Ann Rehabil Med.  2015 Apr;39(2):313-317. 10.5535/arm.2015.39.2.313.

Diagnosis of Spasmodic Dysphonia Manifested by Swallowing Difficulty in Videofluoroscopic Swallowing Study

• Yeo HG
• Lee SJ
• Hyun JK
• Kim TU

• KMID: 2273055
• DOI: http://doi.org/10.5535/arm.2015.39.2.313

Abstract

Spasmodic dysphonia is defined as a focal laryngeal disorder characterized by dystonic spasms of the vocal cord during speech. We described a case of a 22-year-old male patient who presented complaining of idiopathic difficulty swallowing that suddenly developed 6 months ago. The patient also reported pharyngolaryngeal pain, throat discomfort, dyspnea, and voice change. Because laryngoscopy found no specific problems, an electrodiagnostic study and videofluoroscopic swallowing study (VFSS) were performed to find the cause of dysphagia. The VFSS revealed continuous twitch-like involuntary movement of the laryngeal muscle around the vocal folds. Then, he was diagnosed with spasmodic dysphonia by VFSS, auditory-perceptual voice analysis, and physical examination. So, we report the first case of spasmodic dysphonia accompanied with difficulty swallowing that was confirmed by VFSS.

Keyword

Dysphonia; Deglutition disorders; Videofluoroscopic swallowing study (VFSS)

MeSH Terms

Deglutition Disorders
Deglutition*
Diagnosis*
Dyskinesias
Dysphonia*
Dyspnea
Humans
Laryngeal Muscles
Laryngoscopy
Male
Pharynx
Physical Examination
Spasm
Vocal Cords
Voice
Young Adult

Figure

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  Fig. 1 Laryngoscopic examination. (A) Tongue base and epiglottis. There was no swelling around tongue base. (B) Vocal fold. Vocal fold was symmetric, mild hyperemia is only observed around vocal fold and aryepiglottic fold.

• 

  Fig. 2 (A) Videofluoroscopic swallowing study (VFSS) lateral view. Twitch-like involuntary movement (black arrow) in laryngeal muscles around vocal fold. (B) VFSS anterior-posterior view. Involuntary movement was also observed (anterior-posterior view, white arrow). This movement occurred before or after swallowing.

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