ADductor spasmodic dysphonia is the most common type of laryngeal dystonia and involves spasms of the muscles that close the vocal folds. It could be appropriately called the strain-strangled voice. The spasms cause a choking off of the voice or interruptions of the voice. Adductor spasmodic dysphonia may also sound like a tightness or effortfulness without any obvious cutting-out type symptoms.
What to Expect from a Botox Injection
The Initial Wait
For a day or two your voice will usually be unchanged. Approximately 24–72 hours from the injection the spasms begin to diminish and the voice may be very good. Within a few hours the voice may become weak and breathy. Many wonder why this weakness develops. As the medicine begins to take effect, just a part of the muscle in the vocal folds is weak, while a short time later, when the injection has taken complete effect, most or all of the muscle will be weakened, thereby weakening your voice.
In a few uncommon situations, the effect has come on over a week or two rather than right away. Some patients have noticed that if they rest their voice on the day of the injection, the medication works better. Conversely, if they have a lot of coughing on the day of the injection, it does not seem to take as well.
The “Weak/Breathy Voice” Phase
This phase lasts as little as a few days or as long as eight weeks. During this phase, you will notice that your voice is weak and cannot be heard in competition with background noise. You may find that you have to take a breath frequently when you talk, because you run out of air so quickly. A few people will also tend to cough on liquids — a side effect that tends to resolve faster than the breathy voice. If this swallowing problem happens to you, use extra care when drinking liquids, utilize thick liquids when possible, and try tucking your chin towards your chest when you drink.
Patients have used the following words to describe how they feel during this phase:
- Whispery
- Airy
- Helium voice
- Hilarious sounding cough
- “Mickey Mouse” voice
- “I’m exhausted after I talk”
- “My breathing seems harder” (referring to the need to take frequent, deep breaths to keep up talking at a normal rate)
- “I feel a burning in my throat when I talk” (the other normal muscles are working harder and getting achy)