This phase 1 clinical trial involves a prospective, randomized, and placebo-controlled repeated measures parallel arm design to examine the effect of phonatory retraining (""""""""behavioral voice therapy"""""""") following botulinum toxin type A (Botox m) injections for adductor-type spasmodic dysphonia (ADSD). Subjects will include individuals undergoing first-time injections for ADSD. Following the collection of baseline measures, and after Botox injection, subjects will be randomized to 1 of 3 experimental groups: Botox only, Botox plus behavioral voice therapy, or Botox plus sham voice therapy. The Botox plus behavioral therapy group will incorporate current and well-recognized techniques for phonatory retraining that are widely practiced by voice therapists in the management of ADSD. A Botox plus sham voice therapy group is included in the design in order to better examine non-specific treatment effects which may emerge as a result of close patient-therapist interaction during behavioral voice therapy for ADSD. Dependent variables to be examined include voice-related Quality of Life, duration of benefit, as well as acoustic source measures (obtained from both connected speech and sustained phonation) of phonation.
Silverman, Erin P; Garvan, Cynthia; Shrivastav, Rahul et al. (2012) Combined modality treatment of adductor spasmodic dysphonia. J Voice 26:77-86 |