Botulinum toxin for the treatment of spasmodic dysphonia

Spasmodic dysphonia is a focal laryngeal dystonia. Laryngeal dystonia prese nts as: adductor spasmodic dysphonia with the characteristic strain-strangl e voice; abductor spasmodic dysphonia with hypophonia and breathy breaks in connected speech; and adductor respiratory dystonia with paradoxical vocal fold motion and intermittent strider. Current treatment with periodic lary ngeal intramuscular injections of botulinum toxin A has allowed patients to function more normally. In this article, the authors' treatment paradigm a nd experience in treating over 900 patients with laryngeal dystonia are dis cussed.