title: Spasmodic dysphonia combined with insufficient glottic closure by phonation.
abstract: The authors describe the case history of a patient who suffered from symptoms deriving from two different origins. The patient's voice was spasmodic dysphonia-like interrupted and pressed. At the same time, his voice was powerless, too. The reason for this was that besides the spasmodic dysphonia caused by hyperkinesis, an incomplete closure of the vocal cords during phonation in the middle third was present. It was caused by the atrophy of the vocal cords. In order to eliminate the symptoms, initially we injected 25 IU Botox into the left vocal cord transcutaneously under the direction of EMG control. It resulted in a fluent, though breathy voice. In order to manage the closing insufficiency during phonation, we performed lipoaugmentation on the left vocal cord under high-frequency jet anaesthesia. The result of the two-step procedure was a fluent and clear voice. The speech without interruption lasted for 5 months, until the drug was eliminated. Of course, to prolong the result, the Botox injection should be repeated.
authors.affiliation: Szent Rókus Hospital and Institutions, Department of Otorhinolaryngology and Head and Neck Surgery, Gyulai Pál u. 2., 1085 Budapest, Hungary. orl.rokus@mailbox.hu
authors.forename: Z
authors.initials: Z
authors.lastname: Kaszás
authors.forename: G
authors.initials: G
authors.lastname: Lichtenberger
authors.forename: K
authors.initials: K
authors.lastname: Mészáros
authors.forename: J
authors.initials: J
authors.lastname: Falvai
mesh_terms: D000005:Abdomen; D000273:Adipose Tissue / Q000637:transplantation; D000279:Administration, Cutaneous; D001284:Atrophy; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D004576:Electromyography; D006801:Humans; D007821:Laryngeal Muscles / Q000503:physiopathology; D008297:Male; D009465:Neuromuscular Agents / Q000627:therapeutic use*; D010699:Phonation; D013035:Spasm / Q000188:drug therapy* / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome; D014827:Vocal Cords / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D014832:Voice Disorders / Q000188:drug therapy* / Q000503:physiopathology / Q000601:surgery*
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A