Adductor and Abductor Spasmodic Dysphonia Related Until Proven Otherwise Second Opinion
Second Opinion  |   September 01, 1992
Adductor and Abductor Spasmodic Dysphonia
 
Author Affiliations & Notes
  • Michael P. Karnell, PhD
    University of Chicago Medical Center, Otolaryngology-Head and Neck Surgery, 5841 South Maryland Avenue, Box 412, Center for Speech and Swallowing Disorders, Chicago, IL 60637
Article Information
Speech, Voice & Prosodic Disorders / Voice Disorders / Second Opinions
Second Opinion   |   September 01, 1992
Adductor and Abductor Spasmodic Dysphonia
American Journal of Speech-Language Pathology, September 1992, Vol. 1, 17-18. doi:10.1044/1058-0360.0104.17
 
American Journal of Speech-Language Pathology, September 1992, Vol. 1, 17-18. doi:10.1044/1058-0360.0104.17
Question: Is abductor spasmodic (spastic) dysphonia a form of adductor spasmodic dysphonia or is it a different voice disorder?
Response: They are related disorders until proven otherwise.
My initial reaction upon being asked to write an opinion about this issue was that it seemed inappropriate or, at the very least, premature to ask the question. It seems somewhat curious to argue about whether these types of dysphonia belong to the same category when the general category of spasmodic dysphonia itself is so poorly understood. There is a lack of consensus about the origin of either form of spasmodic dysphonia. True, there are those who are willing to assume, given the promising results of recurrent nerve resection (Dedo & Shipp, 1980) and Botulinum toxin injection (Blitzer, Brin, Fahn, Lange, & Lovelace, 1986; Ludlow, Naunton, Sedory, Schultz, & Hallett, 1988), that a strong nonbehavioral neurological component is frequently, if not always, present for the adductor variety. Similarly, the fact that the abductor variety appears somewhat more amenable to voice therapy (Dedo & Shipp, 1980; Prater & Swift, 1984) has stimulated the assumption that a nonneurological behavioral or psychological component is present for that form of the disorder. There may indeed be fundamental differences in etiology between adductor and abductor spasmodic dysphonia and there may be subforms within each of these two general categories with different etiologies (Aronson, 1990). Variable etiology, however, is no more justification for viewing abductor and adductor spasmodic dysphonias as unrelated entities than is the untenable view that the many forms of carcinoma, with their disparate etiologies, are each something other than cancer.
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