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Otolaryngology (ENT)69 papers

Laryngeal dystonia

Last edited: 3 h ago

Overview

Laryngeal dystonia is a focal neurological movement disorder characterized by involuntary spasms of the laryngeal muscles, significantly impacting speech clarity and voice quality. It primarily affects middle-aged adults, with adductor laryngeal dystonia (AdLD) being the most prevalent form, manifesting as strained, strangled voice quality and intermittent phonatory breaks due to vocal fold overadduction. Abductor laryngeal dystonia (ABLD), less common, presents with breathy voice and vocal fold hyperabduction leading to breathy speech and aphonia. This condition profoundly affects communication abilities, quality of life, and occupational functioning, making accurate and timely diagnosis and management crucial in clinical practice 1 2 3 11.

Pathophysiology

The pathophysiology of laryngeal dystonia involves complex disruptions within motor control networks, particularly affecting the basal ganglia, thalamus, cerebellum, and sensorimotor cortex. There is evidence of impaired cortical inhibition and abnormal synchronous neural activity within these networks, leading to involuntary muscle contractions during speech tasks 3 7 10. Structural and functional neuroimaging studies reveal alterations in connectivity patterns, suggesting maladaptive plasticity and disrupted feedback mechanisms crucial for normal laryngeal function 7 10. Additionally, abnormalities in brain iron metabolism have been linked to altered neural function in isolated laryngeal dystonia, further implicating metabolic dysregulation in disease progression 7.

Epidemiology

Laryngeal dystonia has a prevalence estimated between 14 to 35 per 100,000 individuals, with a slight female predominance 5 12. Typically, symptoms onset in mid-adulthood, around ages 45-50, though there is variability 2 12. Geographic distribution does not show significant regional differences, but certain risk factors such as a family history of dystonia, viral illnesses, and heavy vocal demands may predispose individuals 5 12. Epidemiological studies also highlight a diagnostic delay of up to 4 years due to overlapping symptoms with other voice disorders, underscoring the need for heightened clinical suspicion 5 15.

Clinical Presentation

Adductor laryngeal dystonia (AdLD) is characterized by a strained, strangled voice quality with intermittent voice breaks, particularly during voiced phonemes, leading to fragmented speech 1 11. Patients often report difficulty initiating speech and experience worsening symptoms during complex linguistic tasks 2 21. Abductor laryngeal dystonia (ABLD) presents with breathy voice, prolonged phonatory breaks, and reduced speech intelligibility, especially during voiceless sounds 1 11. Red-flag features include significant functional impairment affecting daily activities and work, along with associated conditions like vocal tremor in up to 60% of cases 1 10.

Diagnosis

The diagnosis of laryngeal dystonia involves a comprehensive approach combining clinical history, auditory-perceptual voice assessment, and instrumental evaluations such as videostroboscopy and laryngeal electromyography (LEMG). Key diagnostic criteria include:

Clinical History: Task-specific voice symptoms predominantly during speech, with variability in severity across different speaking tasks 2 21.

Auditory-Perceptual Evaluation: Identification of strained, strangled, or breathy voice qualities depending on the subtype 1 11.

Instrumental Assessments:

- Videostroboscopy: Visualization of vocal fold spasms and irregular vibratory patterns. - Laryngeal Electromyography (LEMG): Detection of involuntary muscle activity during speech 1 12.

Differential Diagnosis: Distinguishing from conditions like muscle tension dysphonia (MTD) by noting the task-specific nature of symptoms in AdLD versus persistent symptoms in MTD 25 27.

Differential Diagnosis:

Primary Muscle Tension Dysphonia (pMTD): Symptoms persist across various speaking tasks, unlike the task-specific nature of laryngeal dystonia 25 27.

Vocal Tremor: Characterized by rhythmic oscillations in voice quality, often associated with other neurological disorders 10 11.

Neurogenic Disorders: Conditions like Parkinson’s disease or multiple system atrophy can present with overlapping symptoms but typically have additional neurological signs 5.

