Trach-ties
Laryngeal Dystonia
aka Spasmodic Dysphonia
Laryngeal Dystonia or "strangled voice", is a rare disorder. It is a tightening of the vocal cords which makes speaking difficult.
There are varying degrees of this phenomenon. Mild is just a break in the voice occassionally. Severe can make it so that breathing is impaired as well.
That is what I faced. Sounds scary doesn't it? Some moments it was. But thanks to a couple good doctors I am still alive to tell you all about it.
Dystonias in general are caused by a "malfunction", for lack of a better word, which causes the muscles affected by those nerves to go into spasm. It can be generalized, meaning all over the body,
or focal, meaning in one area. A wry neck or writers cramp are examples of focal dystonias. So is Spasmodic Dysphonia. It is a spasm in the vocal cords, aka larynx.
Laryngeal Dystonia, "strangled voice", is a disorder which is rare and still widely misunderstood.Laryngeal Dystonia is seen more in people with asthma and/or GERD (Gastro-Esophageal Reflux Disorder), probably due to the irritation of the upper airway including the larynx.
Since the disorder is seen more frequently in women, and asthmatics, the medical profession was quick to classify it as a "hysterical" disorder. Until recently it was believed to be a psychosomatic disorder by many, as well as physicians. Studies have now proven it to be a neurologically based disorder, arising from a problem in the basal ganglia in the brain. Normally when you breathe, your vocal cords receive impulses from the basal ganglia, which tell them to open. In those with LD and SD, the impulses are misinterpreted and close when they should be opening in Adductor Spasmodic Dysphonia, or open so wide that they cannot come together enough to make sound as in Abductor Spasmodic Dysphonia. It is a "focal" dystonia, meaning it's a disturbance in the impulses between the central nervous system and the muscles in one area.
Some have an insidious onset, while others are a more dramatic onset. Mine was a more noticeable onset. It started as a reaction to fumes from a floor stripper. Out of the blue I was wheezing, and having inspiratory and expiratory stridor. It resolved over time with aggressive treatment. Only to happen again with the next exposure to fumes. As time and repeated exposures went on I had more and more difficulty with laryngeal spasm until it was constant, without exposures to trigger it, and interfered with my breathing. I am one of the more severe cases from what I have been told.
Many with this disorder have the spasm on exhalation and therefore the voice that sounds like they have laryngitis, hoarseness, strangled voice or whispering. Voices of those with Spasmodic Dysphonia are noticed to "crack" more on vowels than consonants. Mine was constant and on both inspiration and expiration, leading to respiratory failure. Getting every breath was a battle, so to relieve it, and save my life at that point, the tracheostomy was put in to bypass my vocal cords, which I still have.
Some are treated with medications to try to relieve the spasms, anything from muscle relaxants to psychotropic medications. The most recent medical treatment is the use of Botox, a purified form of the botulism bacteria. After its injected into the specific area of the larynx, it stops the muscles around the vocal cords from contracting by paralyzing them. Hence stopping the spasms caused by Spasmodic Dysphonia. This treatment usually lasts about 3 months and needs to be repeated periodically. Unfortunately that did not work for me. Another treatment, more invasive, is nerve resection. Due to my overall condition surgery isn't an option. There are also exercises that some believe lessen the effects of the SD. Others employ relaxation techniques, using visualization and controlled breathing.
You can find out more about Spasmodic Dysphonia and Laryngeal Dystonia at the links below, or see "My Story" on this website.
Spasmodic Dysphonia Links
Eastern Virginia Medical School Laryngology Department
What is Spasmodic Dysphonia? from the National Institute of Health
Spasmodic Dysphonia
Dystonia Foundation Website #2
Spasmodic Dysphonia Message Board
Center for Voice Disorders of Wake Forest University
American Speech-Language-Hearing Association
Dystonia Society of London
Exercises for SD
Disclaimer; In no way are these web pages or links intended to replace care by a qualified medical professional. They are here for information only. If you feel you fit any of the symptoms listed in any of these links you should seek care from a qualified medical professional.
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