SUMMARY
Spasmodic dysphonia (SD) is a debilitating neurological disorder affecting the muscles
of voice production. Sudden involuntary movements of the vocal folds lead to phonatory
breaks and to forced, strained, and strangled voice quality in adductor SD, or breathy
breaks in abductor SD. There is currently no cure for spasmodic dysphonia, and the
gold standard for treatment is the injection of botulinum toxin in small amounts to
the intrinsic laryngeal musculature.
1
However, botulinum treatment requires periodic reinjection, produces vocal instability
immediately after injection, lacks uniform results among patients, and patients can
develop antibodies to botulinum toxin. Long-term or permanent symptom relief would
be ideal. We present four patients with adductor and one patient with abductor spasmodic
dysphonia who underwent neurectomy and myomectomy for treatment. The mean age was
64 years (age range 45-83). The mean duration of adductor spasmodic dysphonia was
11.8 years. The duration of abductor spasmodic was 4 years. All patients had previously
been treated with voice therapy and botulinum toxin A. The mean duration of follow
up was 1.7 years. Four patients had subjective and objective improvement after surgery.
One patient had subjective improvement.Key words
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Article info
Publication history
Published online: June 21, 2022
Accepted:
July 30,
2021
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2022 Published by Elsevier Inc. on behalf of The Voice Foundation.