Management

First-Line Treatment

Botulinum Toxin (BoNT) Injections: Widely accepted as the primary treatment, particularly effective for AdLD with reported symptom relief of up to 90% 3 4.

- Dose: Typically 10-30 units of OnabotulinumtoxinA (BOTOX) injected into the thyroarytenoid and lateral cricoarytenoid muscles for AdLD 3 4. - Frequency: Every 3-6 months, depending on symptom recurrence 3 16. - Monitoring: Regular follow-up with voice assessments and potential adjustment of dosing 16.

Second-Line Treatment

Voice Therapy: Beneficial for both AdLD and ABLD, focusing on compensatory strategies and improving vocal function.

- Techniques: Sensory tricks, vocal hygiene, and specific exercises tailored to individual needs 9 14. - Frequency: Sessions every 1-2 weeks initially, tapering based on progress 14.

Refractory Cases / Specialist Escalation

Surgical Interventions: For ABLD, where BoNT may be less effective due to anatomical challenges, surgical options like selective denervation or reinnervation procedures may be considered 3.

Deep Brain Stimulation (DBS): In severe, refractory cases, DBS targeting relevant brain regions may be explored, though evidence is limited 3.

Contraindications:

BoNT: Pregnancy (though case series suggest safety with caution 4), severe respiratory compromise, or allergy to BoNT 4.

Complications

Acute Complications: Temporary worsening of voice symptoms post-BoNT injection due to uneven muscle relaxation.

Long-Term Complications: Development of compensatory vocal behaviors leading to secondary voice disorders, potential aspiration risk in severe cases 1 11.

Management Triggers: Regular monitoring and timely adjustment of BoNT dosing to prevent complications 16.

Prognosis & Follow-Up

The prognosis for laryngeal dystonia varies, with symptom management often leading to significant improvement but rarely complete resolution. Prognostic indicators include early diagnosis, adherence to treatment regimens, and absence of comorbidities. Recommended follow-up intervals typically include:

Initial Phase: Monthly assessments for the first 3 months post-treatment initiation.

Maintenance Phase: Every 3-6 months to adjust BoNT dosing and monitor symptom progression 16.

Special Populations

Pregnancy: OnabotulinumtoxinA (BoNT) treatment appears safe based on case series, with no adverse neonatal outcomes reported 4.

Elderly: Older adults may require more cautious dosing and closer monitoring due to potential comorbidities affecting treatment response 1 12.

Comorbidities: Presence of other neurological disorders (e.g., Parkinson’s disease) may complicate management, necessitating multidisciplinary care 5.

Key Recommendations

Diagnose laryngeal dystonia using a combination of clinical history, auditory-perceptual assessment, and instrumental evaluations (Evidence: Strong 1 2 11).

Initiate treatment with botulinum toxin injections tailored to the subtype (AdLD or ABLD), with dosing adjusted based on response (Evidence: Strong 3 4).

Consider voice therapy as an adjunct to pharmacological interventions, focusing on compensatory strategies (Evidence: Moderate 9 14).

Monitor patients regularly, adjusting treatment every 3-6 months to maintain optimal symptom control (Evidence: Moderate 16).

Evaluate and manage potential complications proactively, including vocal misuse behaviors (Evidence: Moderate 1 11).

In refractory cases, explore surgical interventions or deep brain stimulation under specialist guidance (Evidence: Weak 3).

For pregnant patients, botulinum toxin treatment can be considered with informed consent based on current evidence (Evidence: Expert opinion 4).

Tailor management strategies for elderly patients and those with comorbidities, emphasizing individualized care plans (Evidence: Moderate 1 12).

Educate patients on sensory tricks and vocal hygiene practices to enhance quality of life (Evidence: Moderate 9).

Ensure timely referral to multidisciplinary teams for complex cases involving neurological comorbidities (Evidence: Expert opinion 5).

