Assessment of posterior cricoarytenoid botulinum toxin injections in patients with abductor spasmodic dysphonia

Document Type

Journal Article

Publication Date

1-1-2001

Journal

Annals of Otology, Rhinology and Laryngology

Volume

110

Issue

5 I

DOI

10.1177/000348940111000503

Keywords

Botox; Botulinum toxin; Electromyography; Larynx; Posterior cricoarytenoid muscle; Spasmodic dysphonia; Voice

Abstract

In this study, we compared 2 techniques for injection of botulinum toxin type A (Botox) into the posterior cricoarytenoid (PCA) muscle for the treatment of abductor spasmodic dysphonia (ABSD). Fifteen patients with ABSD were enrolled in a prospective randomized crossover treatment trial comparing the 2 injection techniques. The PCA muscle was injected with 5 units on each side, with the injections staged 2 weeks apart, via either a percutaneous posterior-lateral approach or a transnasal fiberoptic approach. Eleven patients reported some benefit with the injections; however, the patient-perceived benefits were not related to changes in symptoms on blinded counts by speech pathologists. No significant reductions in the numbers of breathy breaks occurred with either technique, and no differences were found between techniques. Although patients perceived a benefit, blinded symptom counts did not substantiate these benefits. Thus, PCA muscle injections of Botox provided limited benefits to patients with ABSD, demonstrating the need for a more effective therapy for these patients.

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