Spasmodic Dysphonia

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Swedish Otolaryngology

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Spasmodic dysphonia is a disabling disorder of the voice characterized by involuntary disruptions of phonation.  There are two general types of spasmodic dysphonia.  Adductor spasmodic dysphonia (ADSD) is characterized by a tight, strained, strangled sounding voice with stoppages and voice breaks.  Abductor spasmodic dysphonia (ABSD) is characterized by an excess flow of air and breathiness with intermittent lack of vocal fold closure.  There may also be a mix of both types present.  In many cases of spasmodic dysphonia there is also some degree of muscle tension involved as the speaker attempts to gain better control and stability of the voice.

Botulinum toxin injections have been shown to be safe and effective in treating SD when injected into the larynx by a trained professional.  Typically an EMG needle is used to confirm appropriate placement.  During the injection there may be a small amount of discomfort.  The effects are usually noticed in one to two days, but may continue to evolve for up to seven days.  You may have  slight difficulty swallowing liquids and a breathy voice following the injection, usually resolving in one to two weeks. You will be asked to complete a Botox Diary to track your voice and swallowing.  Most patients experience up to 2-3 months of improvement in their voice, without breathiness or swallowing difficulties.  Short term voice therapy may prolong the duration of effectiveness for those treated with botulinum toxin.