Management of Adductor Spasmodic Dysphonia

Abstract

Spasmodic dysphonia (SD) is a focal laryngeal dystonia. In its most common form, adductor spasmodic dysphonia (AdSD), abnormal contraction of the thyroarytenoid (TA) and lateral cricothyroid muscles results in excessive spasms and disproportionate glottal closure; consequently, the voice is characterized by stoppages and a strained⁄strangled quality. Diagnosis of AdSD is primarily based on patient complaint; i.e. difficulty of phonation and of auditory perception of the voice characteristics of the AdSD.
Type II thyroplasty is a laryngeal framework surgery based on the hypothesis that the voice symptoms in AdSD are a consequence of excessively tight glottal closure. Previously, we reported the outcome of type II thyroplasty for AdSD using a patient questionnaire and objective perceptual, aerodynamic, and acoustic analysis. Type II thyroplasty provides relief from voice strangulation in patients with AdSD, but none of these methods quantifies the effects of AdSD on a patient’s quality of life (QOL).
In this study we outlined a diagnostic approach for AdSD and reported on the effectiveness of type II thyroplasty for AdSD with perceptual analysis through use of the Voice Handicap Index-10 (VHI-10).