Pharyngeal Dystonia Mimicking Spasmodic Dysphonia.
Lucy L Shi, C Blake Simpson, Edie R Hapner and 2 others
PMID 28651822WHAT IT FOUND
Voice breaks that looked like spasmodic dysphonia came from pharyngeal muscle spasms on laryngoscopy.
In four patients, voice improvement was reported after injections that included pharyngeal folds, while laryngeal injections had not helped in some cases. This case series cannot prove treatment works.
Key findings
01Laryngoscopy showed spasms or constriction of oropharyngeal muscles, pharyngeal walls, and posterior tongue base during speech in the reported cases.
02Injection plans that included the pharyngoepiglottic fold were followed by voice improvement in the reported cases.
03Swallowing difficulty for solids was reported at higher pharyngeal botulinum toxin doses in two patients, and was managed by dose reduction or dietary changes.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
Only four patients were described, so this cannot show how common pharyngeal dystonia is or whether treatment works. Records were reviewed retrospectively, and patients were assessed using available scores, not a uniform outcome set. Patients received voice therapy, medication trials, and botulinum toxin at several sites over time, so the paper cannot separate the contribution of any single treatment or injection site. Two patients developed swallowing difficulty for solids, and the paper does not establish long-term safety of repeated pharyngeal injections.
The easy way to misread this
Do not conclude that pharyngeal botulinum toxin is an established treatment for voice breaks. This was only four patients, and the paper does not compare it with other treatments or show how common this diagnosis is.