ear, nose, and throat disorders
Spasmodic Dysphonia
Treatment of Spasmodic Dysphonia
Botulinum toxin injection Selective laryngeal nerve section and reinnervation surgery Foradductor spasmodic dysphonia,injection of botulinum toxin (BoNT) into vocal adductors has become the standard of care, with targeting injections achieving a normal voice in approximately 70% of patients for up to 3 months. Because the effect of BoNT is temporary, injections must be repeated to maintain the improvement. Selective laryngeal nerve section with reinnervation surgery is also an option in certain centers. Laryngeal nerve section without reinnervation has been shown to result in synkinesis and is not the preferred approach to this condition. no known treatment permanently alleviates the disorder, but temporary improvement has been achieved with botulinum toxin delivered to the posterior cricoarytenoid muscle (sole vocal abductor, Treatment references , Mor N, Simonyan K, Blitzer A: Central voice production and pathophysiology of spasmodic dysphonia.Laryngoscope128(1):177-183, 2018. doi:10.1002/lary.26655 Dharia I, Bielamowicz S: Unilateral versus bilateral botulinum toxin injections in adductor spasmodic dysphonia in a large cohort [published online ahead of print, 2019 Dec 14].Laryngoscope10.1002/lary.28457, 2019. doi:10.1002/lary.28457 Dewan K, Berke GS: Bilateral vocal fold medialization: a treatment for abductor spasmodic dysphonia.J Voice33(1):45-48, 2019. doi:10.1016/j.jvoice.2017.09.027 