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5. An open-label study of sodium oxybate (Xyrem®) in spasmodic dysphonia

Author

Rumbach, Anna F., Blitzer, Andrew, Frucht, Steven J., and Simonyan, Kristina

Subjects
Adult, Male, Neurotransmitter Agents, Voice Disorders, Ethanol, Middle Aged, Dysphonia, Article, Treatment Outcome, Voice, Humans, Speech, Female, Single-Blind Method, Sodium Oxybate, Aged
Abstract

Spasmodic dysphonia (SD) is a task-specific laryngeal dystonia that affects speech production. Co-occurring voice tremor (VT) often complicates the diagnosis and clinical management of SD. Treatment of SD and VT is largely limited to botulinum toxin injections into laryngeal musculature; other pharmacological options are not sufficiently developed.Open-label study.We conducted an open-label study in 23 SD and 22 SD/VT patients to examine the effects of sodium oxybate (Xyrem), an oral agent with therapeutic effects similar to those of alcohol in these patients. Blinded randomized analysis of voice and speech samples assessed symptom improvement before and after drug administration.Sodium oxybate significantly improved voice symptoms (P = .001) primarily by reducing the number of SD-characteristic voice breaks and severity of VT. Sodium oxybate further showed a trend for improving VT symptoms (P = .03) in a subset of patients who received successful botulinum toxin injections for the management of their SD symptoms. The drug's effects were observed approximately 30 to 40 minutes after its intake and lasted about 3.5 to 4 hours.Our study demonstrated that sodium oxybate reduced voice symptoms in 82.2% of alcohol-responsive SD patients both with and without co-occurring VT. Our findings suggest that the therapeutic mechanism of sodium oxybate in SD and SD/VT may be linked to that of alcohol, and as such, sodium oxybate might be beneficial for alcohol-responsive SD and SD/VT patients.4 Laryngoscope, 127:1402-1407, 2017.

Published
2016

7. Communication changes following non-glottic head and neck cancer management: The perspectives of survivors and carers

Author

Nund, Rebecca, Rumbach, Anna, Debattista, Bridget, Goodrow, Martha, Johnson, Kori, Tupling, Laura, Scarinci, Nerina, Cartmill, Bena, Ward, Elizabeth, Porceddu, Sandro, Nund, Rebecca, Rumbach, Anna, Debattista, Bridget, Goodrow, Martha, Johnson, Kori, Tupling, Laura, Scarinci, Nerina, Cartmill, Bena, Ward, Elizabeth, and Porceddu, Sandro

Abstract

PURPOSE Head and neck cancer (HNC) survivors may experience functional changes to their voice, speech and hearing following curative chemoradiotherapy. However, few studies have explored the impact of living with such changes from the perspective of the HNC survivor and their carer. The current study employed a person-centred approach to explore the lived experience of communication changes following chemoradiotherapy treatment for HNC from the perspective of survivors and carers. METHOD Participants included 14 survivors with non-glottic HNC and nine carers. All participants took part in in-depth interviews where they were encouraged to describe their experiences of living with and adjusting to communication changes following treatment. Interviews were analysed as a single data set. RESULT Four themes emerged including: (1) impairments in communication sub-systems; (2) the challenges of communicating in everyday life; (3) broad ranging effects of communication changes; and (4) adaptations as a result of communication changes. CONCLUSION These data confirm that communication changes following chemoradiotherapy have potentially negative psychosocial impacts on both the HNC survivor and their carer. Clinicians should consider the impact of communication changes on the life of the HNC survivor and their carer and provide adequate and timely education and management to address the needs of this population.

Published
2015

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