Botox (botulinum toxin) injection is one of the most effective treatments for spasmodic dysphonia, a voice disorder caused by involuntary spasms of the vocal cords during speech. It’s also used for laryngeal spasm or paradoxical vocal fold motion, where the vocal cords close when they should be open, causing breathing difficulty or noisy breathing. Botox gently weakens overactive muscles to reduce spasms and restore more natural voice or breathing.

The injection is done in the office under local anesthesia. A small needle is carefully guided into the vocal fold muscle through the neck, using a combination of electromyography (EMG) or endoscopic guidance. Most patients say the procedure is brief and tolerable — lasting about 15–20 minutes from start to finish. You may notice temporary breathiness, a weaker voice, or mild swallowing difficulty for a few days, but this usually improves within 2 weeks. The therapeutic effect begins after 3–7 days and lasts around 3–4 months, at which point repeat injections are typically scheduled. Botox is extremely effective for managing symptoms and has helped thousands of patients regain control of their voice and breathing with minimal risk.