Management of Supraglottic Squeeze in Adductor Spasmodic Dysphonia: A New Technique

Abstract

We describe a new technique for injection of the supraglottic portion of the lateral cricoarytenoid muscles. We demonstrate this can be done safely and successfully in an office setting with electromyography control.

Botulinum toxin treatment of false vocal folds in adductor spasmodic dysphonia: Functional outcomes

“…Due to the higher doses, there is undoubtedly broad diffusion to surrounding laryngeal musculature, and similar results could possibly be obtained with small doses into the TA/LCA muscles with EMG guidance, as was seen in a substantial number of patients injected in the study by Novokovic et al 4 There are case reports in the literature of the use of Botox injected into the false vocal folds for ventricular dysphonia 7 and muscle tension dysphonia, 8 as well an EMG-guided supraglottic injection for ADSD. 9 To our knowledge, however; this is the first case series of supraglottic Botox injection as primary treatment for adductor spasmodic dysphonia.…”

“…There are case reports in the literature of the use of Botox injected into the false vocal folds for ventricular dysphonia and muscle tension dysphonia, as well an EMG‐guided supraglottic injection for ADSD . To our knowledge, however; this is the first case series of supraglottic Botox injection as primary treatment for adductor spasmodic dysphonia.…”

Treatment for spasmodic dysphonia: limitations of current approaches

“…Such patients appear similar to muscular tension dysphonia with hyperadduction postures [54] either in the vocal folds, the ventricular folds or, in the most severe cases, involving a sphincteric closure above the vocal folds [55]. After EMG-guided injection in the supraglottic region [56 •• ] four cases were reported to have reduced hyperadduction squeeze on an unblinded rating scale. A more controlled study would be needed to determine if this might be an effective treatment for ADSD patients with supraglottic squeeze.…”

Movement disorders in musicians

“…BoNT has been found helpful in musicians playing a large variety of instruments, even in tabla players 132. Singers with spasmodic dysphonia have also been successfully treated with BoNT 133. Although BoNT has been considered the treatment of choice for most patients with focal dystonia, the occasional complications such as increased risk of muscle weakness or paralysis has been unacceptable for some musicians 134.…”