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Laryngeal Manipulation for Dysphagia with Muscle Tension Dysphonia

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Abstract

The purpose of the article is to describe the use of laryngeal manipulation as a treatment for dysphagia resulting from excessive paralaryngeal muscle tension and to identify the patients likely to have symptomatic improvement. This is a retrospective single-center case series. A retrospective review identified patients from 2007 to 2013 with laryngeal manipulation for muscle tension dysphagia in an academic Otolaryngology practice. Subjects with dysphagia not attributable to an anatomic cause who attended therapy at least one time were included in the study. The primary outcome of the study was subjective improvement in dysphagia symptoms (yes/no) during follow-up. Symptoms, demographic information, treatment, and response to therapy were recorded. The Kruskal–Wallis test was used for analysis of continuous variables, while a Chi-squared test or fisher’s exact test was used for analysis of all categorical variables. Forty-four subjects were included, consisting of 37 women and 7 men. Subjective improvement in dysphagia was seen in 34 subjects (77.3%). No significant differences were seen in improvement based on gender (p = 0.3223), race (p = 0.4317), number of sessions with a speech pathologist (p = 0.3198), or presenting symptoms including hoarseness (p = 0.0853), pain (p = 1.000), globus (p = 0.2834), and cough (p = 1.000). We found subjective improvement with laryngeal manipulation as reported during follow-up visits to clinic among individuals with muscle tension dysphagia. Patient age, presenting symptoms, and number of therapy sessions were not found to be significantly associated with resolution of symptoms.

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References

  1. Morrison MD, Rammage LA, Belisle GM, Pullan CB, Nichol H. Muscular tension dysphonia. J Otolaryngol. 1983;12:302–6.

    PubMed  CAS  Google Scholar 

  2. Van Houtte E, Van Lierde K, Claeys S. Pathophysiology and treatment of muscle tension dysphonia: a review of the current knowledge. J Voice. 2011;25:202–7.

    Article  PubMed  Google Scholar 

  3. Roy N. Functional dysphonia. Curr Opin Otolaryngol Head Neck Surg. 2003;11(3):144–8.

    Article  PubMed  Google Scholar 

  4. Koufman JA, Amin MR, Panetti M. Prevalence of reflux in 113 consecutive patients with laryngeal and voice disorders. Otolaryngol Head Neck Surg. 2000;123(4):385–8.

    Article  PubMed  CAS  Google Scholar 

  5. Hoy M, Domer A, Plowman EK, Loch R, Belafsky P. Causes of dysphagia in a tertiary-care swallowing center. Ann Otol Rhinol Laryngol. 2013;122(5):335–8.

    Article  PubMed  Google Scholar 

  6. Pisegna JM, Yang S, Purcell A, Rubio A. A mixed-methods study of patient views on reflux symptoms and medication routines. J Voice. 2016;31:381.

    PubMed  Google Scholar 

  7. Mesallam TA, Farahat M. Self-perception of swallowing-related problems in laryngopharyngeal reflux patients diagnosed with 24-h oropharyngeal pH monitoring. Biomed Res Int. 2016. https://doi.org/10.1155/2016/7659016.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Altman K, Atkinson C, Lazarus C. Current and emerging concepts in muscle tension dysphonia: a 30-month review. J Voice. 2005;19:261–7.

    Article  PubMed  Google Scholar 

  9. Van Houtte E, Van Lierde K, D’haeseleer E, Van Imschoot B, Claeys S. UES pressure during phonation using high-resolution manometry and 24-h dual-probe pH-metry in patients with muscle tension dysphonia. Dysphagia. 2012;27(2):198.

    Article  PubMed  Google Scholar 

  10. Lowell SY, Kelley RT, Colton RH, Smith PB, Portnoy JE. Position of the hyoid and larynx in people with muscle tension dysphonia. Laryngoscope. 2012;122(2):370–7.

    Article  PubMed  Google Scholar 

  11. Rubin JS, Lieberman J, Harris TM. Laryngeal manipulation. Otolaryngol Clin North Am. 2000;33(5):1017–34.

    Article  PubMed  CAS  Google Scholar 

  12. Aronson A. Clinical voice disorders: an interdisciplinary approach. 3rd ed. New York: Thieme Stratton; 1990.

    Google Scholar 

  13. Roy N, Leeper HA. Effects of the manual laryngeal musculoskeletal tension reduction technique as a treatment for functional voice disorders: perceptual and acoustic measures. J Voice. 1993;7:242–9.

