
CONCLUSION
The protocol demonstrated high sensitivity and specificity in differentiating groups of individuals with and without dysphonia in different sample groups and is thus an effective instrument for use in voice clinics.
Topics: Adult; Aged; Auditory Perception; Child; Child, Preschool; Cross-Sectional Studies; Dysphonia; Female; Humans; Male; Middle Aged; Risk Assessment; Sensitivity and Specificity; Speech; Speech Acoustics; Surveys and Questionnaires; Visual Analog Scale; Voice Quality; Young Adult
PubMed: 27074171
DOI: 10.6061/clinics/2016(03)01 -
Ear, Nose, & Throat Journal Jul 2021
Topics: Adult; Dysphonia; Hemorrhage; Humans; Laryngeal Diseases; Male; Medical Illustration; Music; Occupational Diseases; Vocal Cords
PubMed: 31569976
DOI: 10.1177/0145561319869914 -
Ear, Nose, & Throat Journal Sep 2021Hoarseness lasting greater than 2 weeks should be thoroughly evaluated. Here, a case is presented of a 38-year-old female with a 10-year history of dysphonia. Endoscopic...
Hoarseness lasting greater than 2 weeks should be thoroughly evaluated. Here, a case is presented of a 38-year-old female with a 10-year history of dysphonia. Endoscopic examination confirmed the presence of a supraglottic mass, for which operative biopsy and imaging were performed. Pathology confirmed the diagnosis of supraglottic schwannoma. This was excised endoscopically with close management postoperatively to monitor for rapid recurrence and airway compromise. At one month postoperatively, the patient is still mildly dysphonic but vocally improved and the operative site continues to heal well.
Topics: Adult; Dysphonia; Epiglottis; Female; Hoarseness; Humans; Laryngeal Neoplasms; Laryngoscopy; Neurilemmoma
PubMed: 34112006
DOI: 10.1177/01455613211018586 -
International Journal of Pediatric... Apr 2022Clinical experience shows that children with functional dysphonia often present disorders that are associated with abnormal auditory and emotional development. These...
INTRODUCTION
Clinical experience shows that children with functional dysphonia often present disorders that are associated with abnormal auditory and emotional development. These children also struggle with voice therapy, perhaps because of difficulties with auditory control during speech. It has been hypothesized that difficulties in auditory processing in children may be an important factor in the pathogenesis of childhood dysphonia.
OBJECTIVE
The study aimed to assess selected auditory functions in children with hyperfunctional dysphonia.
MATERIALS AND METHOD
The study group consisted of 331 children aged from 7 to 12 years suffering from hyperfunctional dysphonia. The control group consisted of 213 children aged 7-12 years. All patients underwent ENT and phoniatric examination. All children underwent two standardized psychoacoustic tests: the Frequency Pattern Test (FPT) and the Duration Pattern Test (DPT).
RESULTS
In the examined material, 223 children had edematous vocal fold nodules. The largest statistically significant differences were seen in the acoustic parameters describing relative frequency changes. FPT and DPT showed statistically significant differences in children with hyperfunctional dysphonia compared to the control group. At all ages the percentage of correctly identified tone sequences was significantly lower in children with dysphonia.
CONCLUSION
Children with hyperfunctional dysphonia have difficulties in judging the pitch and duration of auditory stimuli. Difficulties in auditory processing appear to be important in the pathomechanism of functional voice disorders. Impaired hearing processes in children with hyperfunctional dysphonia can make it difficult to obtain positive and lasting effects from voice therapy.
Topics: Acoustics; Auditory Perception; Child; Dysphonia; Humans; Speech; Voice
PubMed: 35202899
DOI: 10.1016/j.ijporl.2022.111060 -
The Laryngoscope Jan 2018Our ability to speak is complex, and the role of the central nervous system in controlling speech production is often overlooked in the field of otolaryngology. In this... (Review)
Review
OBJECTIVE
Our ability to speak is complex, and the role of the central nervous system in controlling speech production is often overlooked in the field of otolaryngology. In this brief review, we present an integrated overview of speech production with a focus on the role of central nervous system. The role of central control of voice production is then further discussed in relation to the potential pathophysiology of spasmodic dysphonia (SD).
DATA SOURCES
Peer-review articles on central laryngeal control and SD were identified from PUBMED search. Selected articles were augmented with designated relevant publications.
REVIEW METHODS
Publications that discussed central and peripheral nervous system control of voice production and the central pathophysiology of laryngeal dystonia were chosen.
RESULTS
Our ability to speak is regulated by specialized complex mechanisms coordinated by high-level cortical signaling, brainstem reflexes, peripheral nerves, muscles, and mucosal actions. Recent studies suggest that SD results from a primary central disturbance associated with dysfunction at our highest levels of central voice control. The efficacy of botulinum toxin in treating SD may not be limited solely to its local effect on laryngeal muscles and also may modulate the disorder at the level of the central nervous system.
CONCLUSION
Future therapeutic options that target the central nervous system may help modulate the underlying disorder in SD and allow clinicians to better understand the principal pathophysiology.
LEVEL OF EVIDENCE
NA.Laryngoscope, 128:177-183, 2018.
Topics: Central Nervous System; Dysphonia; Humans; Spasm; Voice Disorders
PubMed: 28543038
DOI: 10.1002/lary.26655