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  • Chapter 11 - Botulinum Neurotoxin Therapy of Laryngeal Muscle Hyperactivity Syndromes

  • Edited by Daniel Truong, University of California, Riverside, Dirk Dressler, Hannover Medical School, Mark Hallett, National Institutes of Health (NIH), Christopher Zachary, University of California, Irvine, Mayank Pathak, Truong Neuroscience Institute
  • Book:
    Manual of Botulinum Toxin Therapy
    Published online:
    02 November 2023
    Print publication:
    23 November 2023, pp 82-88

  • Summary

    Spasmodic dysphonia is a focal dystonia characterized by task-specific, action-induced spasm of the vocal cords.

    There are three types of spasmodic dysphonia: Adductor spasmodic dysphonia (ADSD) is characterized by a strained-strangled voice quality and intermittent voice stoppage or breaks, resulting in a staccato-like voice, caused by overadduction of the vocal folds.

    Abductor spasmodic dysphonia (ABSD) is characterized by intermittent breathy breaks and associated with prolonged abduction folds during voiceless consonants in speech.

    Mixed-type spasmodic dysphonia has features of both.

    The efficacy of botulinum neurotoxin (BoNT) injection in the treatment of spasmodic dysphonia has been proven. This chapter enumerates the muscles involved in each type of spasmodic dysphonia, diagrams and describes different approaches for injection, along with the use of guidance techniques such as laryngoscopy and electromyography, and tabulates dose ranges of the different types of BoNT for each muscle.