28.8K  56K  Cable/T1    (Get RealPlayer) Local injections of botulinum toxin (BTX) into the vocal cord muscles have proven to be the most effective treatment for spasmodic dysphonia. The treatment blocks the ability of nerves to stimulate the vocal muscles so that spasms are greatly diminished and speech is significantly improved. The treatment can also reduce the breathiness and help decrease the effort required to speak. People with the more common adductor form of spasmodic dysphonia typically respond better to botulinum toxin injections than those persons with the abductor form of spasmodic dysphonia. One reason for this is that the muscles affected in abductor are located behind the larynx, making injections more difficult. The benefits of botulinum toxin injections vary for each individual depending on injection technique, suboptimal dosing, and patient biology, but results can last anywhere from six weeks to six months. The two most common side effects are dysphagia, difficulty in swallowing, and an increase breathiness of voice. Both usually only last from 6 to 12 days after the injection. Adjusting the dose by using the lowest possible effective amount should prevent breathy after-effects of botulinum toxin injections.