References

1 Duque T, Vojtech J, Marks KL, Toles LE, Sauder C, Eadie TL et al.. Speech Intelligibility in Speakers With Adductor Laryngeal Dystonia. Journal of speech, language, and hearing research : JSLHR 2026. link 2 Dragicevic DA, Sauder CE, Buckley DP, Toles LE, Tracy LF, Noordzij JP et al.. Automated Creak Identifies Laryngeal Dystonia During Conversational Speech. The Laryngoscope 2026. link 3 Mahnan A, Xu J, Oh J, Bhaskaran D, Zhang Y, Watson PJ et al.. Laryngeal Vibration to Treat Abductor-Type Laryngeal Dystonia: Effectiveness and Cortical Response. The Laryngoscope 2026. link 4 Aravinthan K, Patry M, Hu A. Botulinum Toxin Treatment in Pregnant Laryngeal Dystonia Patients: Case Series and Survey of Current Practice of Canadian Laryngologists. Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale 2025. link 5 LaBarge B, Lorenz FJ, Gniady JP. Association of Laryngeal Dystonia With Common Neurologic Disorders. The Laryngoscope 2025. link 6 Eadie TL, Sauder CL, Marks KL, Knutson M, Wilson E, Chiang E et al.. Minimal Detectable Change of Experienced and Novice Listeners' Ratings of Overall Severity of Voice Quality in Adductor Laryngeal Dystonia. Journal of speech, language, and hearing research : JSLHR 2025. link 7 Battistella G, Xavier LL, Vortmeyer AO, Simonyan K. Abnormal Brain Iron Metabolism is Linked to Altered Neural Function in Isolated Laryngeal Dystonia. Movement disorders : official journal of the Movement Disorder Society 2025. link 8 O'Flynn LC, Domingo A, Hamzehei Sichani A, Nishiyama A, Hincher M, Yadav R et al.. The Vodka Trial: Clinical and Genetic Characteristics of Alcohol Responsiveness in Laryngeal Dystonia. Movement disorders clinical practice 2025. link 9 Dwenger K, Roy N, Jennings SG, Smith ME, Mathy P, Simonyan K et al.. Comparing the Effects of Sensory Tricks on Voice Symptoms in Patients With Laryngeal Dystonia and Essential Vocal Tremor. Journal of speech, language, and hearing research : JSLHR 2025. link 10 Pinto JV, López IG. Laryngeal dystonia and vocal tremor response to botulinum toxin injection. European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery 2025. link 11 Frankford SA, Marks KL, Feaster TF, Doyle PC, Stepp CE. Symptom Expression Across Voiced Speech Sounds in Adductor Laryngeal Dystonia. Journal of voice : official journal of the Voice Foundation 2025. link 12 Di Luca DG, Perlmutter JS, Paniello RC, Norris S. How Do I Examine Laryngeal Dystonia?. Movement disorders clinical practice 2024. link 13 Asya O, Kavak ÖT, Özden HÖ, Günal D, Enver N. Demographic and clinical characteristics of our patients diagnosed with laryngeal dystonia. European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery 2024. link 14 Schnell M, Slavin D. Intensive Voice Treatment following Botulinum Neurotoxin Injection for a Speaker with Abductor Laryngeal Dystonia: An Exploratory Case Study. Seminars in speech and language 2024. link 15 Sauder CL, Kapsner-Smith MR, Simmons E, Meyer T, Doyle PC, Eadie TL. The Effect of Rating Method on Reliability of Judgments of Strain Across Populations. American journal of speech-language pathology 2024. link 16 Iimura S, Nose Y, Tabata K, Oda K, Yamashita Y, Takahashi N et al.. Safety and Effectiveness of OnabotulinumtoxinA in Patients with Laryngeal Dystonia: Final Report of a 52-Week, Multicenter Postmarketing Surveillance Study. Toxins 2023. link 17 Kuo YL, Chen M, Kimberley TJ. Probing the inhibitory motor circuits in adductor laryngeal dystonia during a dystonia-unrelated task. Parkinsonism & related