[Rarely occurring or rarely diagnosed? Spasmodic dysphonia]

Abstract

Spasmodic dysphonia (SD) is a rare, chronic voice disorder characterized by involuntary spasms of the laryngeal muscles, leading to disrupted voice quality. The disorder is classified as a type of focal dystonia. The laryngeal spasms cause the voice to break, tremble, or sound strained and can manifest as adductor SD, which results in a tight, strangled voice, or abductor SD, which produces a breathy, whisper-like sound. The precise etiology of spasmodic dysphonia remains unclear, but it is believed to have a neurological basis, often associated with abnormalities in the central nervous system. Patients with SD typically experience a significant impact on communication and quality of life, as the condition can make speaking effortful and socially challenging. The diagnosis is based on a thorough medical history, voice assessment, and clinical-endoscopic examination. While there is no cure for SD, treatment options focus on symptom management. The most common intervention is the injection of botulinum toxin A (Botox) into the affected laryngeal muscles, temporarily reducing muscle overactivity and improving voice quality. Other therapeutic approaches include voice therapy and, in some cases, surgical procedures, although these may offer varying degrees of efficacy.