When some clinical cases can challenge the phoniatric taxonomy.

It is proposed that taxonomy--the science and practice of classification--can offer significant help in the assessment of vocal dysfunction and in expanding the range of treatment options available to physicians. The first two clinical cases involve instances of "spasmodic dysphonia" which are susceptible to the usual botulinum toxin injections; those two cases were improved by an equally-effective phoniatric orientation that does not subject the patient to repeated injections. Treatment in the second two cases was also redesigned using a phoniatric approach to the patients' problem, after earlier ENT consultations had failed to diagnose malignancy.