What Is Spastic Dysphonia?

Refers to the clinical disease of abnormal voice caused by excessive tension of the muscles of the larynx, the voicing organ. It is usually a disease in which the voice is interrupted, it is difficult to speak, the voice is trembling, and the continuous speech is difficult. Spastic dysphonia is a disease of abnormal muscle tone, and the diagnosis name is a disease from abnormal voice.

Spastic vocal disorder

Refers to the clinical disease of abnormal voice caused by excessive tension of the muscles of the larynx, the voicing organ. It is usually a disease in which the voice is interrupted, it is difficult to speak, the voice is trembling, and the continuous speech is difficult. Spastic dysphonia is a disease of abnormal muscle tone, and the diagnosis name is a disease from abnormal voice.

Chinese name

Spastic vocal disorder

an examination

Acoustic examination

Nature

Clinical disease

Types of

Adductor muscle type

It can cause abnormal tension and contraction of the vocal cord muscles when speaking, and occasionally other symptoms such as local muscle tension or abnormalities. ^[1]

In the past, the cause of spastic dysphonia was often thought to be a mental problem. The reason is that the symptoms may be improved due to alcohol or tranquilizers, and the symptoms may be aggravated when stressed or talking on the phone.

Since 1980, with the active research of brain neurology, it is believed that the cause of spastic dysphonia is the abnormality of the basal ganglia formed during the merger of the central nervous system of the brain and the uncoordinated adjustment of the laryngeal nerve or the larynx. Abnormal muscle spasms. Recently, Professor Ludlow of the National Institute of Neurologic Disorer (NINDS) Laryngeal Voice Center of the National Institute of Health (NIH) demonstrated that in patients with spastic dysphonia, the nucleus of the basal nucleus of the brain (Nucleus Tractus of Solitarius) suppresses abnormalities in the nerves, Loss of fine-tuning of vocal cord muscles when speaking, induces excessive vocal cord muscle tension, causing voice interruptions or strenuous speech.

Adductor type: 84%

1) glottic

2) Upper glottis (supraglottic)

3) Dystonia tremor

4) Adductor type with tremor

Abductor type: 4%

Mixed type: 11% 1) abductor adductor type 2) adductor abductor type

Breathing (adductorbreathing dystonia)

Recently, the breathing pattern has been renamed paradoxical vocal fold motion or vocal fold dysfunction.

Anticholinergics and tranquilizers, baclofen, and dopamine inhibitors are generally used. But medications can cause side effects,

It is usually used for very serious muscle tension disorders. Drug therapy is only complementary therapy in the treatment of spastic dysphonia.

-Recurrent laryngeal neurectomy

-Thyroid cartilage

-Laser vocal cord myotomy

-Nerve Stimulator Transplantation

a. Recurrent laryngeal neurectomy: Dedo reported this method for the first time in 1976 to cut off the nerves that entered the larynx, thereby inhibiting the excessive closure of the vocal cords. However, the recurrence rate was about 64% within 3 years after surgery.

b. Thyroid cartilage surgery: Cut the front of the thyroid cartilage to widen the vocal cord space, thereby weakening the vocal cord tension, so that vocal cord spasm will not occur without excessive vocal cord closure. However, due to the role of the vocal cord intramuscular tension receptor, the voice will deteriorate again after a period of time.

c. Laser vocal cord myotomy: a procedure that uses a laser to remove a portion of the vocal cord muscles to thin the vocal cords.

d. Nerve Stimulator Transplantation: A method of inhibiting excessive contraction of the vocal cord muscles and transplanting the neurostimulator into the vocal cords in order to relieve symptoms. All surgical methods have not shown the possibility of complete cure. According to the results of long-term follow-up investigation, there are shortcomings of recurrence within months or years.

BOTOX treatment is currently the best treatment. However, it is not permanent, and the effect lasts for about 3 to 6 months. There are disadvantages of continuous injection. A few years ago, the method of injecting only specific muscles in the vocal cords or injecting only a large amount in one vocal cord was used, but the learning effect without the brain caused side effects, which caused excessive spasm of the vocal cords without injection on the opposite side. Aggravating phenomenon. The recently implemented compound laryngeal muscle BOTOX injection can accurately inject a small amount of BOTOX into multiple laryngeal muscles that cause abnormal laryngeal voices. The effect is to shorten the hoarse period of the voice after BOTOX injection, extend the good voice time, and make the brain nerves Disorders are normalized by BOTOX-induced repetitive learning reflexes in the brain. That is, a method for prolonging the voice maintenance period and shortening the hoarse voice period after injection, and inducing the brain to repeatedly learn to normalize reflexes. The advantage of this method is that the injection period will become longer with the number of injections, and it also increases the possibility of complete cure of the disease.