User:Kengjalrnvjwngj/sandbox

Plans for Spasmodic Dysphonia Page
One area I definitely want to work on is the treatment section. There are recent reviews and meta-analysis I have found in my preliminary search for information that may provide new information.

Kengjalrnvjwngj (talk) 01:11, 30 September 2017 (UTC)

I think it may be a good idea to add audio samples. Kengjalrnvjwngj (talk) 14:57, 16 October 2017 (UTC)

Draft lead section for Spasmodic Dysphonia
Spasmodic dysphonia, also known as laryngeal dystonia, is a disorder in which the muscles that generate a person's voice go into periods of spasm. This results in breaks or interruptions in the voice which can make a person difficult to understand. The person's voice may also sound strained or they may be nearly unable to speak. Often onset is gradual and the condition is life long.

The cause is unknown. Risk factors may include family history of neurological disorders. , Triggers may include an upper respiratory infection, injury to the larynx, overuse of the voice, and psychological stress. The underlying mechanism is believed to typically involve the central nervous system, specifically the basal ganglia. Diagnosis is typically made following examination by a team of healthcare providers.

While there is no cure, treatment may improve symptoms. Most commonly this involves injecting botulinum toxin into the affected muscles of the larynx. This generally results in improvement for a few months. Other measures include voice therapy, counselling, and amplification devices. Rarely surgery may be considered.

The disorder affects an estimated 1 per 100,000 people. Women are more commonly affected. Average age of onset is 45 years old. , Severity is variable between people. In some work and social life are affected. Life expectancy is, however, normal.

Kengjalrnvjwngj (talk) 00:27, 8 October 2017 (UTC)

Treatment
There are a number of potential treatments for spasmodic dysphonia, including botox, surgery and voice therapy. A number of medications have also been tried including anticholinergics (such as benztropine) which have been found to be effective in 40-50% of people, but which are associated with a number of side effects.

Voice therapy
Voice therapy appears to be ineffective in cases of true spasmodic dysphonia, however as it is difficult to distinguish between spasmodic dysphonia and functional dysphonias and misdiagnosis is relatively common, a trial of voice therapy is often recommended before more invasive procedures are tried. Some also state that it is useful for mild symptoms and as an add-on to botox therapy and others report success in more severe cases. Laryngeal manual therapy, which is massaging of the neck and cervical structures, also shows positive results for intervention of functional dysphonia.

Surgery
A number of operations that cut one of the nerves of the vocal folds (the recurrent laryngeal nerve) has improved the voice of many for several months to several years but the improvement may be temporary.

An operation called "selective laryngeal adductor denervation-rennervation (SLAD-R)" is effective specifically for adductor spasmodic dysphonia which has shown good outcomes in about 80% of people at 8 years. Post-surgery voices can be imperfect and about 15% of people have significant difficulties. If symptoms do recur this is typically in the first 12 months. Another operation called "recurrent laryngeal nerve avulsion" has positive outcomes of 80% at three years.

Another surgical option is a thyroplasty, which ultimately changes the position or length of the vocal folds. After thyroplasty there is an increase in both objective and subjective measures of speech.

Botulinum toxin
Botulinum toxin (Botox) is often used to improve some symptoms of spasmodic dysphonia. Whilst the level of evidence for its use is limited, it remains a popular choice for many patients due to the predictability and low chance of long term side effects. It results in periods of some improvement. The duration of benefit averages 15-18 weeks before the patient returns to baseline. Repeat injection is required to sustain good vocal production. Possible side effects include breathiness of voice and choking on fluid, as well as reduced speech volume