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Laryngeal Dystonia

Laryngeal dystonia is associated with difficulty for speaking (spasmodic dysphonia) or for breathing (laryngeal stridor). Spasmodic dysphonia is characterised by a strained, strangled or breathy voice, frequently interrupted by voiceless pauses.

Two distinct types of spasmodic dysphonia have been identified: abductor due to approximation of the vocal cords and abductor (only 10% of the cases) due to intermittent separation of the vocal cords. Some patients have a combination of the two with compensatory mechanisms and some patients have additional voice tremor.


Since 1989, Botulinum toxin is the most efficient treatment of this condition with 80% improvement in voice symptoms, for 4 to 6 months. The side effects are transient, lasting 2 to 3 weeks and include breathy hypophonia, and mild aspiration of fluids. The injections are performed by an ENT surgeon under electromyography guidance, through the skin of the neck and the cricothyroid cartilage. The injections are well tolerated and the patient can leave the clinic soon after the treatment.

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