Cross-linguistic study of vocal pathology: perceptual features of spasmodic dysphonia in French-speaking subjects

Clinical characterisation of Spasmodic Dysphonia of the adductor type (SD) in French speakers by Klap and colleagues (1993) appears to differ from that of SD in English. This perceptual analysis aims to describe the phonetic features of French SD. A video of 6 French speakers with SD supplied by Klap and colleagues was analysed for frequency of phonatory breaks, pitch breaks, harshness, creak, breathiness and falsetto voice, rate of production, and quantity of speech output. In contrast to English SD, the French speaking SD patients demonstrated no evidence pitch breaks, but phonatory breaks, harshness and breathiness were prominent features. This verifies the French authors’ (1993) clinical description. These findings suggest that phonetic properties of a specific language may affect the manifestation of pathology in neurogenic voice disorders

The laryngoscope and 19th century British understanding of laryngeal movements

The source of the human voice is obscured from view. The development of the laryngoscope in the late 1850s provided the potential to see the action of the vocal folds during speaking for the first time. This new instrument materially contributed to the understanding of vocal fold neuroanatomy, neurophysiology, and neuropathology. The laryngoscope led to the elucidation of disorders that previously were determined by changes in sound. The objective of this paper is to detail the consequences of this novel visualization of the larynx, and to trace how it led to an appreciation of how the voice was produced by movements of the vocal folds. This is demonstrated through an examination of the activities and practices of a group of London clinicians in the second half of the 19th century

Unilateral versus bilateral thyroarytenoid Botulinum toxin injections in adductor spasmodic dysphonia: a prospective study

OBJECTIVES: In this preliminary prospective study, we compared unilateral and bilateral thyroarytenoid muscle injections of Botulinum toxin (Dysport) in 31 patients with adductor spasmodic dysphonia, who had undergone more than 5 consecutive Dysport injections (either unilateral or bilateral) and had completed 5 concomitant self-rated efficacy and complication scores questionnaires related to the previous injections. We also developed a Neurophysiological Scoring (NPS) system which has utility in the treatment administration. METHOD AND MATERIALS: Data were gathered prospectively on voice improvement (self-rated 6 point scale), length of response and duration of complications (breathiness, cough, dysphagia and total voice loss). Injections were performed under electromyography (EMG) guidance. NPS scale was used to describe the EMG response. Dose and unilateral/bilateral injections were determined by clinical judgment based on previous response. Time intervals between injections were patient driven. RESULTS: Low dose unilateral Dysport injection was associated with no significant difference in the patient's outcome in terms of duration of action, voice score (VS) and complication rate when compared to bilateral injections. Unilateral injections were not associated with any post treatment total voice loss unlike the bilateral injections. CONCLUSION: Unilateral low dose Dysport injections are recommended in the treatment of adductor spasmodic dysphonia

The use of a prosthesis to facilitate writing in aphasia and right hemiplegia

Two case studies are presented which demonstrate the therapeutic utility of a new prosthesis to aid the treatment of agraphia in hemiplegic aphasics

Perceptual aspects of spasmodic dysphonia across different languages

Adductor spasmodic dysphonia (ADSD), an action induced dystonia, results in abrupt initiation and termination of voicing. Anglophone and Francophone vocal characteristics of ADSD are reviewed. Perceptual judgements were obtained from the symposium participants with a new Laryngeal Dystonia Feature Analysis checklist on videotaped ADSD interviews from 4 French, 1 Malaysian, 1 Greek, and 2 English, Clear differences were perceived in the presence of pitch breaks in various languages. This group confirmed their absence in French (replicating Lorch & Whurr, 1999) and presence in the other language samples. Language-specific phomotactics are suggested as a source of cross-linguistic differences in ADSD

Acquired disorders of language (aphasia): evaluation of effectiveness of intervention

Book synopsis: This work will provide readers with uniquely systematic coverage of the field of speech and language pathology. Taking as its starting point the highly successful Encyclopedia of Language and Linguistics, the book comprises selected updates from the original work combined with a high proportion of newly commissioned material which together give a comprehensive overview of the state of the art in speech and language pathology. The work is the most up-to-date and detailed reference available in this field. The book addresses all main aspects related to speech and language comprehension and production, both in children and in normal adults. It also presents in a systematic way disorders of speech and language due to developmental and acquired causes, the most common forms of treatment and their degree of efficacy

Meta-analysis of Botulinum toxin treatment of Spasmodic Dysphonia: a review of 22 studies

This meta-analysis focuses on the treatment effects of the use of botulinum toxin in laryngeal dystonia. The vocal symptoms are characterized by spasms of the laryngeal muscles thus the use of the term spasmodic dysphonia (SD). The objective of the intervention, i.e. botulinum toxin treatment, is to reduce or eliminate the vocal spasms and thus improve the acoustic regularity of the voice. The purpose of the present study was to assess the efficacy of botulinum toxin in the treatment of SD by engaging in a ‘best synthesis’ systematic summary of existing research. The average treated SD patient in the 22 studies subjected to meta-analysis obtained 97% improvement as a result of treatment with botulinum toxin

A cross-linguistic study of vocal pathology: perceptual features of spasmodic dysphonia in French-speaking subjects. Journal of Multilingual Communication Disorders 1 (1): 35-52 A Cross-linguistic study of vocal pathology: Perceptual features of spasmodic

ABSTRACT Clinical characterisation of Spasmodic Dysphonia of the adductor type (SD) in French speakers by Klap and colleagues (1993) appears to differ from that of SD in English. This perceptual analysis aims to describe the phonetic features of French SD. A video of 6 French speakers with SD supplied by Klap and colleagues was analysed for frequency of phonatory breaks, pitch breaks, harshness, creak, breathiness and falsetto voice, rate of production, and quantity of speech output. In contrast to English SD, the French speaking SD patients demonstrated no evidence pitch breaks, but phonatory breaks, harshness and breathiness were prominent features. This verifies the French authors' (1993) clinical description. These findings suggest that phonetic properties of a specific language may affect the manifestation of pathology in neurogenic voice disorders

The utility of meta-analysis in the determination of efficacy of treatment in aphasia: a reply to Robey (1994)

In response to Robey (1994) we argue that his judgment of our study and conclusions (Whurr, Lorch, & Nye, 1992) are inaccurate. We point out that our study was in fact an analysis of the effects of treatment for aphasic patients. Further, the results obtained in Robey's analysis, though obtained via a different strategy of analysis, yielded essentially the same degree of overall treatment outcome effect. Thus, we conclude that while Robey does provide a different model of effect size data organization and measurement, the results are no different and do not in fact contradict our data