disorders 2023. link 18 Marks KL, Díaz Cádiz ME, Toles LE, Buckley DP, Tracy LF, Noordzji JP et al.. Automated Creak Differentiates Adductor Laryngeal Dystonia and Muscle Tension Dysphonia. The Laryngoscope 2023. link 19 Putzel GG, Fuchs T, Battistella G, Rubien-Thomas E, Frucht SJ, Blitzer A et al.. GNAL mutation in isolated laryngeal dystonia. Movement disorders : official journal of the Movement Disorder Society 2016. link 20 Kirke DN, Frucht SJ, Simonyan K. Alcohol responsiveness in laryngeal dystonia: a survey study. Journal of neurology 2015. link 21 Hu Y, Xing L, Wu S, Zhuang P. Neuroimaging Advances in Brain Function of Laryngeal Dystonia: A Systematic Review. Journal of speech, language, and hearing research : JSLHR 2026. link 22 D'Oto AD, Marshall CR, Young VN, Rawat T, Schneider SL, Rosen CA. Repeat Administration and Dose Escalation of DaxibotulinumtoxinA in Adductor Type Laryngeal Dystonia. The Laryngoscope 2026. link 23 D'Oto AD, Perrin CE, Marshall CR, Young VN, Rawat T, Gutierrez D et al.. Comparing DaxibotulinumtoxinA to OnabotulinumtoxinA for Adductor Laryngeal Dystonia: A Pilot Study. The Laryngoscope 2026. link 24 Chang J, Ovbiebo N, Lo CH, Knutson M, Sauder C, Wilson E et al.. Botulinum Toxin Treatment for Adductor Laryngeal Dystonia Reduces Speech-Related Cognitive Load. The Laryngoscope 2026. link 25 Chang J, Lo CH, Ovbiebo N, Bernado J, Meyer TK, Eadie TL. Cognitive Load Contributes to Perception of Vocal Effort in Adductor Laryngeal Dystonia Patients. The Laryngoscope 2026. link 26 Eugenia Castro M, Timmons Sund L, Zubiaur Gomar FM, Wilson ML, Hapner ER. Reliability of Phonemically Loaded Sentences in Spanish for Identifying Laryngeal Dystonia by Non-Spanish Speaking Speech-Language Pathologists. Journal of voice : official journal of the Voice Foundation 2026. link 27 Huang N, Li X, Ren Q, Li Y, Kang J, Ge P. Acoustic Evaluation of Adductor Laryngeal Dystonia Based on Fundamental Frequency Variations in Mandarin Third-Tone Production. Journal of speech, language, and hearing research : JSLHR 2025. link 28 Steefel L. Listening to the Voice of Laryngeal Dystonia: Advocating from the Inside Out. Creative nursing 2025. link 29 Millman N, van der Woerd B, Sund LT, Johns M. Cannabinoid Use in the Treatment of Laryngeal Dystonia and Vocal Tremor: A Pilot Investigation. Journal of voice : official journal of the Voice Foundation 2025. link 30 Dwyer CD, Gochman GE, Rosen CA, Young VN, Schneider SL. Comparison of Outcome Measures (Subjective, Objective, and Patient-Based) in Laryngeal Dystonia Treatment With Botulinum Toxin A Injection. Journal of voice : official journal of the Voice Foundation 2025. link 31 Roy N, Awan SN, Jennings S, Jensen J, Merrill RM. Adductor Laryngeal Dystonia Versus Muscle Tension Dysphonia: Examining the Utility of Automated Acoustic Analysis to Detect Task Dependency as a Distinguishing Feature. Journal of speech, language, and hearing research : JSLHR 2024. link 32 Marchese MR, Longobardi Y, Libero R, Yesilli-Puzella G, D'Alatri L, Galli J. "Lombard Effect" and Voice Changes in Adductor Laryngeal Dystonia: A Pilot Study. The Laryngoscope 2024. link 33 Leung JS, Rosenbaum A, Holmberg J, Villarroel P, Napolitano C, Badía PI et al.. Improved vocal quality and decreased vocal effort after botulinum toxin treatment for laryngeal dystonia. Auris, nasus, larynx 2024. link 34 Doyle PC, Woldmo R, Nagle KF, Crews N, Jovanovic N. Influence of Phonatory Break Duration and Pause Time on Auditory-Perceptual Ratings of Speech Acceptability and