Spasmodic dysphonia

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Duke laryngologists are experts in diagnosing spasmodic dysphonia, an often misdiagnosed neurological voice disorder that causes involuntary spasms of the vocal cords. It can interrupt your speech and affect the quality of your voice. We use a combination of treatments and therapy to provide relief, and tailor our treatment recommendations to your individual needs.

Expert diagnosis of spasmodic dysphonia

If you have spasmodic dysphonia, you may experience periodic disruptions in your ability to speak.  At times your voice may be hoarse, jerky, quivering, strangled or even breathy. The vocal spasms are due to a faulty connection between a nerve and the muscle that controls your voice box, also known as your larynx. There are two types of spasmodic dysphonia. Abductor spasmodic dysphonia occurs when the vocal cords spasm open, which results in a breathy voice that can sound like a whisper. Adductor spasmodic dysphonia occurs when the vocal cords spasm shut, which causes a strained and strangled voice. 

There is no simple test to diagnose spasmodic dysphonia, which is why it is often missed or misdiagnosed. Our laryngologists are experts in identifying the signs and symptoms that signal this neurological voice disorder. And, while there is currently no cure, our laryngologists and speech pathologists are equipped to combine proven treatments, such as Botox, and voice therapy, to alleviate your symptoms, and help you live with the condition. Because this is a neurological condition, we may also partner with neurologists in our health system to ensure you receive the best possible care.

If you experience a shaky, trembling, or quivering voice, you may have a vocal tremor. While this may sound like spasmodic dysphonia, it generally does not improve with Botox. It can sometimes be improved with different medications and voice therapy.

Choose Duke for your spasmodic dysphonia treatment because we offer:

  • Voice disorder specialists. We are one of the few voice centers in the Southeast, with a comprehensive team of voice experts. Our nose, and throat (ENT) physicians are laryngologists who undergo advanced training and have years of experience in diagnosing and treating spasmodic dysphonia.
  • Highly specialized speech pathologists. Our speech pathologists undergo specialized training to evaluate and treat patients with voice problems, and they have special expertise in the area of spasmodic dysphonia. Our speech pathologists work closely with our laryngologists to help diagnose your voice disorder and provide the expert voice therapy you need.
    Effective Botox injections. We use sophisticated technology to ensure accuracy of Botox injections for spasmodic dysphonia. 
    Coordinated care. Voice disorders may result from a variety of medical conditions. We coordinate your care with the right specialists throughout our health system to ensure you receive the best therapies to minimize your symptoms, improve your voice, and optimize your recovery.
  • Professional vocal performer services. We provide the highest level of expert care for all vocal performers, from elite professionals who need immediate voice care services to those who sing for enjoyment. 
  • Better treatment decisions. Our ongoing research ensures you receive the best care for your vocal disorder.



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