title: Longitudinal variations of laryngeal overpressure and voice-related quality of life in spasmodic dysphonia.
abstract: OBJECTIVE
  Adductor spasmodic dysphonia (AdSD) is a voice disorder characterized by variable symptom severity and voice disability. Those with the disorder experience a wide spectrum of symptom severity over time, resulting in varied degrees of perceived voice disability. This study investigated the longitudinal variability of AdSD, with a focus on auditory-perceptual judgments of a dimension termed laryngeal overpressure (LO) and patient self-assessments of voice-related quality of life (V-RQOL).
  
  
  METHODS
  Longitudinal, correlational study.
  
  
  METHODS
  Ten adults with AdSD were followed over three time periods. At each, both voice samples and self-ratings of V-RQOL were gathered prior to their scheduled Botox injection. Voice recordings subsequently were perceptually evaluated by eight listeners for LO using a visual analog scale.
  
  
  RESULTS
  LO ratings for all-voiced and Rainbow Passage sentence stimuli were found to be highly correlated. However, only the LO ratings obtained from judgments of AV stimuli were found to correlate moderately with self-ratings of voice disability for both the physical functioning and social-emotional subscores, as well as the total V-RQOL score. Based on perceptual judgments, LO appears to provide a reliable means of quantifying the severity of voice abnormalities in AdSD.
  
  
  CONCLUSIONS
  Variability in self-ratings of the V-RQOL suggest that perceived disability related to AdSD should be actively monitored. Further, auditory-perceptual judgments may provide an accurate index of the potential impact of the disorder on the speaker. Similarly, LO was supported as a simple clinical measure that serves as a reliable index of voice change over time.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Jeffrey C
authors.initials: JC
authors.lastname: Yeung
authors.forename: Kevin
authors.initials: K
authors.lastname: Fung
authors.forename: Eric
authors.initials: E
authors.lastname: Davis
authors.forename: Sunita K
authors.initials: SK
authors.lastname: Rai
authors.forename: Adam M B
authors.initials: AM
authors.lastname: Day
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Dzioba
authors.forename: Catherine
authors.initials: C
authors.lastname: Bornbaum
authors.forename: Philip C
authors.initials: PC
authors.lastname: Doyle
mesh_terms: D000328:Adult; D000368:Aged; D055154:Dysphonia / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007830:Larynx / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011312:Pressure; D011788:Quality of Life; D012647:Self-Assessment; D012720:Severity of Illness Index; D013068:Speech Production Measurement / Q000379:methods; D014833:Voice Quality / Q000502:physiology*
keywords: laryngeal overpressure; laryngology; spasmodic dysphonia; voice-related quality of life; voice/dysphonia