Effects of Botulinum Toxin on Pathophysiology in Spasmodic Dysphonia

2000 ◽  
Vol 109 (2) ◽  
pp. 194-203 ◽  
Author(s):  
Steven Bielamowicz ◽  
Christy L. Ludlow
Keyword(s):  
Botulinum Toxin ◽  
Muscle Activity ◽  
Muscle Activation ◽  
Botulinum Toxin Injection ◽  
Symptom Relief ◽  
Spasmodic Dysphonia ◽  
Laryngeal Muscle ◽  
Adductor Spasmodic Dysphonia ◽  
Before And After ◽  
Thyroarytenoid Muscle

To determine the mechanism of symptom relief with treatment by botulinum toxin injection in persons with adductor spasmodic dysphonia (ADSD), we evaluated the effects of unilateral thyroarytenoid muscle injections on both injected and noninjected muscles in 10 subjects with ADSD, using electromyography on both sides of the larynx before and after treatment. The subjects' speech symptoms were reduced (p = .005) 2 weeks following injection, when the electromyographic study occurred. Muscle activation levels and the numbers of spasmodic muscle bursts decreased significantly (p ≤ .03) postinjection in both the injected and noninjected muscles. The reductions in laryngeal muscle bursts correlated with symptom reduction (r ≥ .7) in all muscles. Reductions in laryngeal muscle bursts did not relate to either absolute or normalized levels of muscle activity before or after botulinum toxin injection. The results suggest that changes in the central pathophysiology are responsible for changes in speech symptoms following treatment.

Effects of Levodopa on Laryngeal Muscle Activity for Voice Onset and Offset in Parkinson Disease

2001 ◽  
Vol 44 (6) ◽  
pp. 1284-1299 ◽  
Author(s):  
Sally Gallena ◽  
Paul J. Smith ◽  
Thomas Zeffiro ◽  
Christy L. Ludlow
Keyword(s):  
Parkinson Disease ◽  
Muscle Activity ◽  
Vocal Fold ◽  
Muscle Activation ◽  
Activity Levels ◽  
Laryngeal Muscle ◽  
Idiopathic Parkinson Disease ◽  
Before And After ◽  
Research Volunteers ◽  
Thyroarytenoid Muscle

The laryngeal pathophysiology underlying the speech disorder in idiopathic Parkinson disease (IPD) was addressed in this electromyographic study of laryngeal muscle activity. This muscle activity was examined during voice onset and offset gestures in 6 persons in the early stages of IPD who were not receiving medication. The purpose was to determine (a) if impaired voice onset and offset control for speech and vocal fold bowing were related to abnormalities in laryngeal muscle activity in the nonmedicated state and (b) if these attributes change with levodopa. Blinded listeners rated the IPD participants' voice onset and offset control before and after levodopa was administered. In the nonmedi-cated state, the IPD participants' vocal fold bowing was examined on nasoendo-scopy, and laryngeal muscle activity levels were compared with normal research volunteers. The IPD participants were then administered a therapeutic dose of levodopa, and changes in laryngeal muscle activity for voice onset and offset gestures were measured during the same session. Significant differences were found between IPD participants in the nonmedicated state:those with higher levels of muscle activation had vocal fold bowing and greater impairment in voice onset and offset control for speech. Similarly, following levodopa administration, those with thyroarytenoid muscle activity reductions had greater improvements in voice onset and offset control for speech. In this study, voice onset and offset control ifficulties and vocal fold bowing were associated with increased levels of aryngeal muscle activity in the absence of medication.

