Treatment Options for Spasmodic Dysphonia

I’m a Senior Research Associate in a Hong-kong based executive search firm. I’m based in Manila, Philippines. So it’s no surprise that when I was diagnosed with sulcus vocalis, then later on changed to spasmodic dysphonia, I did all the research I could. What it is, symptoms, causes, what else can aggravate it, treatments – both conventional medicine and alternative, success rates of the different treatments, doctors who specialize on spasmodic dysphonia (SD).

In my first post, I have mentioned details of my consultation with leading doctors in our country. I had undergone various medical tests (from laryngoscopy to MRI. Yes, I had MRI to rule out neurological brain damage).

MRI – Magnetic Resonance Imaging

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 My doctors recommended botox injections to the vocal cords. I’ve researched about SD cases and learned that botox is the most medically acceptable treatment for SD. I wasn’t too excited about having botox so I asked my doctor if we could try having voice therapy first. He agreed and referred me to the Voice Rehab Dept. of Makati Medical Center. 

I did about 4 sessions of voice therapy which were mostly Press Exercises (Push your hands against the side of the chair then make a sound), Head Manipulation then making a sound (chin on the chest then make a sound, chin on the right shoulder then make a sound). My speech pathologist was still young. I would say with about a year or 2 of experience. In our first meeting she admitted that I was her first case of SD and she said she’ll research on it. We exchanged email addresses and I sent her my research about SD. She’s very kind and supportive. But well-meaning as she was, I needed someone with more experience so I respectfully requested a referral from my doctor.

Regular Voice Therapy

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Professor Bal Ligot’s name kept coming up in my conversations with different doctors. He is a professor in the University of the Philippines Medical College and is the pioneer in voice therapy in the Philippines. I made a schedule with him and he quickly earned my respect. His knowledge on voice and its mechanisms is extensive. He is insistent on recording my voice before and after sessions, which is a wonderful tool in feedback. I have had about 5 sessions with him when I couldn’t stand the prospect of getting healed slowly. So during the Christmas break, I decided that I would take a botox shot first quarter the next year. During that time, I’ve also come across Connie Pike, a speech pathologist in the US who has had spasmodic dysphonia herself and has overcome it by a specially designed voice therapy. I had consultation with her via Skype, she gave pointers. Still, her course was the slow and steady one. I needed something fast and effective because my voice disorder was affecting my career and my social life. I also battled with frustration bordering depression. And so I wanted to end the torment as quickly as possible.

February (or March) of 2010, I had my first botox shot. Done by the doctor who has been referred by 2 other ENTs as the specialist who has done the most number of botox injections (with success) in our country. I would want nothing less.

Botox Injection

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No need to give details of the injection. It just didn’t work for me. No effect whatsoever. It didn’t turn worse, it didn’t get better. Later on, I learned that spasmodic dysphonia ABductor type does not get as much successes from botox (compared with Adductor). In short, I got the rarer form of SD, and the less responsive to the only suggested form of treatment – botox. Of course there is still surgery which would cut some nerves, but that is the last resort. And no one, as far as I know, does the procedure in the Philippines.

Given no other option, I had to search for more treatments available. I’ll mention them in my next posts.