Spasmodic dysphonia is a neurologic disorder that causes certain muscles in the voice box to be over-active, most often leading to a non-fluent, strangled-sounding voice. 


One management strategy for spasmodic dysphonia is the injection of certain vocal cord muscles with botulinium toxin (Botox) in order to provide a smoother, more fluid voice. This is typically performed in the office, without sedation, with a small needle inserted through the neck skin. A specialized machine that can detect the electrical signals of muscles (EMG) is used to confirm delivery of the drug to the correct site.