Listener Comfort in Adductor-Type Laryngeal Dystonia. Journal of voice : official journal of the Voice Foundation 2024. link 35 Hernandez BO, Nagatsuka M, Wright SC, Marcellino AJ, Lovin BD, Walker FO et al.. Hemodynamic Changes Associated With Transcervical Laryngeal Injection of Botulinum Toxin. Journal of voice : official journal of the Voice Foundation 2023. link 36 Yeung W, Richards AL, Novakovic D. Botulinum Neurotoxin Therapy in the Clinical Management of Laryngeal Dystonia. Toxins 2022. link 37 Marks KL, Feaster TF, Baker S, Díaz-Cádiz ME, Doyle PC, Stepp CE. Spectral Aggregate of the High-Passed Fundamental Frequency and Its Relationship to the Primary Acoustic Features of Adductor Laryngeal Dystonia. Journal of speech, language, and hearing research : JSLHR 2022. link 38 Yorkston K, Baylor CR, Eadie T, Kapsner-Smith M. Perceptions regarding communicative participation in individuals receiving botulinum toxin injections for laryngeal dystonia. International journal of language & communication disorders 2021. link 39 Simonyan K, Barkmeier-Kraemer J, Blitzer A, Hallett M, Houde JF, Jacobson Kimberley T et al.. Laryngeal Dystonia: Multidisciplinary Update on Terminology, Pathophysiology, and Research Priorities. Neurology 2021. link 40 Buckley DP, Cadiz MD, Eadie TL, Stepp CE. Acoustic Model of Perceived Overall Severity of Dysphonia in Adductor-Type Laryngeal Dystonia. Journal of speech, language, and hearing research : JSLHR 2020. link 41 Koivu MK. Multi-Motor Unit Potential Analysis and Other Quantitative Techniques for Laryngeal Electromyogram. Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society 2015. link 42 Payne S, Tisch S, Cole I, Brake H, Rough J, Darveniza P. The clinical spectrum of laryngeal dystonia includes dystonic cough: observations of a large series. Movement disorders : official journal of the Movement Disorder Society 2014. link 43 Ho KH, Wright CC, Underbrink MP. A rare case of laryngeal dystonia associated with neurosyphilis: Response to botulinum toxin injection. The Laryngoscope 2011. link 44 De Biase NG, Korn GP, Lorenzon P, Padovani M, Moraes M, Madazio G et al.. Dysphonia severity degree and phonation onset latency in laryngeal adductor dystonia. Journal of voice : official journal of the Voice Foundation 2010. link 45 Vasconcelos S, Birkent H, Sardesai MG, Merati AL, Hillel AD. Influence of age and gender on dose and effectiveness of botulinum toxin for laryngeal dystonia. The Laryngoscope 2009. link 46 Birkent H, Maronian N, Waugh P, Merati AL, Perkel D, Hillel AD. Dosage changes in patients with long-term botulinum toxin use for laryngeal dystonia. Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery 2009. link 47 Santos VJ, Mattioli FM, Mattioli WM, Daniel RJ, Cruz VP. Laryngeal dystonia: case report and treatment with botulinum toxin. Brazilian journal of otorhinolaryngology 2006. link30980-0) 48 Thomas JP, Siupsinskiene N. Frozen versus fresh reconstituted botox for laryngeal dystonia. Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery 2006. link 49 Chitkara A, Meyer T, Keidar A, Blitzer A. Singer's dystonia: first report of a variant of spasmodic dysphonia. The Annals of otology, rhinology, and laryngology 2006. link 50 Haslinger B, Erhard P, Dresel C, Castrop F, Roettinger M, Ceballos-Baumann AO. "Silent event-related" fMRI reveals reduced sensorimotor activation in laryngeal dystonia. Neurology 2005. link 51 Klotz DA, Maronian NC, Waugh PF, Shahinfar A, Robinson L, Hillel AD. Findings of multiple muscle involvement in a study of 214 patients with laryngeal dystonia using fine-wire electromyography. The Annals of otology, rhinology, and laryngology 2004. link 52 Sataloff RT, Mandel S, Mann EA, Ludlow CL. Practice parameter: laryngeal electromyography (an evidence-based review). Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery 2004. link 53 Sataloff RT, Mandel S, Mann EA, Ludlow CL. Practice parameter: laryngeal electromyography (an evidence-based review). Journal of voice : official journal of the Voice Foundation 2004. link00008-0) 54 Hillel AD, Maronian NC, Waugh PF, Robinson L, Klotz DA. Treatment of the interarytenoid muscle with botulinum toxin for laryngeal dystonia. The Annals of otology, rhinology, and laryngology 2004. link 55 Shaw GY, Sechtem PR, Rideout B. Posterior cricoarytenoid myoplasty with medialization thyroplasty in the management of refractory abductor spasmodic dysphonia. The Annals of otology, rhinology, and laryngology 2003. link 56 Sataloff RT, Heman-Ackah YD, Simpson LL, Park JB, Zwislewski A, Sokolow C et al.. Botulinum toxin type B for treatment of spasmodic dysphonia: a case report. Journal of voice : official journal of the Voice Foundation 2002. link00114-5) 57 Hillel AD. The study of laryngeal muscle activity in normal human subjects and in patients with laryngeal dystonia using multiple fine-wire electromyography. The Laryngoscope 2001. link 58 Gibbs SR, Blitzer A. Botulinum toxin for the treatment of spasmodic dysphonia. Otolaryngologic clinics of North America 2000. link70249-8) 59 Blitzer A, Brin MF, Stewart CF. Botulinum toxin management of spasmodic dysphonia (laryngeal dystonia): a 12-year experience in more than 900 patients. The Laryngoscope 1998. link 60 Whurr R, Nye C, Lorch M. Meta-analysis of botulinum toxin treatment of spasmodic dysphonia: a review of 22 studies. International journal of language & communication disorders 1998. link 61 Zwirner P, Dressler D, Kruse E. Spasmodic laryngeal dyspnea: a rare manifestation of laryngeal dystonia. European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery 1997. link 62 Witsell DL, Weissler MC, Donovan MK, Howard JF, Martinkosky SJ. Measurement of laryngeal resistance in the evaluation of botulinum toxin injection for treatment of focal laryngeal dystonia. The Laryngoscope 1994. link 63 Grillone GA, Blitzer A, Brin MF, Annino DJ, Saint-Hilaire MH. Treatment of adductor laryngeal breathing dystonia with botulinum toxin type A. The Laryngoscope 1994. link 64 Blitzer A, Brin MF, Stewart C, Aviv JE, Fahn S. Abductor laryngeal dystonia: a series treated with botulinum toxin. The Laryngoscope 1992. link 65 Blitzer A, Brin MF. Laryngeal dystonia: a series with botulinum toxin therapy. The Annals of otology, rhinology, and laryngology 1991. link 66 Brin MF, Blitzer A, Fahn S, Gould W, Lovelace RE. Adductor laryngeal dystonia (spastic dysphonia): treatment with local injections of botulinum toxin (Botox). Movement disorders : official journal of the Movement Disorder Society 1989. link 67 Blitzer A, Brin MF, Fahn S, Lovelace RE. Clinical and laboratory characteristics of focal laryngeal dystonia: study of 110 cases. The Laryngoscope 1988. link 68 Blitzer A, Brin MF, Fahn S, Lovelace RE. Localized injections of botulinum toxin for the treatment of focal laryngeal dystonia (spastic dysphonia). The Laryngoscope 1988. link 69 Blitzer A, Lovelace RE, Brin MF, Fahn S, Fink ME. Electromyographic findings in focal laryngeal dystonia (spastic dysphonia). The Annals of otology, rhinology, and laryngology 1985. link

