Structural Disorders of the Vocal Cords
John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford in Head & Neck Surgery Plastic Surgery, 2018
Spasmodic dysphonia is an uncommon and frequently overlooked condition. Traditionally it is classified as adductor, abductor, mixed and tremor and respiratory forms, although further subtypes have been described.72–74 The adductor form is characterized by a strained/strangled quality to the voice, which cuts out at the onset of phonation, while the rare abductor type (approximately 15%) is characterized by breathy breaks following consonant sounds.72, 75 Some patients present with a whispery (compensated voice) that is easier for them to use in conversation. Others have a mixed form that becomes more obvious during treatment, as the untreated form often worsens or is complicated by tremor. The spasmodic laryngeal activity can be seen by careful observation with a fibre-optic endoscope during speech.
Movement Disorders
John W. Scadding, Nicholas A. Losseff in Clinical Neurology, 2011
In laryngeal dystonia, dystonic spasms affect the muscles controlling the vocal cords. Usually, the adductors are involved, causing a strangled, forced voice with stops and pitch breaks. Much less commonly, the abductors are affected, causing a whispering dysphonia. Spasmodic dysphonia may be isolated, or may be part of a more widespread segmental dystonia. EMG-guided injection of botulinum toxin into laryngeal muscles is the treatment of choice.
Signs and Symptoms in Psychiatry
Mohamed Ahmed Abd El-Hay in Essentials of Psychiatric Assessment, 2018
In spasmodic dysphonia, the vocal cords experience sudden involuntary movements (spasms) that interfere with the ability of the folds to vibrate and produce voice. It gives the voice a tight, strained quality, and results in voice breaks that occur once every few sentences. However, the disorder may be severe and spasms may occur on every other word, making it difficult for others to understand.
Botulinum toxin-B injection into the lacrimal gland and posterior cricoarytenoid muscle for the treatment of epiphora and abductor spasmodic dysphonia secondary to Parkinson’s disease
Published in Orbit, 2019
Amun Sachdev, Declan Costello, Simon Madge
Spasmodic dysphonia is a focal, action-induced, potentially disabling neuromuscular voice disorder, thought to be secondary to laryngeal dystonia during phonation, resulting in abnormal voice patterns. Adductor spasmodic dysphonia (ADSD) accounts for 80–90% of cases and has been well-studied; BTX injections into the thyroarytenoid muscles have been very successful in its treatment.7 Conversely, abductor spasmodic dysphonia (ABSD) is relatively rare, characterised by spasmodic abduction of the vocal cords resulting in a hypophonic voice interrupted by breathy voice breaks or whispered segments. Whilst BTX injections have been aimed at reducing tone in the posterior cricoarytenoid (PCA) muscle, the major abductor of the vocal folds, the degree and duration of treatment effect has generally been disappointing compared to that seen in ADSD.7
Correlation between dysphonia and dysphagia evolution in amyotrophic lateral sclerosis patients
Published in Logopedics Phoniatrics Vocology, 2021
Chiara Mezzedimi, Enza Vinci, Fabio Giannini, Serena Cocca
Dysarthria, tongue fasciculation, dysphagia, dysphonia, and incomplete closure or paralysis of vocal fold are a constellation of findings which increase suspicion for neuromuscular disease [16]. About the phonatory system, perceptual features can include harshness, strain-strangled voice, breathiness, tremor, and pitch abnormalities [1]. In addition, features of spasmodic dysphonia (or focal laryngeal dystonia) have also been reported in speakers with ALS [5]. In cases of bulbar involvement, dysphonia can be the initial clinical symptom, and often results in a referral to the otolaryngologist before the diagnosis of ALS has been made [7]. Typically, laryngeal structure is morphologically normal in appearance. When corticobulbar involvement dominates, there is often a pattern of hyper-adduction of the vocal mechanism, and when bulbar involvement dominates, there is often a pattern of hypo-adduction. Sometimes, paralysis of the vocal cords can be also a sign of presentation of ALS.
Voice therapy in paediatric dysphonia
Published in Hearing, Balance and Communication, 2020
Mattia Gambalonga, Davide Brotto, Niccolò Favaretto
The term dysphonia characterizes impaired voice production as recognized by a clinician and it refers to a wide spectrum of voice disorders impairing the communication skills of the affected patients [1]. Dysphonia impacts the quality of voice, loudness, pitch or vocal effort thus reducing the voice quality [2]. The estimated prevalence in paediatric population greatly varies in different reports [3–5] and this disease affects most frequently children between 8 to 14 years old [6]. Dysphonia has a tremendous impact in terms of public health resources implicated in the management of the patients and diminished work-related function [7], even if only about 6 percent of the general population (adult and children) seeks for medical intervention/support [1]. The causes of dysphonia are frequently benign or self-limiting conditions, but it may also be the symptom of serious or progressive conditions with severe neurological implications (such as Parkinson’s disease, spasmodic dysphonia, vocal tremor, or vocal fold paralysis) [7]. Consequently, a prompt medical evaluation is mandatory in order to choose the best medical, surgical or rehabilitative approach for the correction of dysphonia.
Related Knowledge Centers
- Botulinum Toxin
- Central Nervous System
- Focal Dystonia
- Psychological Stress
- Upper Respiratory Tract Infection
- Basal Ganglia
- Larynx
- Spasm
- Voice Therapy
- Outline of Counseling