Ultrasound examination in the diagnosis of dysphonia associated with cervical spine disease

Introduction.
Myofascial pain syndrome is a common musculoskeletal pain problem. It is characterized by localized muscle spasm, possible generalized myofixation, and the formation of painful indurations – myofascial trigger points (MTPs). Ultrasound allows for the visualization of muscles and fascia, the identification of their structural features, and the dynamic assessment of their condition.
The aim of this study was to investigate the role of ultrasound in the diagnosis of established MTPs in dysphonia associated with cervical spine disease.
Material and methods. A total of 18 individuals with dysphonia and painful muscle spasm in the cervical spine were examined. The examination included: interviewing, taking medical history and concomitant disease history; neurological examination and kinesiology testing. Multiparametric ultrasound included: B-mode for assessing muscle architecture; compression elastography and shear wave elastography to determine tissue properties such as elasticity and stiffness.
Results. Eighteen patients were divided into equal subgroups (A and B) based on the localization of the MTPs. All patients received conservative treatment, while subgroup B additionally received manual manipulation of the cervical spine. Post-treatment observation of patients showed that the architecture of muscles with MTPs, according to B- mode ultrasound, remained unchanged, while ultrasound elastography revealed a decrease in stiffness compared to baseline values. Patients in subgroup B demonstrated more pronounced improvement in pain severity and muscle syndrome index.
Conclusions. Clinical presentation and ultrasound diagnostics help determine the localization of referred pain and select the optimal treatment strategy for dysphonia associated with cervical spine disease. Incorporating muscle ultrasound into the practice of ultrasound specialists and otolaryngologists would expand diagnostic capabilities, allowing for real-time assessment of the muscle tissue and more effective treatment.
Key words: dysphonia, ultrasound examination of the neck muscles, dysphonia in cervical spine disease, myofascial pain, functional dysphonia of the larynx
Conflict of interest. The authors declare no conflict of interest.
Funding. The study was performed without external funding.