Abstract
Spasmodic dysphonia (SD) is disabling speech disturbance caused by involuntary contractions of the vocal folds. Surgical treatment and oral medication provide unsatisfactory results. The first choice treatment is represented by local injections of botulinum toxin that provide improvement in up to 80% of the patients. The aim of our study was to evaluate the efficacy of botulinum toxin therapy in a series of patients with SD followed at our center. We treated 10 patients with adductor SD. After diagnostic procedures, botulinum toxin was applied either unilaterally or bilaterally in the vocal folds, in doses of 12–16 units each. Voice and speech analysis was performed prior and after treatment using a structured scale for voice and speech abnormalities occurring in SD. The majority of patients experienced both subjective and objective improvement. Quality of life improvement was rated as highly significant ( t =3.562; p =0.006). Functional voice improvement was facilitated by speech therapy and psychotherapy. Speech therapy included structured vocal techniques to reduce the degree of vocal tension and rapid changes in voice power and pitch. Currently, there is no standardized procedure for a comprehensive treatment of SD that requires a multidisciplinary approach.
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