Hostname: page-component-586b7cd67f-t8hqh Total loading time: 0 Render date: 2024-11-30T21:20:04.080Z Has data issue: false hasContentIssue false
  • English
  • Français

Botulinum toxin A injection under electromyographic guidance for treatment of spasmodic dysphonia

Published online by Cambridge University Press:  01 May 2007

P Casserly  and
C Timon
P Casserly*
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Royal Victoria Eye and Ear Hospital, Dublin, Ireland
C Timon
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Royal Victoria Eye and Ear Hospital, Dublin, Ireland
*
Address for correspondence: Ms Paula Casserly, 16 Newbridge Ave, Sandymount, Dublin 4, Ireland. Fax: 003531 8093148 E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Spasmodic dysphonia is a disabling voice condition caused by a chronic neurological disorder of central motor processing. Present therapy is directed at relief of symptoms rather than cure. Botulinum toxin type A injection into the thyroarytenoid muscle has become the pre-eminent approach for treatment of adductor spasmodic dysphonia. Botulinum toxin A injections can be performed in an out-patient setting under electromyographic guidance. We present our experience with 153 injections in 14 patients with adductor spasmodic dysphonia over a 10-year period. We demonstrate that the electromyography signal is a reliable prognostic indicator in terms of efficacy, and that patients' subjective opinion is a valid indicator of treatment success and future treatment strategy.

Keywords

Voice DisordersSpastic DysphoniaLarynxMusclesBotulinum Toxin Type A
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 122 , Issue 1 , January 2008 , pp. 52 - 56
Copyright
Copyright © JLO (1984) Limited 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Aronson, A.Aronson, AAbductor spastic dysphoniaClinical Voice Disorders, 2nd edn.New York: Thieme Medical Publishing, 1985;187–97Google Scholar
2Aronson, A, Hartman, DE. Adductor spastic dysphonia as a sign of essential tremor. J Speech Hear Disord 1981;46:52–8CrossRefGoogle Scholar
3Blitzer, A, Brin, MF, Fahn, S, Lovelace, RE. Localised injections of botulinum toxin for the treatment of focal laryngeal dystonia (spastic dysphonia). Laryngoscope 1988;98:193–7CrossRefGoogle ScholarPubMed
4Blitzer, A, Sulica, L. Botulinum toxin; basic science and clinical uses in otolaryngology. Laryngoscope 2001;111:218–26CrossRefGoogle ScholarPubMed
5Blitzer, A, Brin, MF, Stewart, CF. Botulinum toxin management of spasmodic dysphonia: a 12-year experience in more than 900 patients. Laryngoscope 1998;98:1435–41CrossRefGoogle Scholar
6Cannito, MP, Johnson, JP. Spastic dysphonia: a continuum disorder. J Commun Disord 1981;14:215–23CrossRefGoogle ScholarPubMed
7Sulica, L. Contemporary management of spasmodic dysphonia. Curr Opin Otolaryngol Head Neck Surg 2004;12:543–8CrossRefGoogle ScholarPubMed
8Ludlow, CL. Treatment of speech and voice disorders with botulinum toxin. JAMA 1990;264:2671–5CrossRefGoogle ScholarPubMed
9Dedo, HH. Recurrent laryngeal nerve sectioning for spastic dysphonia. Ann Otol Rhinol Laryngol 1979;85:451–9CrossRefGoogle Scholar
10Aronson, AE, De Santo, LW. Adductor spastic dysphonia: three years after recurrent laryngeal nerve section. Laryngoscope 1983;93:1–8CrossRefGoogle Scholar
11Murry, T, Woodson, GE. Combined-modality treatment of adductor spasmodic dysphonia with botulinum toxin and voice therapy. J Voice 1995;9:460–5CrossRefGoogle ScholarPubMed
12Sheppert, AD, Spirou, GA, Berrebi, J, Garrnet, D. Three-dimensional reconstruction of immunolabeled neuromuscular junctions in the human thyroarytenoid muscle. Laryngoscope 2003;113:1973–6CrossRefGoogle ScholarPubMed
13Ford, CN, Bless, DM, Lowery, JD. Indirect laryngoscopic approach for injection of botulinum toxin in spasmodic dysphonia. Otol Head Neck Surg 1990;103:752–8CrossRefGoogle ScholarPubMed
14Rhew, K, Fiedler, DA, Ludlow, CL. Technique for injection of botulinum toxin through a flexible nasolaryngoscope. Otolaryngol Head Neck Surg 1994;111:787–94CrossRefGoogle ScholarPubMed
15Rubin, AD, Wodchis, WP, Spak, C, Kileny, PR, Hogikyan, ND. Longitudinal effects of Botox injections on Voice-Related Quality of Life (V-RQOL) for patients with adductory spasmodic dysphonia. Arch Otolaryngol Head Neck Surg 2004;130:415–20CrossRefGoogle ScholarPubMed
16Zwirner, P, Murry, T, Swenson, M, Woodson, G. Effects of botulinum toxin therapy in patients with adductor spasmodic dysphonia: acoustic, aerodynamic, and videoendoscopic findings. Laryngoscope 1992;102:400–6CrossRefGoogle ScholarPubMed
17Sapienza, CM, Cannito, MP, Murry, T, Branski, R, Woodson, G. Acoustic variations in reading produced by speakers with spasmodic dysphonia pre-Botox injection and within early stages of post-Botox injection. J Speech Lang Hear Res 2002;45:830–43CrossRefGoogle ScholarPubMed
18Wong, DL, Irish, JC, Adams, SG, Durkin, LC, Hunt, EJ. Laryngeal image analysis following botulinum toxin injections in spasmodic dysphonia. J Otolaryngol 1995;24:64–8Google ScholarPubMed
19Rodriguez, A, Ford, C, Bless, D, Harmon, R. Electromyographic assessment of spasmodic dysphonia patients prior to botulinum toxin injection. Electromyography and Clinical Neurophysiology 1994;34:403–7Google Scholar
20Benninger, MS, Gardiner, G, Grywalski, C. Outcomes of botulinum toxin treatment for patients with spasmodic dysphonia. Arch Otolaryngol Head Neck Surg 2001;127:1083–5CrossRefGoogle ScholarPubMed
21Tisch, SH, Brake, HM, Law, M, Cole, IE, Darveniza, P. Spasmodic dysphonia: clinical features and effects of botulinum therapy in 169 patients: an Australian experience. J Clin Neurosci 2003;10:434–8CrossRefGoogle ScholarPubMed
22Boutsen, F, Cannito, MP, Taylor, M, Bender, B. Botox treatment in adductor spasmodic dysphonia: a meta-analysis. J Speech Lang Hear Res 2002;43:469–81CrossRefGoogle Scholar
23Bielamowicz, S, Stager, SV, Badillo, A, Godlewski, A. Unilateral versus bilateral injections in patients with adductor spasmodic dysphonia. J Voice 2002;16:117–23CrossRefGoogle ScholarPubMed
24Pearson, EJ, Sapienza, CM. Historical approaches to the treatment of adductor spasmodic dysphonia (ADSD): review and tutorial. Neurorehabiliation 2003;18:325–38CrossRefGoogle Scholar