Does treatment of the laryngeal mucosa reduce dystonic symptoms? A prospective clinical cohort study of mannose-binding lectin and other immunological parameters with diagnostic use of phonatory function studies & HSDI

Chapter 13

  • Mette Pedersen
  • Martin Eeg
Keywords: larynx, mucosa, voice, edema, phonatory function studies, HSDI, EGG, dystonia, mannose-binding lectin, innate immune system


This study examined efficacy of the innate immune defense via the mannose-binding lectin (MBL) in a cohort of 55 dystonic patients, prospectively referred to the clinic with laryngeal mucosal complaints, who were placed on local steroids (budesonid inhaler, 400 μg twice daily) and antihistamines (fexofenadin 180 mg mostly three times daily) with adjuvant lifestyle corrections. Treatment efficacy of the larynx was assessed based on mucosal findings of the vocal folds (VF) examined with phonatory function studies (PhFS) comprising simultaneous high speed digital imagines (HSDI), kymography, electroglottography (EGG), and voice acoustics combined with a visual score of arytenoids edema as these measures are indicative of the magnitude of laryngitis. Lactose and gluten intolerance and immunological analyses of the innate system were made systematically. Results showed that the genetic aspects of immunology did not reveal a role for the innate immune system, represented by the MBL. But an unexpected positive effect of the larynx treatment on dystonia symptoms was found, evidenced by reduction of dystonic complaints and more normative results of PhFS, and a reduction of edema of the interarytenoids region. Symptom relief and better quality of life was observed on follow-up for the dystonia complaints.