This procedure is most commonly used to treat spasmodic dysphonia, a voice disorder in which the vocal cords involuntarily spasm during speech. Botox (botulinum toxin) is a well-established treatment that temporarily weakens the overactive muscles, allowing for smoother, more controlled speech. Botox may also be used in select cases of vocal tremor or other laryngeal dystonias.

When performed under general anesthesia with a laryngoscope and surgical microscope, this procedure allows for precise placement of Botox into the vocal muscles. It is generally very safe and takes only a few minutes. Afterward, patients may experience temporary breathiness, reduced vocal strength, or mild swallowing difficulty, which usually resolves within a few days to weeks as the muscles adjust. The full benefit typically appears within a week and lasts around 3–6 months. Repeat injections are often needed to maintain voice improvement.