Clinical Trial: Effect of Vocal Exercise After Botulinum Toxin Injection for Spasmodic Dysphonia

Study Status: Terminated
Recruit Status: Terminated
Study Type: Interventional

Official Title: Effect of Vocal Exercise After Botulinum Toxin Injection for Spasmodic Dysphonia

Brief Summary: Studies have suggested that voluntary muscle exercise in the hand and face after botulinum toxin injection may enhance the clinical effects of the toxin. Exercise may speed up the absorption of the toxin by the nerves and enhance the clinical response. This study will explore the effect of exercise on botulinum toxin injections for spasmodic dysphonia (SD).

Detailed Summary:

SD is a rare voice disorder that usually starts when individuals are in early adulthood and occurs in two common forms: adductor and abductor (Aronson, 1968, Brin et al., 1992, Schweinfurth et al., 2002). Adductor is the more common form (Aronson, 1985, Blitzer et al. 1998). With adductor SD, patients have been described as "trying to talk whilst being choked" (Critchley, 1939). The spasmodic hyperadduction of the vocal folds is associated with strained-strangled, rough voice quality and sudden intermittent voice arrests (Aminoff, Dedo, & Izdebski, 1978, Blitzer & Brin, 1992, Hillel, 2001, Izdebski 1992, Ludlow, Nauton, & Bassich, 1984, Woodson, Zwirner, Murry, & Swenson, 1991). On the other hand, the intermittent or continuous abduction of the vocal folds linked with abductor SD results in breathy or whispered voice quality with sudden intermittent voice arrests (Aronson, 1985, Hillel, 2001, and Zwitman, 1979).

Local injection of botulinum toxin is an effective treatment for spasmodic dysphonia and The National Academies of Otolaryngology and Neurology has endorsed the toxin as the treatment of choice for adductor spasmodic dysphonia. Consequently, this treatment is widely used. The clinical benefit of the botulinum toxin is related to muscle weakness in the vocal folds and the benefit lasts from 6 weeks to 6 months.

Studies have suggested that voluntary muscle exercise in the hand and face after botulinum toxin injection may enhance the clinical effects of the toxin (Chen, Scott, & Smith, 2002; Chen et al., 1999; Kim et. al 2003;. Exercise may speed up the absorption of the toxin by the nerves and enhance the clinical response. You are invited to take part in a research study to learn more about the effect of exercise on botulinum toxin injections for spasmodic dysphonic. This project will e
Sponsor: New York University School of Medicine

Current Primary Outcome: Self-rating of vocal function [ Time Frame: Baseline, 2 weeks, 6 weeks, 3 months ]

Original Primary Outcome: Same as current

Current Secondary Outcome:

Original Secondary Outcome:

  • Number of voice breaks during connected speech [ Time Frame: Baseline, 2 weeks, 6 weeks, 3 months ]
  • Duration of voice onset time in speech [ Time Frame: Baseline, 2 weeks, 6 weeks, 3 months ]


Information By: New York University School of Medicine

Dates:
Date Received: May 6, 2009
Date Started: December 2007
Date Completion:
Last Updated: March 2, 2016
Last Verified: March 2016