Diagnosis and Treatment of Laryngeal Dystonia: Past, Present and Future Directions

Abstract

Background: Laryngeal dystonia is a task-specific focal dystonia of the internal laryngeal muscles. Methods: Peer-reviewed articles on laryngeal dystonia from PUBMED were identified. Manuscripts that supported selected points of discussion were chosen. Illustrative figures and videos from the authors’ personal files support selected ideas. Results: This manuscript presents a comprehensive overview of the diagnoses and treatment of laryngeal dystonia and includes a brief history of the terminology, genetic mutations, and common misdiagnosis. In addition, the manuscript provides an in-depth description of the use of botulinum toxin (BoNT), including the mechanism of action, techniques for injections, and outcomes. Discussion: Laryngeal dystonia is a complex clinically heterogeneous disorder. BoNT injection provides targeted therapy to the laryngeal muscles and has shown great efficacy in improving voice fluidity. Nevertheless, BoNT provides only symptomatic relief without altering the underlying disorder. Future therapeutic options that target the central nervous system may help clinicians better understand the pathophysiology of this condition.