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Botulinum toxin injection for failed tracheo-oesophageal voice in laryngectomees: the Sunderland experience

Published online by Cambridge University Press:  08 March 2006

K. Ramachandran ,
P. S. Arunachalam ,
Anne Hurren ,
R. L. Marsh  and
P. R. Samuel
K. Ramachandran
Affiliation:
Department of Otolaryngology and Head and Neck Surgery, Sunderland Royal Hospital, Sunderland.
P. S. Arunachalam
Affiliation:
Department of Otolaryngology and Head and Neck Surgery, Sunderland Royal Hospital, Sunderland.
Anne Hurren
Affiliation:
Department of Speech and Language Therapy, Sunderland Royal Hospital, Sunderland.
R. L. Marsh
Affiliation:
Department of Radiology, Sunderland Royal Hospital, Sunderland.
P. R. Samuel
Affiliation:
Department of Otolaryngology and Head and Neck Surgery, Sunderland Royal Hospital, Sunderland.
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Abstract

Spasm of the pharyngo-oesophageal segment is one of the important causes of tracheo-oesophageal voice failure. Traditionally it has been managed by either prolonged speech therapy, surgical pharyngeal myotomy or pharyngeal plexus neurectomy with varying degrees of success. Botulinum neurotoxin has been found to be effective in relieving pharyngo-oesophageal segment spasm. Since 1995, we have used botulinum toxin injection on 10 laryngectomees with either aphonia or hypertonicity due to pharyngo-oesophageal segment spasm. Early results were analysed by the Sunderland Surgical Voice Restoration Rating scale. Seven of the 10 patients, who were previously completely aphonic, developed voice following this therapy and are using their valve choice as their only method of communication. Out of the three patients who were treated for hypertonic voice, two did derive some benefit from the procedure. One patient developed a hypotonic voice, which lasted for a few months.

Keywords

LaryngectomyLarynx, ArtificialBotulinum Toxins
Type
Research Article
Information
The Journal of Laryngology & Otology , Volume 117 , Issue 7 , July 2003 , pp. 544 - 548
Copyright
© Royal Society of Medicine Press Limited 2003

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