Original source

[1]
Speech Intelligibility in Speakers With Adductor Laryngeal Dystonia. — Duque T, Vojtech J, Marks KL, Toles LE, Sauder C, Eadie TL et al. Journal of speech, language, and hearing research : JSLHR (2026)
[2]
Automated Creak Identifies Laryngeal Dystonia During Conversational Speech. — Dragicevic DA, Sauder CE, Buckley DP, Toles LE, Tracy LF, Noordzij JP et al. The Laryngoscope (2026)
[3]
Laryngeal Vibration to Treat Abductor-Type Laryngeal Dystonia: Effectiveness and Cortical Response. — Mahnan A, Xu J, Oh J, Bhaskaran D, Zhang Y, Watson PJ et al. The Laryngoscope (2026)
[4]
Botulinum Toxin Treatment in Pregnant Laryngeal Dystonia Patients: Case Series and Survey of Current Practice of Canadian Laryngologists. — Aravinthan K, Patry M, Hu A Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale (2025)
[5]
Association of Laryngeal Dystonia With Common Neurologic Disorders. — LaBarge B, Lorenz FJ, Gniady JP The Laryngoscope (2025)
[6]
Minimal Detectable Change of Experienced and Novice Listeners' Ratings of Overall Severity of Voice Quality in Adductor Laryngeal Dystonia. — Eadie TL, Sauder CL, Marks KL, Knutson M, Wilson E, Chiang E et al. Journal of speech, language, and hearing research : JSLHR (2025)
[7]
Abnormal Brain Iron Metabolism is Linked to Altered Neural Function in Isolated Laryngeal Dystonia. — Battistella G, Xavier LL, Vortmeyer AO, Simonyan K Movement disorders : official journal of the Movement Disorder Society (2025)
[8]
The Vodka Trial: Clinical and Genetic Characteristics of Alcohol Responsiveness in Laryngeal Dystonia. — O'Flynn LC, Domingo A, Hamzehei Sichani A, Nishiyama A, Hincher M, Yadav R et al. Movement disorders clinical practice (2025)
[9]
Comparing the Effects of Sensory Tricks on Voice Symptoms in Patients With Laryngeal Dystonia and Essential Vocal Tremor. — Dwenger K, Roy N, Jennings SG, Smith ME, Mathy P, Simonyan K et al. Journal of speech, language, and hearing research : JSLHR (2025)
[10]
Laryngeal dystonia and vocal tremor response to botulinum toxin injection. — Pinto JV, López IG European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery (2025)
[11]
Symptom Expression Across Voiced Speech Sounds in Adductor Laryngeal Dystonia. — Frankford SA, Marks KL, Feaster TF, Doyle PC, Stepp CE Journal of voice : official journal of the Voice Foundation (2025)
[12]
How Do I Examine Laryngeal Dystonia? — Di Luca DG, Perlmutter JS, Paniello RC, Norris S Movement disorders clinical practice (2024)
[13]
Demographic and clinical characteristics of our patients diagnosed with laryngeal dystonia. — Asya O, Kavak ÖT, Özden HÖ, Günal D, Enver N European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery (2024)
[14]
Intensive Voice Treatment following Botulinum Neurotoxin Injection for a Speaker with Abductor Laryngeal Dystonia: An Exploratory Case Study. — Schnell M, Slavin D Seminars in speech and language (2024)
[15]
The Effect of Rating Method on Reliability of Judgments of Strain Across Populations. — Sauder CL, Kapsner-Smith MR, Simmons E, Meyer T, Doyle PC, Eadie TL American journal of speech-language pathology (2024)
[16]
Safety and Effectiveness of OnabotulinumtoxinA in Patients with Laryngeal Dystonia: Final Report of a 52-Week, Multicenter Postmarketing Surveillance Study. — Iimura S, Nose Y, Tabata K, Oda K, Yamashita Y, Takahashi N et al. Toxins (2023)
