It is a clinical disease in which the voice is abnormal due to excessive tension in the muscles of the larynx, which is the voice producing organ. It is a disease in which the voice is usually interrupted when speaking, difficulty in speaking, having voice tremors, and difficulty in continuous speech. Spasmodic dysphonia is a disease of abnormal muscle tension and the diagnostic name is from voice abnormalities. I. Medication Generally, anticholinergic drugs and tranquilizers, baclofen, dopamine inhibitors, etc. are used. But medication will be used due to side effects, usually used in very serious diseases of abnormal muscle tension. In the treatment of spasmodic dysphonia medication is just a supplementary therapy. Surgical treatment 1.Returning laryngeal nerve excision: Dedo first reported this method in 1976, cutting the nerve into the larynx to inhibit the excessive closure of the vocal folds. However, there is a recurrence rate of about 64% within 3 years after surgery. 2. Thyroid chondroplasty: The front of the thyroid cartilage is cut to widen the pitch of the vocal folds, thus weakening the vocal fold tension, so that the vocal folds do not close excessively even when spasm occurs. However, due to the effect of muscle tension receptors within the vocal fold muscle, there will be another deterioration of the voice after some time. 3.Laser vocal cord muscle excision: A procedure that uses a laser to remove a portion of the vocal cord muscle to make the vocal cords thinner. 4.Neural stimulator transplantation: A method to suppress excessive contraction of the vocal fold muscles and transplant a neural stimulator into the vocal folds in order to relieve the symptoms. All surgical methods have not yet presented the possibility of a complete cure, and have the disadvantage of recurrence within a few months or years as seen by long-term follow-up results. Third, BOTOX treatment BOTOX treatment is the best treatment method available. However, it is not permanent, the effect lasts about 3 to 6 months, and has the disadvantage of continuous injection. A few years ago, the method of injecting only specific muscles in the vocal folds or a large number of injections in one side of the vocal folds was used, but the learning effect of no brain caused side effects, causing excessive spasm in the vocal folds on the opposite side that were not injected, and the injection caused symptoms to worsen. The effect is to shorten the period of hoarseness and prolong the period of good voice after BOTOX injection, and to normalize the repetitive learning reflex of the brain induced by BOTOX. In other words, it is a method to prolong the period of voice maintenance and shorten the period of hoarseness after injection, and to induce the normalization of the repetitive learning reflex of the brain. The advantage of this method is that the injection period becomes longer with the number of injections, and the possibility of complete cure of the disease is increased.