The role of voice therapy in the treatment of dyspnea and dysphonia in a patient with a vagal nerve stimulation device.
Vagal nerve stimulators (VNS) are implanted to treat medically refractory epilepsy and depression. The VNS stimulates the vagus nerve in the left neck. Laryngeal side effects are common and include dysphagia, dysphonia, and dyspnea. The current case study represents a patient with severe dyspnea and dysphonia, persisting even with VNS deactivation. The case demonstrates the use of voice and respiratory retraining therapy for the treatment of VNS-induced dysphonia and dyspnea. It also highlights the importance of a multidisciplinary approach, including laryngology, neurology, and speech-language pathology, in the treatment of these challenging patients.
Department of Otolaryngology - Head and Neck Surgery, University of Pittsburgh Voice Center, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania. Electronic address: gillespieai@upmc.edu.
Amanda I
AI
Gillespie
Department of Otolaryngology - Head and Neck Surgery, University of Pittsburgh Voice Center, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
Leah B
LB
Helou
Department of Otolaryngology - Head and Neck Surgery, University of Pittsburgh Voice Center, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
John W
JW
Ingle
Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
Maria
M
Baldwin
Department of Otolaryngology - Head and Neck Surgery, University of Pittsburgh Voice Center, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
Clark A
CA
Rosen
D001945:Breathing Exercises; D003299:Cooperative Behavior; D004185:Disability Evaluation; D055154:Dysphonia / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D004417:Dyspnea / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D004827:Epilepsy / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D033183:Interdisciplinary Communication; D008297:Male; D008875:Middle Aged; D058117:Neural Prostheses; D010348:Patient Care Team; D010699:Phonation; D012119:Respiration; D016896:Treatment Outcome; D055536:Vagus Nerve Stimulation / Q000009:adverse effects* / Q000295:instrumentation*; D014833:Voice Quality; D014834:Voice Training
Epilepsy; PVFMD; Respiratory retraining; Vagal nerve stimulation