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Objectives/hypothesis: The objective of this study was to ascertain whether clinicians can reliably distinguish between spasmodic dysphonia (SD)/vocal tremor and other voice disorders by telephone, despite this modality's limited frequency response., Study Design: Randomized, single-blinded, and prospective study., Methods: Voice-disordered patients with (n = 22) and without (n = 17) SD and/or vocal tremor recorded standardized utterances via landline telephone. A laryngologist and two speech-language pathologists blinded to the diagnoses rated each recording as "yes" or "no" to "SD or tremor present?," and if "yes" categorized into adductor, abductor, tremor only, or adductor with tremor subtypes. Twenty-one recordings were presented twice at random so intrarater reliability could be assessed. All ratings were compared with gold standard diagnosis by a second laryngologist who performed a full examination, including videostroboscopy, on each patient., Results: For the comparison "SD or tremor" yes versus no, sensitivity, specificity, positive predictive value, and negative predictive value are 90%, 95%, 96%, and 89%, respectively. Interrater reliability (Cohen kappa) compared with the gold standard ranged from 0.70 to 0.93 (substantial to almost perfect agreement). Cronbach alpha among three raters was 0.90 for this comparison. Intrarater reliability (number matched/number inspected) was very high, ranging from 0.97 to 1.0. Comparing gold standard and telephone rating of SD/tremor subtypes, kappa ranged from 0.48 to 0.60 (moderate agreement). Cronbach alpha among three raters was 0.88 for this comparison. Intrarater reliability ranged from 0.84 to 0.97., Conclusions: SD and tremor can be reliably distinguished from other voice disorders over the telephone., (Copyright © 2014 The Voice Foundation. Published by Elsevier Inc. All rights reserved.)

Introduction: There is evidence supporting an association between depression and anxiety in patients with chronic disease. Spasmodic dysphonia (SD) is a chronic, incurable, and disabling voice disorder. Reported rates of depression and anxiety in SD range from 7.1% to 72%, with a maximum number of 18 patients. The goal of this study was to define the coprevalence of depression and anxiety with SD., Materials and Methods: A single-institution case-control study was performed from May to July 2010. Consecutive patients with SD and benign voice disorders were enrolled prospectively. On enrollment, patients were asked to fill out a questionnaire that reviewed the duration of the voice disorder and personal history of anxiety and depression, including current and lifetime diagnosis., Results: One hundred forty-six controls with benign voice disorders and 128 patients with SD were enrolled. Patients with SD were no more likely to be diagnosed with depression or anxiety than those of the control group (odds ratio [OR]=0.985, 95% confidence interval [CI]=0.59-1.63; and OR=1.314; 95% CI=0.75-2.3, respectively). Additionally, duration of disease was a risk factor for depression in both the SD group and the control group, and the association was not significantly different between groups., Conclusion: Patients with SD were no more likely to have depression or anxiety than those with other voice disorders. It is important for otolaryngologists to be aware of the increased rates of depression in patients diagnosed with chronic diseases, including voice disorders, and to refer to a psychiatrist when appropriate., (Copyright © 2012 The Voice Foundation. Published by Mosby, Inc. All rights reserved.)

Objectives: The aim of this study was to examine temporal variables thought to be associated with voice therapy completion., Study Design: Retrospective chart review of 197 cases (120 dropouts and 77 completers) seen at two voice centers., Methods: Cases included males and females aged 15-90 years presenting with a chief complaint of dysphonia who were referred by an otolaryngologist to a speech-language pathologist for voice therapy. Cases were analyzed from the date of physician referral through the final therapy session. The dependent variable was completion of voice therapy. Independent variables included selected temporal variables related to the timing, frequency, and duration of voice therapy. A binary logistic regression was performed to evaluate the relationship between the dependent variable and the temporal variables. Differences between groups were assessed with independent t tests and post hoc analysis., Results: There were significant differences between groups for the number of sessions attended and the wait time between otolaryngology referral and speech-language pathology evaluation, which were also the strongest predictors of therapy completion., Conclusions: There was a strong relationship found between selected temporal variables and therapy completion. Future research directions will examine methods to use these findings to effect a reduction in voice therapy dropout., (Copyright © 2011 The Voice Foundation. Published by Mosby, Inc. All rights reserved.)