By Elizabeth Weise
April 20, 2004
Having Botox injected into your vocal cords
might not sound like fun, but for the nation's
estimated 15,500 suffers of the voice disorder
spasmodic dysphonia, it's a godsend.
Botox is best known for its powers to reduce
wrinkles. But a new study validates the
almost decade-long use of the potent neurotoxin
to quell the voice disorder that gives a
strained, broken or sometimes breathy tone
to people who have the condition, who include
Robert F. Kennedy Jr. and National Public
Radio's Diane Rehm.
Norman Hogikyan of the University of Michigan
followed 42 patients for three years to
gauge how long and how well the treatments
worked. The study, published in the April
issue of the Archives of Otolaryngology,
found that patients typically needed follow-up
Botox shots two or three times a year but
did significantly better both socially and
Emotionally is important, because people
with the disorder can have voices that sound
strangled or as if they are about to cry.
Because the disorder is so rare, few physicians
are familiar with it.
"It can be misconstrued as an emotional
or even psychiatric disorder, but it's absolutely
not that. It's a neurological-control disorder
manifesting in the vocal cords," says Hogikyan,
who directs the University of Michigan Vocal
It can often take years for patients to
be diagnosed correctly and get appropriate
treatment. Many are reluctant to speak in
public and find themselves becoming increasingly
"The number of suffers could be much larger
because so many patients are misdiagnosed," says
Robert McAlister, executive director of
the National Spasmodic Dysphonia Association. "Botox
is definitely the cat's meow when it comes
to this disease."
Botulinum toxin type A, aka Botox, is used
to ease the symptoms of an increasing number
of ailments tied to muscle function, including
cerebral palsy and Tourette's syndrome.
With spasmodic dysphonia, which is caused
by the involuntary movement of muscles in
the larynx, Botox relaxes those muscles
in the same way it relaxes the muscles in
the furrowed foreheads of those who use
it for cosmetic reasons.
Treatment involves first numbing the skin
of the neck and then injecting Botox directly
into the vocal cords.
This temporarily disconnects the nerve-to-muscle
signals and reduces abnormal muscle activity
while still allowing normal speech.
Before Botox, patients either lived with
the disorder or tried a surgical procedure
that severed some of the nerves but didn't
provide lasting benefit, Hogikyan says.