Historical approaches to the treatment of Adductor-Type Spasmodic Dysphonia (ADSD): review and tutorial

Adductor-type spasmodic dysphonia (ADSD) is a voice disorder of uncertain, though likely neurogenic origin. Symptoms of the disorder include mild to profound "strain and strangle" sensations during voiced speech tasks that, in the most severe form, are physically and psychologically debilitating. Over the years, treatment approaches have evolved from behavioral attempts at voice modification, to surgical and, most recently, pharmacological treatments involving partial and temporary paralysis of muscle fibers within the larynx following injection of botulinum toxin or Botox. The most current research hints at the potential benefits of a multi-faceted approach to symptom management, combining behavioral with pharmacological treatments. The following is intended as a review and tutorial of treatment approaches for ADSD. The tutorial is intended for practicing clinical professionals with an interest in the treatment of neurogenic disorders of voice and speech.