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Botulinum toxin (Botox) is often used to improve some symptoms of spasmodic dysphonia through weakening or paralyzing the vocal folds, thus preventing muscle spasms. [ 1 ] [ 32 ] The level of evidence for its use is currently limited; little is known about optimal dosage, frequency of injections, or exact location of injection.
A vocal fold stuck in an abducted or open position may cause breathiness and low volume. Listen for vocal flutter and diplophonia. Having both vocal folds stuck in an abducted position creates a breathy voice, with potential inspiratory stridor. Having both vocal folds stuck in an adducted or closed position compromises the airway significantly.
In speech, voiceless phones are associated with vocal folds that are elongated, highly tensed, and placed laterally (abducted) when compared to vocal folds during phonation. [6] Fundamental frequency, the main acoustic cue for the percept pitch, can be varied through a variety of means.
The male's vocal folds are between 1.75 cm and 2.5 cm (approx 0.75" to 1.0") in length, [3] while females' vocal folds are between 1.25 cm and 1.75 cm (approx 0.5" to 0.75") in length. The vocal folds of children are much shorter than those of adult males and females.
Each of these techniques results in medialization of the paralyzed vocal cord. However, arytenoid adduction is preferred in cases where there is a large posterior glottal gap or vertical misalignment between the vocal folds. Arytenoid adduction is often performed at the same time as a medialization thyroplasty.
The vocal timbres created by physical changes in the vocal fold vibrations and muscular changes in the laryngeal muscles are known as glottal configurations. [11] These configurations happen as a result of adduction and abduction of the glottis. A glottal configuration is the area in which the vocal folds come together when phonating.
At the level of the larynx, the exhaled air causes the vocal folds to move toward the midline of the tract (a process called adduction). The adducted vocal folds do not close completely but instead remain partially open. The narrow opening between the folds is referred to as the glottis.
Grunting while lifting heavy objects is the result of some air escaping through the adducted vocal cords ready for phonation. [14] Abduction of the vocal cords is important during physical exertion. The vocal cords are separated by about 8 mm (0.31 in) during normal respiration, but this width is doubled during forced respiration. [14]