About Spasmodic Dysphonia
Spasmodic dysphonia is an organic voice disorder. It is caused by involuntary spasms of the muscles located in the larynx (voice box). An organic voice disorder occurs due to changes to the structures of the voice box, or the nerves that control vocal fold movement.
Spasmodic dysphonia is also idiopathic in nature, meaning there is no known cause. Research suggests that both psychological (traumatic or emotional event) and/or neurological (from the brain or nerves) causes may be closely associated with the onset of symptoms.
Symptoms/Common Complaints
Dysphonia is a term given to disorders of the voice, essentially refering to the inability to produce adequate sound using the vocal mechanism. People with spasmodic dysphonia may experience:
- Occasional or frequent breaks in their voice
- A strained or tight vocal quality
- Laryngeal tension
- Sudden interruptions in the normal flow of speech – stoppages in phonation
- Pitch and loudness variations
Symptom severity varies from person to person. If the presentation is severe, a person’s intelligibility (or ability to be understood) may be significantly impacted and it may be difficult for others to understand their speech. Even if symptoms are initially mild, they may worsen over time if the appropriate treatment is not sought.
Types of Spasmodic Dysphonia
There are three primary types of spasmodic dysphonia. These include:
| Adductor | This is the most common form of spasmodic dysphonia. It is characterised by muscular spasms that cause the vocal folds to forcefully come together and stiffen. Vocal quality is affected because it becomes difficult for the vocal folds to vibrate and produce clear voice. |
| Abductor | This type of spasmodic dysphonia is characterised by muscular spasms that cause the vocal folds to open (abduct). When vocal folds are in an open position, they are unable to vibrate to generate sound. This allows air to escape during speech. Vocal quality in people with this form of spasmodic dysphonia is often breathy and weak. |
| Mixed | This is a rare hybrid combination of the two other types of spasmodic dysphonia. Spasms cause both the forceful opening and closure of the vocal folds. |
Treatment Strategies for Spasmodic Dysphonia
Long-term success in the treatment of Spasmodic Dysphonia involves various factors, as this particular voice disorder does not resolve on its own. Treatment options will vary and depend on the individual, and in addition, the severity of the voice disorder. Treatment options may include:
- Speech therapy: Aims to improve vocal quality and overall voice production.
- Surgical: Operations to address nerve control.
- Botulinum toxin: This toxin serves to weaken nerve impulses to the muscle in order to reduce forceful muscular spasms. The effects of the treatment generally last between 3-4 months, after which repeat injections may be required to sustain vocal quality.
If voice quality results in a person being significantly inaudible, Augmentative and Alternative Communication (AAC) devices can be used to assist a person to communicate. (See Jenna’s article about Augmentative and Alternative Communication).
Contact us for results focused speech therapy in Sydney
This article was written by our speech pathologist Eugene Pillay who is a Speech Pathology Australia member.
To find out more about how speech therapy can help people with Spasmodic Dysphonia or to make an appointment with one of our speech pathologists contact us today!
Reference
Colton, R.H., & Casper, J.K. (1996). Understanding voice problems: A physiological perspective for diagnosis and treatment (2nd ed.). USA: Lippincott Williams & Wilkins.