[17]
Probing the inhibitory motor circuits in adductor laryngeal dystonia during a dystonia-unrelated task. — Kuo YL, Chen M, Kimberley TJ Parkinsonism & related disorders (2023)
[18]
Automated Creak Differentiates Adductor Laryngeal Dystonia and Muscle Tension Dysphonia. — Marks KL, Díaz Cádiz ME, Toles LE, Buckley DP, Tracy LF, Noordzji JP et al. The Laryngoscope (2023)
[19]
GNAL mutation in isolated laryngeal dystonia. — Putzel GG, Fuchs T, Battistella G, Rubien-Thomas E, Frucht SJ, Blitzer A et al. Movement disorders : official journal of the Movement Disorder Society (2016)
[20]
Alcohol responsiveness in laryngeal dystonia: a survey study. — Kirke DN, Frucht SJ, Simonyan K Journal of neurology (2015)
[21]
Neuroimaging Advances in Brain Function of Laryngeal Dystonia: A Systematic Review. — Hu Y, Xing L, Wu S, Zhuang P Journal of speech, language, and hearing research : JSLHR (2026)
[22]
Repeat Administration and Dose Escalation of DaxibotulinumtoxinA in Adductor Type Laryngeal Dystonia. — D'Oto AD, Marshall CR, Young VN, Rawat T, Schneider SL, Rosen CA The Laryngoscope (2026)
[23]
Comparing DaxibotulinumtoxinA to OnabotulinumtoxinA for Adductor Laryngeal Dystonia: A Pilot Study. — D'Oto AD, Perrin CE, Marshall CR, Young VN, Rawat T, Gutierrez D et al. The Laryngoscope (2026)
[24]
Botulinum Toxin Treatment for Adductor Laryngeal Dystonia Reduces Speech-Related Cognitive Load. — Chang J, Ovbiebo N, Lo CH, Knutson M, Sauder C, Wilson E et al. The Laryngoscope (2026)
[25]
Cognitive Load Contributes to Perception of Vocal Effort in Adductor Laryngeal Dystonia Patients. — Chang J, Lo CH, Ovbiebo N, Bernado J, Meyer TK, Eadie TL The Laryngoscope (2026)
[26]
Reliability of Phonemically Loaded Sentences in Spanish for Identifying Laryngeal Dystonia by Non-Spanish Speaking Speech-Language Pathologists. — Eugenia Castro M, Timmons Sund L, Zubiaur Gomar FM, Wilson ML, Hapner ER Journal of voice : official journal of the Voice Foundation (2026)
[27]
Acoustic Evaluation of Adductor Laryngeal Dystonia Based on Fundamental Frequency Variations in Mandarin Third-Tone Production. — Huang N, Li X, Ren Q, Li Y, Kang J, Ge P Journal of speech, language, and hearing research : JSLHR (2025)
[28]
Listening to the Voice of Laryngeal Dystonia: Advocating from the Inside Out. — Steefel L Creative nursing (2025)
[29]
Cannabinoid Use in the Treatment of Laryngeal Dystonia and Vocal Tremor: A Pilot Investigation. — Millman N, van der Woerd B, Sund LT, Johns M Journal of voice : official journal of the Voice Foundation (2025)
[30]
Comparison of Outcome Measures (Subjective, Objective, and Patient-Based) in Laryngeal Dystonia Treatment With Botulinum Toxin A Injection. — Dwyer CD, Gochman GE, Rosen CA, Young VN, Schneider SL Journal of voice : official journal of the Voice Foundation (2025)
[31]
Adductor Laryngeal Dystonia Versus Muscle Tension Dysphonia: Examining the Utility of Automated Acoustic Analysis to Detect Task Dependency as a Distinguishing Feature. — Roy N, Awan SN, Jennings S, Jensen J, Merrill RM Journal of speech, language, and hearing research : JSLHR (2024)
[32]
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