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Chapter 11 - Botulinum Neurotoxin Therapy of Laryngeal Muscle Hyperactivity Syndromes

Published online by Cambridge University Press:  02 November 2023

Daniel Truong
Affiliation:
University of California, Riverside
Dirk Dressler
Affiliation:
Hannover Medical School
Mark Hallett
Affiliation:
National Institutes of Health (NIH)
Christopher Zachary
Affiliation:
University of California, Irvine
Mayank Pathak
Affiliation:
Truong Neuroscience Institute
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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.

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Publisher: Cambridge University Press
Print publication year: 2023

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References

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