The movement of our vocal cords is under the very delicate control of our brain and nervous system. With this control, our vocal cords open on time when we breathe and close sufficiently when we speak. Diseases related to even minor disruptions in this control can lead to significant changes in voice quality. The most common manifestation of this disruption is the uncontrolled closing or attempting to open of the vocal cords, which is known as Spasmodic Dysphonia. The more modern and widely accepted term for this condition is Laryngeal Dystonia.
Spasmodic dysphonia is a neurological disorder and is often related solely to speech. The disease is caused by issues in the connections between the centers in the brain that control our muscles. It can occur at any age, but symptoms most commonly begin between the ages of 30 and 40. There are two types: adduction (uncontrolled closing) and abduction (uncontrolled opening). The most common form is adduction-type spasmodic dysphonia.
Common symptoms of spasmodic dysphonia include:
- Speech is uncontrollably interrupted as if choking,
- Shortness of breath during speech,
- As a result, speech becomes difficult to understand.
In the treatment of this disease, a detailed vocal cord examination along with acoustic and perceptual evaluations play an important role. Unfortunately, due to the rarity of this disease, it is often misdiagnosed, leading to prolonged periods without treatment.
The most modern and accepted treatment is the injection of botulinum toxin (Botox) into the vocal cords. In most cases, small doses applied in an outpatient setting are sufficient. For the majority of our patients, this procedure alone is enough to improve their voice-related quality of life. Although more effective and permanent alternative treatments for spasmodic dysphonia are still being researched, Botox injections remain the most effective treatment to date.