Spasmodic dysphonia is defined as a focal laryngeal disorder characterized by dystonic spasms of the vocal cord during speech. We described a case of a 22-year-old male patient who presented complaining of idiopathic difficulty swallowing that suddenly developed 6 months ago. The patient also reported pharyngolaryngeal pain, throat discomfort, dyspnea, and voice change. Because laryngoscopy found no specific problems, an electrodiagnostic study and videofluoroscopic swallowing study (VFSS) were performed to find the cause of dysphagia. The VFSS revealed continuous twitch-like involuntary movement of the laryngeal muscle around the vocal folds. Then, he was diagnosed with spasmodic dysphonia by VFSS, auditory-perceptual voice analysis, and physical examination. So, we report the first case of spasmodic dysphonia accompanied with difficulty swallowing that was confirmed by VFSS.
Deglutition Disorders ; Deglutition* ; Diagnosis* ; Dyskinesias ; Dysphonia* ; Dyspnea ; Humans ; Laryngeal Muscles ; Laryngoscopy ; Male ; Pharynx ; Physical Examination ; Spasm ; Vocal Cords ; Voice ; Young Adult

Although first-line treatment option for single, small sized hepatocellular carcinoma in patients with preserved liver function and good performance status is resection or ablation, sometimes these modalities cannot be applied for variable reasons. For them, alternative options such as transarterial chemoeombolization, ethanol injection, and external radiation therapy can be considered, with variable success rates. Herein, we describe 45 year-old male who presented with a single small tumor located at caudate lobe. After multi-disciplinary discussion, the patient was treated with proton beam therapy, which resulted in favorable treatment outcome.
Carcinoma, Hepatocellular ; Ethanol ; Humans ; Liver ; Male ; Proton Therapy ; Protons ; Treatment Outcome