    Article  PubMed  CAS  Google Scholar 

  14. Greene M, Mathieson L. The voice and its disorders. London: Whurr Publishers; 1991.

    Google Scholar 

  15. Mackenzie K, Millar A, Wilson JA, Sellars C, Deary IJ. Is voice therapy an effective treatment for dysphonia? A randomised controlled trial. BMJ. 2001;323(7314):658–61.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  16. Carding P, Horsley I, Docherty G. A study of the effectiveness of voice therapy in the treatment of 45 patients with nonorganic dysphonia. J Voice. 1999;13:72–104.

    Article  PubMed  CAS  Google Scholar 

  17. Roy N. Manual circumlaryngeal therapy for functional dysphonia: an evaluation of short- and long-term treatment outcomes. J Voice. 1997;11(3):321–31.

    Article  PubMed  CAS  Google Scholar 

  18. Mathieson L, Hirani S, Epstein R, Baken R, Wood G, Rubin J. Laryngeal manual therapy: a preliminary study to examine its treatment effects in the management of muscle tension dysphonia. J Voice. 2009;23:353–66.

    Article  PubMed  CAS  Google Scholar 

  19. Van Lierde KM, De Bodt M, Dhaeseleer E, Wuyts F, Claeys S. The treatment of muscle tension dysphonia: a comparison of two treatment techniques by means of an objective multiparameter approach. J Voice. 2010;24(3):294–301.

    Article  PubMed  Google Scholar 

  20. Harris T, Harris S, Rubin JS, Howard DM. The voice clinic handbook. London: Whurr; 1998.

    Google Scholar 

  21. Stemple J, Weiler E, Whitehead W, Komray R. EMG bio- feedback training with patients exhibiting a hyperfunctional voice disorder. Laryngoscope. 1980;90:471–6.

    Article  PubMed  CAS  Google Scholar 

  22. Andrews S, Warner J, Stewart R. EMG biofeedback and relaxation in the treatment of hyperfunctional dysphonia. Brit J Dis Commun. 1986;21:353–69.

    Article  CAS  Google Scholar 

  23. Allen K, Bernstein B, Chait D. EMG biofeedback treatment of pediatric hyperfunctional dysphonia. J Behav Theory Exp Psych. 1991;22:97–101.

    Article  CAS  Google Scholar 

  24. Fex B, Fex S, Shiromoto O, Hirano M. Acoustic analysis of functional dysphonia: before and after voice therapy (accent method). J Voice. 1994;8:163–7.

    Article  PubMed  CAS  Google Scholar 

  25. Dworkin J, Garfield I, Meleca R, Simpson M. Use of topical lidocaine in the treatment of muscle tension dysphonia. J Voice. 2000;14:567–74.

    Article  PubMed  CAS  Google Scholar 

  26. Kang CH, Hentz JG, Lott DG. Muscle tension dysphagia: symptomology and theoretical framework. Otolaryngol Head Neck Surg. 2016;155(5):837–42.

    Article  PubMed  Google Scholar 

  27. Kennard EJ, Lieberman J, Saaid A, Rolfe KJ. A preliminary comparison of laryngeal manipulation and postural treatment on voice quality in a prospective randomized crossover study. J Voice. 2015;29(6):751–4.

    Article  PubMed  Google Scholar 

  28. Craig J, Tomlinson C, Stevens K, et al. Combining voice therapy and physical therapy: a novel approach to treating muscle tension dysphonia. J Commun Disord. 2015;58:169–78.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Ruotsalainen JH, Sellman J, Lehto L, Jauhiainen M, Verbeek JH. Interventions for treating functional dysphonia in adults. Cochrane Database Syst Rev. 2007;18(3):CD006373.

    Google Scholar 

  30. Rangarathnam B, Mccullough GH, Pickett H, Zraick RI, Tulunay-ugur O, Mccullough KC. Telepractice versus in-person delivery of voice therapy for primary muscle tension dysphonia. Am J Speech Lang Pathol. 2015;24(3):386–99.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Otolaryngology - Head and Neck Surgery, Boston Medical Center, 820 Harrison Avenue, Boston, MA, 02118, USA

    Joseph D. DePietro, Samuel Rubin, Daniel J. Stein, Hadas Golan & J. Pieter Noordzij

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  1. Joseph D. DePietro
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  2. Samuel Rubin
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  3. Daniel J. Stein
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  4. Hadas Golan
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  5. J. Pieter Noordzij
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Correspondence to J. Pieter Noordzij.

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DePietro, J.D., Rubin, S., Stein, D.J. et al. Laryngeal Manipulation for Dysphagia with Muscle Tension Dysphonia. Dysphagia 33, 468–473 (2018). https://doi.org/10.1007/s00455-018-9875-x

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  • DOI: https://doi.org/10.1007/s00455-018-9875-x

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