scholarly journals Botulinum toxin efficacy in the treatment of patients with spasmodic dysphonia

2007 ◽  
Vol 64 (10) ◽  
pp. 671-675
Author(s):  
Marina Svetel ◽  
Milan Vasic ◽  
Gordana Tomic ◽  
Predrag Stankovic ◽  
Milena Stojanovic ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Botulinum Toxin ◽  
Diagnostic Procedures ◽  
Vocal Folds ◽  
Spasmodic Dysphonia ◽  
Efficacy Evaluation ◽  
Adductor Spasmodic Dysphonia ◽  
Botulinum Toxin Therapy ◽  
Voice And Speech

Background/Aim. Spasmodic dysphonia (DS) is a disabling speech disturbance appearing as the consequence of dystonic vocal folds contraction. Its intermittent appearance in the laryngeal muscles causes vocal function discontinuation. The quality of life of these patients is significantly disturbed. Surgical and a medical therapy appear to be inadequate and unsuccessful ones of no steady improvement. It is the botulinum toxin therapy that proved to be highly efficacious one, with the established improvement in 80?100% of patients. The aim of our study was to evaluate the efficacy of botulinum toxin therapy in patients with SD and to show our preliminary results. Methods. The study included 10 patients with adductor spasmodic dysphonia. After diagnostic procedures, botulinum toxin was applied either in one or both vocal folds, in doses of 12?16 units each. In our study we applied indirect technique originally developed by Hocevar and Pirtosek. Perceptive voice and speech analysis was performed prior to and after the instillation of botuline toxin as per structured Scale of pathological characteristics of voice and speech appearing in the spasmodic dysphonia. Results. The majority of our patients experienced both subjective improvement and the improvement in the terms of the quality of life, Voice Henolicap Index ? (VHI) that was rated as rather significant one (t = 3.562; p = 0.006). Conclusion. Regardless unquestionable improvement of definite phonation, further function restitution requires individual vocal therapy and psychotherapy. Vocal therapy includes structural vocal techniques which reduce degree of vocal tension and rapid changes in the power and the height of voice. Further investigations are necessary for the scope of the definition of a standardized therapeutically procedure for spasmodic dysphonia treatment which comprises multidisciplinary approach in diagnosis, therapy and treatment efficacy evaluation.

The point-touch technique for botulinum toxin injection in adductor spasmodic dysphonia: quality of life assessment

2011 ◽  
Vol 125 (7) ◽  
pp. 714-718 ◽  
Author(s):  
S Morzaria ◽  
E J Damrose
Keyword(s):  
Quality Of Life ◽  
Botulinum Toxin ◽  
Assessment Tool ◽  
Botulinum Toxin Injection ◽  
Spasmodic Dysphonia ◽  
Life Questionnaire ◽  
Adductor Spasmodic Dysphonia ◽  
Related Quality ◽  
Pre Treatment

AbstractBackground:Botulinum toxin injection under electromyographic guidance is the ‘gold standard’ for adductor spasmodic dysphonia treatment. The point-touch technique, an alternative injection method which relies on anatomical landmarks, is cheaper, quicker and more accessible, but has not yet gained widespread acceptance due to concerns about patient satisfaction.Objective:To assess swallowing and voice-related quality of life following point-touch botulinum toxin injection in adductor spasmodic dysphonia patients.Setting:Stanford University Voice and Swallowing Center.Design:Prospective case series (evidence level four).Methods:Consecutive adductor spasmodic dysphonia patients with a stable botulinum toxin dose–response relationship were recruited prospectively. The Eating Assessment Tool and Voice-Related Quality of Life questionnaires were completed pre-treatment and at 10 and 30 per cent completion of the injection cycle, respectively.Results:Thirty-seven patients completed follow up. The mean total botulinum toxin dose was 0.88 units. Pre-treatment Voice-Related Quality of Life questionnaire results reflected the burden of disease. Post-treatment Eating Assessment Tool and Voice-Related Quality of Life questionnaire results were collected at 2.53 and 7.84 weeks, respectively; the former showed an increase in dysphagia, albeit statistically insignificant, while the latter showed significantly improved scores (both domain and total).Conclusion:The point-touch technique is a viable alternative for botulinum toxin injection in the treatment of adductor spasmodic dysphonia.

scholarly journals Advances in the Management of Neurogenic Detrusor Overactivity in Multiple Sclerosis

