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Spasmodic Dysphonia

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Dysphonia is a medical term used for voice disorders. Any problems with the sound production due to impairment of the vocal organs, in any way, leads to dysphonia. One of the types of voice disorder is spasmodic dysphonia.  It is very different from dysarthia that occurs due to dysfunctional muscles that help with speech.

What is Spasmodic Dysphonia?

Spasmodic dysphonia is a condition that occurs due to the involuntary movements or spasms of the muscles in the larynx during speech. It is one of the most common forms of laryngeal dystonia, where the voice is the primary site of the problem. Thus, the voice sounds strangled, broken, whispery, hoarse, tight, squeaky or strained. In many cases, the person finds it very difficult to talk.

The larynx is made up of the cartilages that contain the vocal cords. When these vocal cords vibrate, it helps in the production of sound. When the larynx is involuntarily and intermittently tightened or constricted, it affects phonation. This leads to a labored, jerk filled speech. At times, these spasms could affect the bvocal folds causing production of a breathy voice.

Types of Spasmodic Dysphonia

There are three types spasmodic dysphonia. These include:

Abductor Spasmodic Dysphonia

When the dysphonia involves muscles that help open the voice box for breathing, it is called as abductor spasmodic dysphonia. When these muscles spasm during the speech, it causes production of an involuntary whisper or a breathy, weak voice. This happens because the vocal folds fail to vibrate when open. These spasms are absent during laughing and singing, but can result in the inability to produce certain notes and projection.

Adductor Spasmodic Dysphonia

The spasms of the muscles that help close the vocal is called as adductor spasmodic dysphonia. It is one of the most common type of laryngeal dystonia. The sudden spasms cause the vocal cords to stiffen. Thus, leading to cutting off of words during speech. Thus, the speech sounds strained, strangled and interrupted. The spams do not happen during laughter or while singing.

Mixed Spasmodic Dysphonia

When both the muscles that open and close the vocal cords are affected, it leads to mixed spasmodic dyshphonia.

What Causes Spasmodic Dysphonia?

There is no specific or definitive cause for spasmodic dysphonia. It is believed to be a neurological condition. The abnormal functioning in an area called the basal ganglia within the brain may lead to dysphonia. The basal ganglia are responsible for the movement of muscles within the body. When the coordination between the vocal cord muscles is interrupted, it leads to spasmodic dysphonia.

At times, stress, emotional upheaval, weakness, chronic diseases, scarring of the vocal cords, etc. can also lead to spasmodic dysphonia. Trauma or injury to the vocal cords or larynx can also lead to dysphonia. GERD disease can also cause hoarseness of voice.

Diagnosis of Dysphonia

Any person with a hoarse voice for four weeks or more should seek medical attention. An ENT specialist will examine the larynx for disorders. For a correct diagnosis, one may have to visit an otolaryngologist, neurologist and a speech-language therapist. Diagnosis will be based on the results of an fiberoptic laryngoscopy, stroboscopy as well as the evaluation of the voice and voice quality by the speech-language pathologist.

Treatment for Dysphonia

There are different treatments for dysphonia that includes surgery to cut one of the nerves in the vocal cord. This surgery is effective in about 80% of people for about 4 years. Botulinum toxin or Botox injection can help provide some improvement in the symptoms of spasmodic dysphonia.

It is very difficult to diagnose spasmodic dysphonia. The symptoms are similar to other voice disorders and thus requires expertise for correct diagnosis as well as treatment. If you have trouble with your voice and think it require medical attention, visit an ENT specialist for advice.

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Written by: Saptakee sengupta
Date last updated: April 01, 2015