This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Voice and Speech Disorders, Subject name: ENT
A 26-year-old female complaining of scratchy croaky voice. Which of the following is true? 
Select and explain. 
A. The best treatment is botulinum in cricoarytenoid, B. Type I thyroplasty can be used as treatment, C. Adductor dysphonia is the cause, D. Abductor dysphonia is the cause
C: Adductor dysphonia is the cause
Answer: C: Adductor dysphonia is the cause 
Explanation: (c) Adductor dysphonia is the cause(Ref. Scott Brown, 8th ed., Vol 3; 957; 997)Scratchy croaky is a high pitched sound arising due to rubbing of vocal cords in adductor dysphonias. The best treatment here will be percutaneous botulinum injection in the thyroarytenoid muscle.Percutaneous botulinum injection in the cricoarytenoid muscle (the only abductor of VC), is done in abductor dysphonias.In abductor dysphonia the voice produced is low pitched breathy and whispery.Isshiki TypeI thyroplasty is medialisation of vocal cords done in unilateral complete paralysis of vocal cords.