title: Vocal Parameters and Self-Perception in Individuals With Adductor Spasmodic Dysphonia.
abstract: OBJECTIVE
  The study aimed to compare and correlate perceptual-auditory analysis of vocal parameters and self-perception in individuals with adductor spasmodic dysphonia before and after the application of botulinum toxin.
  
  
  METHODS
  This is a prospective cohort study.
  
  
  METHODS
  Sixteen individuals with a diagnosis of adductor spasmodic dysphonia were submitted to the application of botulinum toxin in the thyroarytenoid muscle, to the recording of a voice signal, and to the Voice Handicap Index (VHI) questionnaire before the application and at two time points after application. Two judges performed a perceptual-auditory analysis of eight vocal parameters with the aid of the Praat software for the visualization of narrow band spectrography, pitch, and intensity contour.
  
  
  RESULTS
  Comparison of the vocal parameters before toxin application and on the first return revealed a reduction of oscillation intensity (P = 0.002), voice breaks (P = 0.002), and vocal tremor (P = 0.002). The same parameters increased on the second return. The degree of severity, strained-strangled voice, roughness, breathiness, and asthenia was unchanged. The total score and the emotional domain score of the VHI were reduced on the first return. There was a moderate correlation between the degree of voice severity and the total VHI score before application and on the second return, and a weak correlation on the first return.
  
  
  CONCLUSIONS
  Perceptual-auditory analysis and self-perception proved to be efficient in the recognition of vocal changes and of the vocal impact on individuals with adductor spasmodic dysphonia under treatment with botulinum toxin, permitting the quantitation of changes along time.
authors.affiliation: Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil.
authors.forename: Gleidy Vannesa E
authors.initials: GVE
authors.lastname: Rojas
authors.affiliation: Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil.
authors.forename: Hilton
authors.initials: H
authors.lastname: Ricz
authors.affiliation: Department of Neurosciences and Behavioral Sciences, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil.
authors.forename: Vitor
authors.initials: V
authors.lastname: Tumas
authors.affiliation: Department of Neurosciences and Behavioral Sciences, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil.
authors.forename: Guilherme R
authors.initials: GR
authors.lastname: Rodrigues
authors.affiliation: Department of Neurosciences and Behavioral Sciences, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil.
authors.forename: Patrícia
authors.initials: P
authors.lastname: Toscano
authors.affiliation: Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil. Electronic address: liricz@fmrp.usp.br.
authors.forename: Lílian
authors.initials: L
authors.lastname: Aguiar-Ricz
mesh_terms: D065087:Acetylcholine Release Inhibitors / Q000008:administration & dosage; D000162:Acoustics; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001307:Auditory Perception; D001905:Botulinum Toxins / Q000008:administration & dosage; D004185:Disability Evaluation; D055154:Dysphonia / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology* / Q000523:psychology*; D004644:Emotions; D005260:Female; D006801:Humans; D007600:Judgment; D007821:Laryngeal Muscles / Q000187:drug effects / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010699:Phonation / Q000187:drug effects; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012649:Self Concept; D012815:Signal Processing, Computer-Assisted; D012984:Software; D013018:Sound Spectrography; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014833:Voice Quality / Q000187:drug effects
chemical_list: D065087:Acetylcholine Release Inhibitors; D001905:Botulinum Toxins
keywords: Adductor spasmodic dysphonia; Botulinum toxin; Perceptual voice judgments; Vocal quality; Voice handicap