SLAD-R (Selective laryngeal adductor denervation-reinnervation). This procedure was introduced by Dr. Gerald Berke of UCLA in the late 1990’s. It is a surgical option for adductory spasmodic dysphonia. The concept is to sever the anterior branch of the recurrent laryngeal nerve. This denervates the spasming laryngeal adductors (particularly thyroarytenoid and lateral cricoarytenoid muscles). The squeezed, strained […]

Pharyngeal Paralysis

The pharynx (loosely “throat”) has a “foodway” function to convey food and liquid from the mouth to the esophagus. It also serves as part of the “airway,” also from mouth into the Larynx and trachea. These foodway/airway functions are kept separate so food and liquid do not enter the airway towards the lungs. At the […]

IA-Only Paresis

IA-only paresis refers to weakness or paralysis of the larynx’s interarytenoid (IA) muscle—an unpaired muscle spanning between the bodies of both arytenoid cartilages—but with normal function of the other muscles in the larynx. The IA muscle helps to bring the posterior commissure together for voice production and, more specifically, to bring the bodies or “heels” […]

Parkinson’s Disease-Related Voice Change

Voice change that accompanies Parkinson’s disease (PD) typically has two components. One component is a change to the “inner engine” of the voice. It is as if the inner motivation or vitality of communication or voice is damped down; think of the “motor” being limited mostly to “idle” rather than “first, second, third, and fourth” […]

Mixed AB-AD Spasmodic Dysphonia

The combination of both abductor (AB) and adductor (AD) vocal cord spasms in a person who has spasmodic dysphonia (SD). Most individuals with SD have a predominance of one spasm type or the other—AB or AD—such that we classify the person as having either “AB-SD” or “AD-SD.” Some individuals, however, have a significant amount of […]

Vocal self-rapport

The ability to relate to one’s voice and to hear and experience it insightfully. Vocal self-rapport includes being self-aware of pitch, effort level, quality, loudness, etc. Accomplished singers may have exquisite vocal self-rapport, being able to match pitch and be aware of vowel color, larynx position in the neck, and other kinesthetic feedback. At the […]

Spasmodic Dysphonia (SD): Definition and Treatments

A non-life-threatening neurological disorder in which the muscles of the larynx involuntarily spasm and interfere with the voice. Spasmodic dysphonia (SD) is a focal dystonia, in this case involving the larynx—i.e., laryngeal dystonia. Laryngeal dystonia typically affects the voice, but can occasionally also affect breathing (respiratory dystonia). The term spasmodic dysphonia refers specifically to voice-affecting […]

Vocal Cord Paresis

Vocal cord paresis is the partial loss of voluntary motion for one or more of the muscles that move the vocal cords. Paresis is to be distinguished from paralysis, which refers to a complete loss of motion. Sometimes, however, the terms “paralysis” or “paralyzed” are used less precisely to encompass any kind of loss of […]

PCA-only Paresis

Weakness or paralysis of the vocal cord’s posterior cricoarytenoid (PCA) muscle, but with normal function of the vocal cord’s other muscles. The PCA muscle abducts (lateralizes) the vocal cord for breathing. The following are indicators of PCA-only paresis: Movement: The vocal cord closes normally for voicing, but it does not abduct for breathing. It remains […]

TA-only Paresis

Weakness or paralysis of the vocal cord’s thyroarytenoid (TA) muscle, but with normal function of the vocal cord’s other muscles. The TA muscle “inhabits” the vocal cord and normally provides bulk and internal tone to the cord. The following are indicators of TA-only paresis: Movement: The vocal cord opens normally for breathing and closes normally […]