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Botox (Type A) Therapy for Spasmodic Dysphonia
What is dysphonia?
Dysphonia is a physician's term for an abnormal voice. It can also be called hoarseness. There are several types of dysphonia. One specific type of dysphonia is called spasmodic dysphonia.
What is spasmodic dysphonia?
Spasmodic dysphonia (better known as SD) relates to specific dysfunction of the nerves in the voice box. In patients with spasmodic dysphonia, many of whom can be reclusive because of their severe voice spasms, the voice typically has tight, strangulated speech with frequent interruptions and, in severe cases, a complete inability to communicate.
What causes spasmodic dysphonia?
The underlying cause is actually unknown, however researchers and neurologists believe it is a dystonia (muscle spasm) of the vocal cord. This same process can be seen in other parts of the body such as writer's cramp, spasms or tics of the eye, or torticolis, which is spasm of the neck muscles.
How do you treat spasmodic dysphonia?
Until recently the only treatment was vocal therapy with a speech therapist. However, advances in medical research led to the use of botulinum toxin (Botox) in 1991.
What is botulinum toxin, and is it safe?
The medical application of Botox has been approved safe by the FDA. However, medical application has been approved safe by the FDA for many uses. In very minute and dilute doses a medical grade of botulinum toxin called Botox (Type A) has been proven an effective treatment for several spasmodic muscular disorders, including eye twitching (blepharospasm), Freyer’s Syndrome (gustatory sweating), muscle spasms of the jaw (oromandibular dystonia), spasms of the esophagus (cricopharyngeal spasm) as well as cosmetic procedures. The most dramatic effect however is its application in voice disorders. Dr. Coniglio specializes in Botox use for vocal disorders.
How does the Botox Work?
The Botox affects nerve receptors in muscles and relaxes them. If one has spasmodic dysphonia, the Botox can relax the muscles of the voice box. This allows a smoother and uninterrupted pattern of speech.
How is Botox administered?
It is administered in an office setting by physicians who have special advanced training in voice disorders. The Botox is injected through the skin with a needle that is connected to a nerve monitor. Once we are in the voice box, we ask the patient to speak so we can inject the toxin directly into the muscle, thus giving the greatest benefit.
Does it hurt?
A very minute amount of numbing medicine is given prior to the injection so that the injection causes minimal discomfort.
Are there any side effects?
The only known side effect is a temporary breathy voice for up to 2-4 weeks post injection, and slight aspiration of liquids that will subside.
How soon after the injection will it become effective?
Within 2-7 days after a patient receives an injection, the voice relaxes. The beneficial effect can last upwards of three to six weeks.
Is the treatment permanent?
Unfortunately the toxin will wear off and patients will need a repeat injection. However, for some patients, this treatment can be the difference between reclusive existence and a healthy lifestyle.
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