This condition is fortunately very uncommon. It involves an uncontrollable spasming of the vocal cords. This more commonly is called adductor spasmodic dysphonia where there is a spasming of the vocal cords together, similar to a writer’s cramp of the hand. The other form, which is less common, involves spasming of the vocal cords apart, leading to a more breathy and softer speech deficit. The exact mechanism for the development of this condition is unknown and despite decades since it was described, the laryngology world is no closer to a cure. To date the gold standard for treatment involves the use of botulinum toxin (Botox). This is injected into the spasming muscles and is usually done under EMG guidance. The injection typically causes the voice to be weak for between 5-15 days. When the voice regains some strength, in most settings it is substantially smoother and easy to use for the patient. The majority of patients report substantial benefit from the injection. Between 3-6 months following the injection the benefit has worn off and the procedure is repeated.
Dr Andrew Blitzer in New York is the world leader in this neurolaryngological disorder and Dr Broadhurst’s treatment approach has been modelled on Dr Blitzer’s approach.
There are only a handful of ENT Surgeons in Australia who perform Botox injections for this condition. Most are actually performed by neurologists who unfortunately do not have significant training in the larynx and vocal cord structure and function. Despite this however, they do have extensive experience with the use of EMG guided injections, which is why they tend to do most of the injections in Australia for this condition. For patients, this often means multiple visits each year to both the ENT specialist and the neurologist. At the Queensland Voice Centre this is all able to be done under Dr Broadhurst.