Overview
Adductor spasmodic dysphonia (ADSD) is a voice disorder characterized by involuntary spasms of the lateral cricoarytenoid muscles during speech, leading to strained, harsh, and often interrupted vocal quality 1.Diagnosis
Key Diagnostic Criteria: Perceptual evaluation using the GRBAS scale, extended with additional parameters for comprehensive assessment 1.
Recommended Tests: Voice assessment by experienced observers using the extended GRBAS system to capture a broader range of symptoms 1.
Grading: Utilize cluster analysis to identify distinct voice types within ADSD, aiding in personalized diagnosis 1.Management
First-Line Treatments: Botulinum toxin injections targeting the thyroarytenoid muscle to reduce laryngeal muscle spasms 1.
Adjunctive Treatments: Voice therapy aimed at modifying vocal behaviors and reducing compensatory strategies 1.Special Populations
Pregnancy: Limited data; botulinum toxin use should be carefully considered due to potential effects on the fetus 1.
Pediatrics: Specific guidelines are lacking; management typically mirrors adult protocols with close monitoring 1.
Elderly: Voice therapy may be less effective due to decreased plasticity; botulinum toxin remains a viable option 1.
Comorbidities: No specific guidance provided; individualized treatment plans considering overall health status are recommended 1.Key Recommendations
Utilize the extended GRBAS system for perceptual assessment of ADSD to improve diagnostic accuracy and reproducibility (Evidence: Moderate 1).
Consider botulinum toxin injections as a first-line treatment for managing ADSD symptoms (Evidence: Expert opinion 1).
Implement voice therapy as an adjunctive treatment to complement pharmacological interventions (Evidence: Expert opinion 1).References
1 Langeveld TP, Drost HA, Frijns JH, Zwinderman AH, Baatenburg de Jong RJ. Perceptual characteristics of adductor spasmodic dysphonia. The Annals of otology, rhinology, and laryngology 2000. link