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.
An injection through the neck and into the vocal cord temporarily weakens overactive vocal cord muscles, and allows you to speak more easily and clearly. Repeat injections are usually needed every four to six months.
Improves your speaking voice technique, pacing, and vocal hygiene. You work with a speech pathologist who guides you through vocal exercises to improve breathing, reduce throat strain, find your optimal pitch and volume for strong, healthy speaking. We work with you to get your voice back and to meet your daily voice needs. Voice therapy can be customized for specific needs, and can be helpful in decreasing strain often associated with spasmodic dysphonia.
Assesses your voice use patterns - how much you speak, sing, or use a loud voice, and what your voice sounds like. Your laryngologist will evaluate the role of any of your medical conditions that can cause voice changes, such as surgeries and recent illness. A head and neck examination is performed. A visual examination of the voice box is also completed. When spasmodic dysphonia is suspected, your speech pathologist completes a detailed evaluation of your speaking patterns, with particular focus on the signs of spasmodic dysphonia.
This visual exam evaluates how your vocal cords vibrate while you make sounds. A tiny camera attached to a small tube called an endoscope is inserted through your nose to the top of the throat. This camera uses a flashing strobe light to capture slow motion images of your vocal cords. You will be able to see these images, which are analyzed to reveal growths, stiffness, paralysis, irregular movements, throat strain, and incomplete closure of the vocal cords. Videostroboscopy is often essential to reach an accurate voice diagnosis.
Creates a visual display on a computer screen as you speak into a microphone. Allows you and your speech pathologist to see characteristics of your voice, including pitch, loudness, and vocal quality (including hoarseness and breathy voice). It is used to identify abnormalities, including subtle vocal problems that cannot be detected with the unaided ear. It may be repeated during treatment to monitor your progress. This exam is usually completed on your second visit.