Spasmodic dysphonia is a chronic (long-term) voice disorder. With spasmodic dysphonia, movement of the vocal cords is forced and strained resulting in a jerky, quivery, hoarse, tight, or groaning voice. Vocal interruptions or spasms, periods of no sound (aphonia), and periods when there is near normal voice occur.
Signs and symptoms
At first, symptoms may be mild. They may occur only occasionally. Later on, they may worsen and become more frequent before they even out. Symptoms may be worse when a person is tired or stressed. They may be greatly reduced or even disappear, for example, during singing or laughing.
Spasmodic dysphonia is a disorder characterized by involuntary movements of one or more muscles of the larynx or voice box. The first signs of spasmodic dysphonia are most often found in individuals between 30 and 50 years old. More women appear to be affected by spasmodic dysphonia than men. Voice spasms fluctuate in severity. They may lessen for hours or even days at a time.
There is no simple test for spasmodic dysphonia. Diagnosis is based on the presence of the typical signs and symptoms described above and the absence of other conditions that can produce similar problems. The best evaluation involves a team approach and includes:
- a speech-language pathologist (SLP) to evaluate voice production and voice quality,
- an otolaryngologist (ear, nose, and throat specialist) to examine the vocal cords and their movement, and
- a neurologist who looks for signs of neurological problems.
At present, there is no cure for spasmodic dysphonia. However, several treatment options do exist for voice improvement.
Repeat injections of small doses of botulinum toxin (Botox) into one or both vocal cords are frequently recommended. Botox weakens the laryngeal muscles and results in a smoother, less effortful voice because of less forceful closing of the vocal cords. Temporary breathiness or difficulty swallowing sometimes occurs for a short time after injection. Treatment by an SLP may also be recommended following injections to optimize voice production.
Psychological or psychiatric counseling is most useful when acceptance of the disorder and learning coping techniques are the desired goals. Career or vocational counseling may also be advised for persons who fear that the disorder threatens their occupation. Participation in local self-help support groups can also promote adjustment to the problem and provide contact with excellent sources of information
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