Laryngoscopy evaluation protocol for the differentiation of essential and dystonic voice tremor

ABSTRACT INTRODUCTION: Although syndromes that cause voice tremor have singular characteristics, the differential diagnosis of these diseases is a challenge because of the overlap of the existing signs and symptoms. OBJECTIVE: To develop a task-specific protocol to assess voice tremor by means of...

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Main Authors: Bruno Teixeira de Moraes, Noemi Grigoletto de Biase
Format: Article
Language:English
Published: Elsevier 2016-02-01
Series:Brazilian Journal of Otorhinolaryngology
Subjects:
Online Access:http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1808-86942016000100088&lng=en&tlng=en
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author Bruno Teixeira de Moraes
Noemi Grigoletto de Biase
author_facet Bruno Teixeira de Moraes
Noemi Grigoletto de Biase
author_sort Bruno Teixeira de Moraes
collection DOAJ
description ABSTRACT INTRODUCTION: Although syndromes that cause voice tremor have singular characteristics, the differential diagnosis of these diseases is a challenge because of the overlap of the existing signs and symptoms. OBJECTIVE: To develop a task-specific protocol to assess voice tremor by means of nasofibrolaryngoscopy and to identify those tasks that can distinguish between essential and dystonic tremor syndromes. METHODS: Cross-sectional study. The transnasal fiberoptic laryngoscopy protocol, which consisted of the assessment of palate, pharynx and larynx tremor during the performance of several vocal and non-vocal tasks with distinct phenomenological characteristics, was applied to 19 patients with voice tremor. Patients were diagnosed with essential or dystonic tremor according to the phenomenological characterization of each group. Once they were classified, the tasks associated with the presence of tremor in each syndrome were identified. RESULTS: The tasks that significantly contributed to the differential diagnosis between essential and dystonic tremor were /s/ production, continuous whistling and reduction of tremor in falsetto. These tasks were phenomenologically different with respect to the presence of tremor in the two syndromes. CONCLUSION: The protocol of specific tasks by means of transnasal fiberoptic laryngoscopy is a viable method to differentiate between essential and dystonic voice tremor syndromes through the following tasks: /s/ production, continuous whistling and reduction of tremor in falsetto.
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spelling doaj.art-a1a5030dbfd24d0e9cece3a74c845ad62022-12-21T22:01:25ZengElsevierBrazilian Journal of Otorhinolaryngology1808-86862016-02-01821889610.1016/j.bjorl.2015.11.001S1808-86942016000100088Laryngoscopy evaluation protocol for the differentiation of essential and dystonic voice tremorBruno Teixeira de MoraesNoemi Grigoletto de BiaseABSTRACT INTRODUCTION: Although syndromes that cause voice tremor have singular characteristics, the differential diagnosis of these diseases is a challenge because of the overlap of the existing signs and symptoms. OBJECTIVE: To develop a task-specific protocol to assess voice tremor by means of nasofibrolaryngoscopy and to identify those tasks that can distinguish between essential and dystonic tremor syndromes. METHODS: Cross-sectional study. The transnasal fiberoptic laryngoscopy protocol, which consisted of the assessment of palate, pharynx and larynx tremor during the performance of several vocal and non-vocal tasks with distinct phenomenological characteristics, was applied to 19 patients with voice tremor. Patients were diagnosed with essential or dystonic tremor according to the phenomenological characterization of each group. Once they were classified, the tasks associated with the presence of tremor in each syndrome were identified. RESULTS: The tasks that significantly contributed to the differential diagnosis between essential and dystonic tremor were /s/ production, continuous whistling and reduction of tremor in falsetto. These tasks were phenomenologically different with respect to the presence of tremor in the two syndromes. CONCLUSION: The protocol of specific tasks by means of transnasal fiberoptic laryngoscopy is a viable method to differentiate between essential and dystonic voice tremor syndromes through the following tasks: /s/ production, continuous whistling and reduction of tremor in falsetto.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1808-86942016000100088&lng=en&tlng=enTremorTremor essencialDistoniaLaringoscopia
spellingShingle Bruno Teixeira de Moraes
Noemi Grigoletto de Biase
Laryngoscopy evaluation protocol for the differentiation of essential and dystonic voice tremor
Brazilian Journal of Otorhinolaryngology
Tremor
Tremor essencial
Distonia
Laringoscopia
title Laryngoscopy evaluation protocol for the differentiation of essential and dystonic voice tremor
title_full Laryngoscopy evaluation protocol for the differentiation of essential and dystonic voice tremor
title_fullStr Laryngoscopy evaluation protocol for the differentiation of essential and dystonic voice tremor
title_full_unstemmed Laryngoscopy evaluation protocol for the differentiation of essential and dystonic voice tremor
title_short Laryngoscopy evaluation protocol for the differentiation of essential and dystonic voice tremor
title_sort laryngoscopy evaluation protocol for the differentiation of essential and dystonic voice tremor
topic Tremor
Tremor essencial
Distonia
Laringoscopia
url http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1808-86942016000100088&lng=en&tlng=en
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