Because no cure for LDs exists, the ultimate goal of current treatment modalities is functional symptomatic relief without airway compromise. Botulinum toxin has proven to be a safe and effective treatment for relief of the symptoms of spasmodic dysphonia. Its effects are localized, transient, and nondestructive, and its side effects are few. Outcomes may be improved with the universal use of classification schemes. New surgical approaches await the crucial test of time. Surgery is best reserved for the rare patient who does not benefit from, or cannot tolerate, botulinum toxin injections.
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