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Differentiation of adductor-type spasmodic dysphonia from muscle tension dysphonia using spectrogram.
Seung Ho Noh, Sung Min Jin , So Yean Kim , Jae Kyung Cho, Sang Hyuk Lee
Department of Otorhinolaryngology-Head and Neck Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, seoul, Democratic People s Republic of Korea
Correspondence  Sang Hyuk Lee ,Tel: 02-2001-2269 , Fax: 02-2001-2273, Email: entlsh@hanmail.net
Received: 31 October 2017;  Accepted: 26 November 2017.  Published online: 26 November 2017.
Adductor type spasmodic dysphonia is neurogenic disorder and focal laryngeal dystonia, while muscle tension dysphonia is caused by functional voice disorder. Both ADSD and MTD may be associated with excessive supraglottic contraction and compensation, resulting in a strained voice quality with spastic voice breaks. Differential diagnosis of two voice disorders is important, because treatment for ADSD and MTD are quite different. The aim of this study was to determine the utility of spectrogram analysis in the differentiation of ADSD from MTD. Method:From 2015 through 2017, 17 patients of ADSD and 20 patient of MTD, underwent acoustic recording and phonatory function studies, were enrolled for this study. Jitter(frequency perturbation), Shimmer(amplitude perturbation) were obtained using MDVP(Multi-dimensional Voice Program) and GRBAS scale was used for perceptual evaluation. The two speech therapist evaluated a wide band spectrogram by blind test using 4 scales(0-3 point) for four spectral findings, abrupt voice breaks, irregular wide spaced vertical striations, well defined formants and high frequency spectral noise. Result:Jitter, Shimmer and GRBAS were not found different between two groups with no significant correlation(P>0.05). Abrupt voice breaks and irregular wide spaced vertical striations of ADSD were significantly higher than those of MTD with strong correlation(P<0.01). High frequency spectral noise of MTD were higher than those of ADSD with strong correlation(P<0.01).
The wide band spectrograms provided visual perceptual information can differentiate ADSD from MTD. Spectrogram analysis is a useful diagnostic tool for differentiating ADSD from MTD where perceptual analysis and clinical evaluation alone are insufficient.
KEY WORDS: Adductor-type spasmodic dysphonia; Muscle tension dysphonia; Spectrogram; Voice analysis; Differential diagnosis
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Related article
Differentiation of Adductor-Type Spasmodic Dysphonia from Muscle Tension Dysphonia Using Spectrogram  2017 December;28(2)
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