Spasmodic Dysphonia Management AT IMVC MANILA

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Spasmodic dysphonia (SD) is a neurological disorder that affects the muscles of the voice box (larynx), causing involuntary spasms or tightness during speech. This results in voice changes, often making speech difficult or strained. It can significantly impact communication, causing frustration and social anxiety for those affected. There are two main types of spasmodic dysphonia: adductor and abductor, each with distinct characteristics.

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Adductor Spasmodic Dysphonia (ADSD)

Adductor spasmodic dysphonia is the most common type of SD. In this condition, the muscles that bring the vocal cords together spasm uncontrollably, causing the voice to sound strained, tight, or choked. Speech may be broken or interrupted by sudden stops, as the vocal cords close too tightly. This can make it difficult to speak continuously, and the person may sound like they are struggling to get words out. ADSD often worsens with stress, and the voice may become weaker or more strained after prolonged talking.

 

Abductor Spasmodic Dysphonia (ABSD)

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In contrast, abductor spasmodic dysphonia involves spasms of the muscles that control the opening of the vocal cords. These spasms cause the vocal cords to open too much during speech, leading to a breathy or whispery voice. People with ABSD may find their speech to be softer, and it may sound airy or weak, especially during certain consonant sounds. This type of SD can also make it difficult to speak at a normal volume and may be more noticeable when the person tries to speak loudly.

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Treatment Options

 

While there is no cure for spasmodic dysphonia, treatment options are available to manage symptoms:

• Botulinum toxin (Botox) injections - this is done to temporarily relax the affected muscles, 

• Voice therapy

• Spasmodic dysphonia surgery is known as thyroplasty

 

Surgery for abductor spasmodic dysphonia: Thyroplasty type 1

 

Thyroplasty type I - medialization is also known as medialization laryngoplasty.  During the surgery, the doctor inserts a small mesh device into the voice box to move the paralyzed vocal cord closer to the healthy one, improving the ability to speak clearly.

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Surgery for adductor spasmodic dysphonia: Thyroplasty type II 

 

Also known as lateralization. It is a surgery used to treat the adductor form of spasmodic dysphonia, a condition where the vocal cords close too tightly while speaking. This tight closure makes it hard to speak clearly. In the surgery, the surgeon gently separates the vocal cords to reduce the tight contact between them, which helps improve speech and makes it easier to talk. 

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Botox injections, speech therapy and thyroplasty for spasmodic dysphonia are offered at IMVC Manila. Botox and thyroplasty are done by our surgeons who have been trained by Japanese physician mentors including Dr. Nobuhiko Isshiki who pioneered these procedures. Speech therapy sessions are run by our team’s licensed speech pathologists.

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Spasmodic dysphonia vs muscle tension dysphonia (MTD)

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Spasmodic dysphonia (SD) is often confused with muscle tension dysphonia (MTD) because they share some similar symptoms. Both conditions can cause a voice that sounds strained or tight.

 

However, there are key differences in how they affect the voice:

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• In MTD, the muscles controlling the vocal cords are often overly tight in a consistent way, leading to a constant feeling of strain. On the other hand, SD causes the vocal cords to move in sudden, spasmodic bursts, which can make the voice sound shaky or unsteady.

• Another difference is that people with SD often experience voice difficulties only during certain activities, like speaking or singing, whereas those with MTD tend to have ongoing voice problems in most situations.

Several other conditions can also be mistaken for SD. These include neurological disorders that cause a harsh, strained voice, Parkinson's disease, which may lead to a weak voice, psychogenic voice disorders, acid reflux, and voice tremors.

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Symptoms of spasmodic dysphonia

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You might be asking yourself, "Do I have spasmodic dysphonia?" Here are some common symptoms of this condition:

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1. Voice strain or tightness: A strained, tight, or tense voice, often described as feeling as if it’s difficult to get the words out.

2. Intermittent breaks or jerks in the voice: The voice may suddenly break or have spasms, making speech sound shaky, choppy, or stuttered.

3. Voice fatigue: After speaking for a short time, the voice may become more strained or weak.

4. Unpredictable voice changes: The voice may sound normal one moment and then suddenly become strained or hoarse during speech.

5. Difficulty with certain sounds or phrases: Some people with SD have more trouble speaking certain words or sounds, especially when trying to hold a tone or pitch.

 

You should see a doctor if you experience any of these symptoms, especially if they last for more than a few weeks or worsen over time. A specialist, such as an ear, nose, and throat (ENT) doctor or a speech-language pathologist, can evaluate your symptoms and determine if they are due to SD or another condition.

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Our surgeons have extensive experience in diagnosing this condition and have received specialized training to address it. They have successfully assisted both local and international patients. If you'd like to get help, you can schedule a consultation with us. We offer both virtual and in-person consultations. 

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The Isshiki Memorial Voice Center Manila is located at 2217B Centuria Medical Makati, Metro Manila, Philippines.