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Tonic Variant Spasmodic Dysphonia

A variant of spasmodic dysphonia (SD) in which the spasms (and their effect on the voice) are sustained rather than intermittent. Tonic variant spasmodic dysphonia is to be distinguished from classic variant SD.

Individuals with a tonic variant of adductor SD have a sustained strained-sounding voice. Individuals with a tonic variant of abductor SD have a voice that is more or less continuously breathy. Tonic variant SD goes undiagnosed or misdiagnosed far more frequently than does classic variant SD.

“Pure” tonic-variant adductory Spasmodic Dysphonia

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tonic-variant adductory spasmodic dysphonia

Strained and pressed sounding voice (1 of 4)

At speech pitch of B3 (247 Hz), the not only true, but also false cords are continually compressed together and voice is very strained and pressed-sounding.
False cords relax

False cords relax (2 of 4)

Just a note higher, at C4 (262 Hz), false cords relax a little to reveal the true cords.
true cords are now nearly completely seen

Voice quality less strained (3 of 4)

An octave above, in falsetto, true cords are now nearly completely seen. Voice quality is less strained. This exemplifies the common but not universal finding that falsetto is less affected by the dystonia than chest register.
marked adductory tone during breathing

Adductory tone during breathing (4 of 4)

This patient’s larynx also demonstrates marked adductory tone during breathing, though not to the point of classifying this individual as having a respiratory dystonia component.

Four subtypes of adductor SD, tonic variant

What AD-SD sounds like YT Thumbnail

AD-SD | Tonic Variant

Adductory spasmodic dysphonia is a variant of spasmodic dysphonia in which the spasms push the vocal cords together, choking off or straining the voice. There are two variants of adductory spasmodic dysphonia: classic and tonic.

In the tonic variant, the adductory spasms are more constant and sustained than intermittent, so that instead of interrupting the person’s speech, the spasms cause a constant strained or “tight” vocal quality.

what is SLAD-R YT Thumbnail

One Man’s Experience Over Time with SLAD-R

SLAD-R is a surgical alternative to ongoing “botox” injections for treatment of adductory spasmodic dysphonia. The surgery involves intentionally cutting the nerves that close the vocal cords for voice and reconnecting a different nearby nerve supply (reinnervating the nerves).

This surgery requires the patient’s willingness to endure an extremely breathy voice for many months after the procedure, while awaiting reinnervation.

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