Point-Touch Technique of Botulinum Toxin Injection for the Treatment of Spasmodic Dysphonia

1992 ◽  
Vol 101 (11) ◽  
pp. 883-887 ◽  
Author(s):  
David C. Green ◽  
Paul H. Ward ◽  
Gerald S. Berke ◽  
Bruce R. Gerratt
Keyword(s):  
Botulinum Toxin ◽  
Botulinum Toxin Injection ◽  
Current Method ◽  
Spasmodic Dysphonia ◽  
Needle Placement ◽  
Careful Evaluation ◽  
Anatomic Landmarks ◽  
Adductor Spasmodic Dysphonia ◽  
Botox Injection ◽  
Thyroarytenoid Muscle

Intralaryngeal injections of botulinum toxin (Botox), under electromyographic guidance, have emerged as an effective treatment for adductor spasmodic dysphonia. To remain effective, these injections must be repeated every 3 to 9 months as the symptoms recur. One drawback to the current method is the need for electromyographic confirmation of needle placement into the thyroarytenoid muscle. This report describes an anatomic approach to Botox injection that requires only flexible nasopharyngeal endoscopy and careful evaluation of the anatomic landmarks. This technique has been used successfully on 13 patients, and objective pretreatment and posttreatment measures are reported.

Evaluation of Voice Quality in Adductor Spasmodic Dysphonia before and after Botulinum Toxin Treatment

2001 ◽  
Vol 110 (7) ◽  
pp. 627-634 ◽  
Author(s):  
Ton P. M. Langeveld ◽  
Edgar H. Houtman ◽  
Jeroen J. Briaire ◽  
Maya van Rossum ◽  
Aeilko H. Zwinderman ◽  
...  
Keyword(s):  
Botulinum Toxin ◽  
Voice Quality ◽  
Spasmodic Dysphonia ◽  
Adductor Spasmodic Dysphonia ◽  
Before And After ◽  
Botulinum Toxin Treatment

Adductor spasmodic dysphonia: case reports withacoustic analysis following botulinum toxin injection and acupuncture

1997 ◽  
Vol 11 (2) ◽  
pp. 232-237 ◽  
Author(s):  
Lise Crevier-Buchman ◽  
Ollivier Laccourreye ◽  
Jean-François Papon ◽  
Dominique Nurit ◽  
Daniel Brasnu
Keyword(s):  
Botulinum Toxin ◽  
Case Reports ◽  
Botulinum Toxin Injection ◽  
Spasmodic Dysphonia ◽  
Adductor Spasmodic Dysphonia

scholarly journals Treatment Efficacy of Electromyography versus Fiberscopy-Guided Botulinum Toxin Injection in Adductor Spasmodic Dysphonia Patients: A Prospective Comparative Study

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Jae Wook Kim ◽  
Jae Hong Park ◽  
Ki Nam Park ◽  
Seung Won Lee
Keyword(s):  
Botulinum Toxin ◽  
Treatment Efficacy ◽  
Botulinum Toxin Injection ◽  
Spasmodic Dysphonia ◽  
Total Dosage ◽  
Adductor Spasmodic Dysphonia ◽  
Prospective Comparative Study ◽  
The Mean ◽  
Botulinum Toxin Injections ◽  
The Voice

Introduction. This study prospectively evaluates and compares the treatment efficacy of botulinum toxin injection under electromyography guidance (EMG group) and percutaneous botulinum toxin injection under flexible fiberscopic guidance (fiberscopy group).Methods. Thirty patients with adductor spasmodic dysphonia (ADSD), who had never received treatment, were randomly allocated into EMG- or fiberscopy-guided botulinum toxin injections between March 2008 and February 2010. We assessed acoustic and aerodynamic voice parameters, and the voice handicap index (VHI) before injection and at 1, 3, and 6 months after injection.Results. The mean total dosage of botulinum toxin was similar for both groups: 1.7 ± 0.5 U for the EMG group and 1.8 ± 0.4 U for the fiberscopy group (P>0.05). There were no significant differences in outcomes between the two groups in either the duration of effectiveness or complications such as breathy voice and aspiration.Conclusion. Botulinum toxin injection under fiberscopic guidance is a viable alternative to EMG-guided botulinum toxin injection for the treatment of adductor spasmodic dysphonia when EMG equipment is unavailable.

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