- 作者：Shannon Kraft&lowast ; ; skraft3@kumc.edu" class="auth_mail" title="E-mail the corresponding author ; Jana Childes&dagger ; ; Allen Hillel&Dagger ; ; Joshua Schindler&dagger ;
- 关键词：Laryngeal dystonia ; Spasmodic dysphonia ; Cricothyroid muscle ; Laryngeal electromyography
- 刊名：Journal of Voice
- 出版年：2016
- 出版时间：July 2016
- 年：2016
- 卷：30
- 期：4
- 页码：501-505
- 全文大小：1170 K
Method
We report a case of refractory dysphonia in which EMG was used to identify and treat isolated cricothyroid (CT) dystonia.
Results
The patient, a healthy 43-year-old woman, presented with 9 months of progressive hoarseness. Her symptoms were present across vocal tasks but were particularly bothersome while dictating. On presentation, her voice was rated grade 3, roughness 3, breathiness 1, asthenia 0, and strain 3 (G3R3B1A0S3). Videostroboscopy was remarkable for hyperfunction. Voice therapy was not beneficial despite appropriate effort. Microdirect laryngoscopy revealed no evidence of structural pathology. The patient was referred for EMG because of her normal examination and failure to improve with therapy. The CT muscle demonstrated an increased latency of 750 ms in all vocal tasks. One month after CT injection with 3 units of botulinum toxin (BTX), her voice was improved. Perceptual voice evaluation was rated G1R1B0A0S1. Voice Handicap Index improved from 87 to 35.
Conclusions
In the absence of structural pathology, EMG can be a useful adjunct in the diagnosis of dysphonia that persists despite adequate trials of voice therapy. To our knowledge, this is the only report of laryngeal dystonia due to isolated CT dysfunction successfully treated with BTX.