Biomedical subjects

S E Sedory

Publications and source records attributed to S E Sedory.

4 recordsLinked to original sources

PubMed1990

Spasmodic dysphonia: botulinum toxin injection after recurrent nerve surgery.

The purpose of this study was to determine if botulinum toxin injections into the thyroarytenoid muscle would reduce symptoms in adductor spasmodic dysphonic patients who had experienced symptom recurrence after recurrent laryngeal nerve surgery. Five patients were seen between 3 to 10 years after surgery with a return of speech symptoms and persistent unilateral vocal fold paralysis. Before injection, comparisons with controls on spectrographic measures of pitch and voice breaks, aperiodicity, and sentence length demonstrated significant symptoms of spasmodic dysphonia (p less than or equal to 0.02). Electromyographic measures demonstrated equal levels of thyroarytenoid muscle activation on the operated and non-operated sides with bipolar needle electrodes, and heightened activity in both muscles relative to normal. Therefore, symptom return was associated with thyroarytenoid innervation after recurrent nerve surgery. In all patients, the thyroarytenoid muscle on the side operated on was injected with type A botulinum toxin. In two patients, toxin was also injected on the side not operated on. Significant (p less than or equal to 0.002) reductions in all speech symptoms occurred after injection. Electromyographic measures demonstrated significant reductions in the percent activation levels of both the injected muscle and noninjected muscles (p less than or equal to 0.01). Botulinum toxin injections were an effective treatment of post-surgical symptom recurrence in adductor spasmodic dysphonia.

Adult↗

PubMed1989

Comparisons of perceptual and acoustic characteristics of tracheoesophageal and excellent esophageal speech.

The results of recent studies have established significant acoustic differences between tracheoesophageal (TE) and conventional esophageal speech. Listener preferences and acoustic differences between TE and excellent esophageal speech were examined in the present investigation. Although, as a group, TE speech was characterized by longer extended phonation, more syllables per breath, and increased intensity, there were no significant differences in listener preference between the groups.

Acoustics↗

PubMed1989

Blink reflex excitability recovery curves in patients with spasmodic dysphonia.

We studied 12 patients with spasmodic dysphonia (SD) and 12 healthy control subjects. The patients, who had no symptomatic involvement of the eyes, were evaluated for increased excitability of blink reflexes, which is characteristic of blepharospasm and generalized dystonia. We measured symptom severity from sound spectrograms of five sentences, including sentence production time, number of pitch phonatory breaks, and percentage of aperiodic phonation. We evoked blink reflexes by electrical and mechanical stimulation, and assessed excitability by obtaining excitability recovery curves and responses to trains of stimuli. Patients and controls differed from each other in test R2 amplitude attenuation across all intervals from 150 to 1,000 msec to electrical and mechanical stimulation. Our results indicate that patients with SD have increased excitability of blink reflexes, which suggests that the dystonia involves not only the larynx but also other anatomical structures.

Adult↗

PubMed1988

Effects of botulinum toxin injections on speech in adductor spasmodic dysphonia.

Adductor spasmodic dysphonia involves an overadduction of the vocal folds during speech causing uncontrolled voice and pitch breaks and slow, effortful speech. The disorder is resistant to speech therapy and often recurs following initial benefit from unilateral recurrent laryngeal nerve resection. Botulinum toxin injections into multiple sites of the thyroarytenoid muscle on one side were performed in 16 patients. Speech was recorded prior to injection and three times post-injection. Symptoms were measured by two examiners from speech spectrograms without knowledge of speaker identity or recording session. Significant (p less than or equal to 0.03) reductions in pitch and voice breaks, phonatory aperiodicity, and sentence time occurred only when injections resulted in unilateral vocal fold paralysis. Symptoms returned with the restoration of vocal fold movement, 3 months later. Reduction in speed of swallowing without aspiration was reported in 80% of cases. Although speech volume was reduced, there were no instances of aphonia.

Adult↗