The Voice Therapy Program for Adductor Spasmodic Dysphonia (ADSD)

Abstract

The purpose of this paper is to provide a concept, protocol and preliminary efficacy data for a behavioral voice therapy program for patients with adductor spasmodic dysphonia (ADSD). A voice therapy program was designed to target the underlying pathophysiology of focal laryngeal dystonia accompanying a disordered voice in patients with ADSD. The focus of the treatment was systematic voice training to improve the simple short nonspasmodic phonation to the conversational level. Twenty-one patients (twenty females, one male) were included in this therapy program. The outcome of the treatment was measured using the mora method. Recorded materials, including a passage from “The North Wind and the Sun” (24 morae total) read by the patients before and after the treatment were judged by three clinicians: two speech-language-hearing therapists and one otolaryngologist. The median score based on the mora method for all 21 patients was 24 pre-treatment and 12 post-treatment, indicating statistically significant improvement of the voice following treatment (Wilcoxon signed-ranks test, p<0.01). In detail, the score was improved in 10 patients, remained unchanged in 10 patients and was worsened in one patient after the treatment. Five (24%) of the twenty-one patients were satisfied with the effectiveness of the treatment, and required no further medical interventions. Our results indicated that behavioral voice therapy for ADSD was efficacious and could be a treatment option for ADSD.