2013 ◽  
Vol 15 (2) ◽  
pp. 66-72 ◽  
Author(s):  
Gael J. Yonnet ◽  
Anette S. Fjeldstad ◽  
Noel G. Carlson ◽  
John W. Rose
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Botulinum Toxin ◽  
Urinary Tract ◽  
Detrusor Overactivity ◽  
Anticholinergic Drugs ◽  
Neurogenic Detrusor Overactivity ◽  
Botulinum Toxin Therapy ◽  
Tract Infections

Bladder dysfunction in multiple sclerosis (MS) can be socially disabling, have negative psychological and economic consequences, and impair patients' quality of life. Knowledge of the functional anatomy and physiology of the urinary tract is essential to understand the symptoms associated with central nervous system lesions and the pharmacotherapies used to treat them. Treatments for neurogenic detrusor overactivity (NDO) have consisted mainly of administration of anticholinergic drugs, which have been shown to provide suboptimal clinical benefits and be poorly tolerated. The US Food and Drug Administration (FDA) approval of intravesicular botulinum toxin therapy provides a second-line option for MS patients with NDO not responsive to anticholinergic drugs. We performed a review of key literature pertaining to the intravesicular application of botulinum toxin. In the management of NDO, administration of intravesicular botulinum toxin using clean intermittent catheterization decreases the incidence of urinary tract infections, promotes urinary continence, and improves quality of life for 9 months after a single injection; moreover, those benefits are maintained with repeated injections over time.

Selective lateral laser thyroarytenoid myotomy for adductor spasmodic dysphonia

2010 ◽  
Vol 124 (8) ◽  
pp. 886-891 ◽  
Author(s):  
A Hussain ◽  
M Shakeel
Keyword(s):  
Botulinum Toxin ◽  
Minimally Invasive ◽  
Clinical Assessment ◽  
Clinical Case ◽  
Case Series ◽  
Spasmodic Dysphonia ◽  
Adductor Spasmodic Dysphonia ◽  
Glasgow Benefit Inventory ◽  
Botulinum Toxin Therapy

AbstractObjective:Selective lateral laser thyroarytenoid myotomy is a conceptually sound, simple, minimally invasive, repeatable and predictable new surgical procedure for treating adductor spasmodic dysphonia. This paper aims to introduce and describe the surgical technique, and to present a clinical case series and its outcomes.Study design:A prospective, clinical case series treated with selective lateral laser thyroarytenoid myotomy, with follow up of 2.5 years.Method:Pre- and post-operative data were collected prospectively for patients undergoing selective lateral laser thyroarytenoid myotomy. These data included patient demographics, previous interventions for adductor spasmodic dysphonia, technical aspects of surgery and clinical outcome. Outcome data included clinical assessment, voice handicap index, need for further intervention, and patient satisfaction assessed by subjective improvement (detailed subjectively by the patients themselves and objectively using the Glasgow benefit inventory).Results:Four patients (two men and two women; mean age 65 years; age range 41–80 years) were included. The mean duration of adductor spasmodic dysphonia was 11 years. All patients had previously been treated with botulinum toxin A. All patients reported improvement in voice quality, fluency, sustainability and elimination of voice breaks over 2.5 years' follow up. Clinical assessment revealed no alteration in mucosal wave, and complete relief of hyperadduction was observed on phonation. No patients required supplementary botulinum toxin treatment during follow up.Conclusion:Selective lateral laser thyroarytenoid myotomy seems to represent a curative procedure for adductor spasmodic dysphonia, a chronic, debilitating condition. This procedure is conceptually simple, minimally invasive and repeatable. It also seems to offer a safe and lasting alternative to botulinum toxin therapy.

Botulinum toxin treatment of false vocal folds in adductor spasmodic dysphonia: Functional outcomes

2015 ◽  
Vol 126 (1) ◽  
pp. 118-121 ◽  
Author(s):  
C. Blake Simpson ◽  
Christopher T. Lee ◽  
Jeanne L. Hatcher ◽  
Joel Michalek
Keyword(s):  
Botulinum Toxin ◽  
Functional Outcomes ◽  
Vocal Folds ◽  
Spasmodic Dysphonia ◽  
Adductor Spasmodic Dysphonia ◽  
Botulinum Toxin Treatment ◽  
False Vocal
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