[Laryngeal dystonia]

Laryngeal dystonia alters phonatory and respiratory functions in ways that may differ according to the various clinical forms. Spasmodic dysphonia, however, is the most usual clinical consequence; it is characterized either and most often by an raucous, strained, jerky voice and dotted by vocal short stops, or, more rarely, by a breathed, murmured hardly audible voice. Laryngeal dystonia may also express itself by a permanent inspiratory dyspnea witch will increase with effort. The authors describe the principal diagnostic data with are provided essentially by laryngeo-video-fibroscopy and laryngeal electromyography. Treatment of laryngeal dystonia by botulinium toxin is spectacularly efficient, with 66.7 to 100p.100 of good results in literature. Injection techniques are described as well as combined surgical treatments. In adductor spasmodic dysphonia and permanent inspiratory dyspnea, each thyro-arytenoids muscles are injected with 20 to 40 Dysport units or 5 to 10 Botox units, bilaterally; in abductor spasmodic dysphonia, we inject uni or bilaterally, 60 to 80 Dysport units or 15 to 20 Botox units in each posterior crico-arytenoïds muscles. Endoscopic or external laryngeal surgery is proposed to improve functional results when the effects of botulinium toxin injection are disappointing.