Hypertonicity/spasm of the neoglottis
In case of hypertonicity of the neoglottis (characterized by a strained, strangled voice sound) the patient might not be able to lower the backpressure since more pressure is needed to produce voice. Evaluation of the neoglottis by means of videofluoroscopy is necessary to diagnose hypertonicity or spasm. Hypertonicity can be solved by means of Botox injections or secondary myotomy.