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Invited Commentary
August 2018

Classifying and Diagnosing Laryngeal Dystonia—Are We Artists or Are We Scientists?

Author Affiliations
  • 1Department of Otolaryngology–Head and Neck Surgery, University of Washington, Seattle
JAMA Otolaryngol Head Neck Surg. 2018;144(8):666-667. doi:10.1001/jamaoto.2018.0645

Laryngology is a relatively young subspecialty in otolaryngology. Although some practitioners focused on or limited their practices to laryngology in the late 1980s and early 1990s, the subspecialty began its more formal development near the turn of the century when laryngology programs began to produce the first fellowship-trained laryngologists, initially at about the rate of 10 per year.

The interest in laryngeal dystonia began earlier in a few centers with the first foray into treating the disorder by recurrent nerve section.1 However, a widely accepted treatment for laryngeal dystonia did not develop until the later 1980s and early 1990s with the publication of Andrew Blitzer’s description of spasmodic dysphonia as a focal dystonia that was treatable with botulinum toxin.2 As the treatment of laryngeal dystonia became more widely available, the recognition of the disorder and the diagnosis became much more prominent. Laryngologists who began treatment of laryngeal dystonia in that era often had patients present in their offices with a medical history of 20, 30, or more years of symptoms before receiving a diagnosis. In more recent times, laryngeal dystonia has become a relatively common entity in many laryngeal practices and often is part of the differential diagnosis in nonlesion disorders of the larynx.

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