Diagnostic Delays in Spasmodic Dysphonia: A Call for Clinician Education

• Type of Material: Article
• Authors: Francis X. Creighton, Harvard University; Edie Hapner, Emory University; Adam Klein, Emory University; Ami Rosen, Emory University; Hyder Jinnah, Emory University; Michael Johns, Emory University
• Language: English
• Date: 2015-09-01
• Publisher: Elsevier
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2015 The Voice Foundation.
• Final Published Version (URL): http://dx.doi.org/10.1016/j.jvoice.2013.10.022
• Title of Journal or Parent Work: Journal of Voice
• ISSN: 0892-1997
• Volume: 29
• Issue: 5
• Start Page: 592
• End Page: 594
• Grant/Funding Information: This research was supported in part by NIH Grant # NS065701.
• Keywords: CERVICAL DYSTONIA; Otorhinolaryngology; Voice; Science & Technology; RISK; Spasmodic dysphonia; Diagnostic delay; Life Sciences & Biomedicine; Larynx
• Research Categories: Health Sciences, Medicine and Surgery; Biology, Neuroscience; Health Sciences, Education

Abstract

Purpose. Spasmodic dysphonia (SD) is a rare but often debilitating disease. Due to lack of awareness among practitioners and lack of well-defined diagnostic criteria, it can be difficult for patients with SD to receive a diagnosis and subsequent treatment. There is currently no literature documenting the efficacy of the medical community in recognizing and diagnosing this disorder. We aimed to quantify the patients' experiences with obtaining a diagnosis of SD. Methods. One hundred seven consecutive patients with SD completed questionnaires about their experiences with SD. Patients were recruited either during outpatient laryngology visits or during participation in a National Institutes of Health funded study investigating SD. Results. It took patients an average of 4.43 years (53.21 months) to be diagnosed with SD after first going to a physician with vocal symptoms. Patients had to see an average of 3.95 physicians to receive a diagnosis of SD. Patients (31.4%) had been prescribed medications other than botulinum toxin to treat their symptoms. Patients (30%) attempted alternative therapies for treatment of SD, such as chiropractor or dietary modification. Conclusions. Despite advances in diagnostic modalities in medicine, the diagnosis of SD still remains elusive. Objective criteria for the diagnosis of SD and increased clinician education are warranted to address this diagnostic delay.