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Case-control study of risk factors for spasmodic dysphonia: A comparison with other voice disorders

Authors

  • Kristine Tanner PhD,

    Corresponding author
    1. Department of Communication Sciences and Disorders (K.T., N.R.), Division of Otolaryngology–Head and Neck Surgery, The University of Utah, Salt Lake City, Utah
    2. Voice Disorders Center, The University of Utah, Salt Lake City, Utah
    • CCC-SLP, Voice Disorders Center, 729 Arapeen Dr., Salt Lake City, UT 84108
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  • Nelson Roy PhD,

    1. Department of Communication Sciences and Disorders (K.T., N.R.), Division of Otolaryngology–Head and Neck Surgery, The University of Utah, Salt Lake City, Utah
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  • Ray M. Merrill PhD, MPH,

    1. Department of Health Science, Brigham Young University, Provo, Utah
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  • Cara Sauder MA,

    1. Department of Speech–Language Pathology, University of New Mexico Hospitals, Albuquerque, New Mexico, U.S.A
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  • Daniel R. Houtz MA,

    1. Voice Disorders Center, The University of Utah, Salt Lake City, Utah
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  • Marshall E. Smith MD

    1. Department of Communication Sciences and Disorders (K.T., N.R.), Division of Otolaryngology–Head and Neck Surgery, The University of Utah, Salt Lake City, Utah
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  • This work was supported in part by a University of Utah College of Health Research and Creative Grant. The authors have no other funding, financial relationships, or conflicts of interest to disclose.

Abstract

Objectives/Hypothesis:

This epidemiology study examined risk factors uniquely associated with spasmodic dysphonia (SD).

Study Design:

Case-control.

Methods:

A questionnaire was administered to 150 patients with SD (with and without coexisting vocal tremor) and 136 patients with other structural, neurological, and functional voice disorders (excluding SD and vocal tremor). Questions included personal and family medical histories, environmental exposures, trauma, illnesses, voice use habits, and the Short Form 36.

Results:

Several factors were uniquely associated with SD (α = .05), including: 1) a personal history of cervical dystonia, sinus and throat illnesses, mumps, rubella, dust exposure, and frequent volunteer voice use, 2) a family history of voice disorders, 3) an immediate family history of vocal tremor and meningitis, and 4) an extended family history of head and neck tremor, ocular disease, and meningitis. Vocal tremor coexisted with SD in 29% of cases. Measles and mumps vaccines were protective for SD.

Conclusions:

SD is likely multifactorial and associated with several endogenous and exogenous factors. Certain viral exposures, voice use patterns, and familial neurological conditions may contribute to the onset of SD later in life.

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