scholarly journals Botulinum toxin treatment for adductor spasmodic dysphonia with EMG and endoscopic guidance

2021 ◽  
Vol 26 (4) ◽  
pp. 715-719
Author(s):  
Thanh Tuan Nguyen ◽  
Ngoc Tai Tran ◽  
Truc Dung Nguyen ◽  
Thi Hung Nguyen
Keyword(s):  
Botulinum Toxin ◽  
Spasmodic Dysphonia ◽  
Control Methods ◽  
Laryngeal Muscles ◽  
Adductor Spasmodic Dysphonia ◽  
Endoscopic Guidance ◽  
Botulinum Toxin Treatment ◽  
The Voice ◽  
Postural Disorders ◽  
Thyroarytenoid Muscle

Background & Objective: Spasmodic dysphonia is idiopathic focal dystonia characterized by irregular contractions or postural disorders of the laryngeal muscles, resulting in abnormal speech. Progress in laryngoscopy has resulted in development of a precise technique of botulinum toxin (BTX) injection into the thyroarytenoid muscle under visual control. Methods: We used EMG and endoscopic guidance for BTX injection in adductor spasmodic dysphonia (AdSD). Results: Thirty eight patients with AdSD were injected with BTX in 84 treatment sessions. The voice handicap index (VHI) level of the patients were: severe (73.8%), moderate (26.2%) and mild (none). The average VHI score was 74.6 points. After 8 weeks of BTX treatment, the VHI level was: Severe (3.6%), moderate (10.8%), and mild (85.7%). The average VHI score was 27.7 points. The average values of jitter, shimmer and harmonic to noice ratio (HNR) improved statistically (p < 0.05). The incidence of side effects were: breathiness (17.9%), choking (15.5%); hoarseness (8.5%), and dysphagia (4.7%). Conclusions: Injection of BTX under both EMG and laryngoscopy guidance for treatment of adductor spasmodic dysphonia is an effective and safe treatment.

Technique for Injection of Botulinum Toxin through the Flexible Nasolaryngoscope

1994 ◽  
Vol 111 (6) ◽  
pp. 787-794 ◽  
Author(s):  
Karen Rhew ◽  
Diane A. Fiedler ◽  
Christy L. Ludlow
Keyword(s):  
Botulinum Toxin ◽  
Spasmodic Dysphonia ◽  
Spectrographic Analysis ◽  
Effective Technique ◽  
Laryngeal Muscles ◽  
Patient Interviews ◽  
Endoscopic Method ◽  
Adductor Spasmodic Dysphonia ◽  
Thyroarytenoid Muscle ◽  
Video Visualization

A new endoscopic method of injecting botulinum toxin into the thyroarytenoid muscles for treatment of adductor spasmodic dysphonia was evaluated. Twelve patients with adductor spasmodic dysphonla were given injections in the thyroarytenoid muscle under video visualization with a flexible catheter needle that was passed through the working channel of a flexible nasolaryngoscope. Six patients received unilateral injections, and six received bilateral injections. Preinjection and postinjection speech samples were compared by use of spectrographic analysis. Significant decreases in voice breaks and sentence duration were found after treatment with both unilateral and bilateral injections. Patient interviews and diaries documented the reported degree and duration of symptom reduction. All 12 patients reported that the injections were of significant benefit and that the endoscopic procedure was tolerable. We concluded that this is a safe and effective technique for injecting botulinium toxin into laryngeal muscles for treatment of spasmodic dysphonia.

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

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

Longitudinal Phonatory Characteristics After Botulinum Toxin Type A Injection

1996 ◽  
Vol 39 (5) ◽  
pp. 968-980 ◽  
Author(s):  
Kimberly V. Fisher ◽  
Ronald C. Scherer ◽  
Chwen G. Guo ◽  
Ann S. Owen
Keyword(s):  
Botulinum Toxin ◽  
Botulinum Toxin Type A ◽  
Type A ◽  
Botulinum Toxin Type ◽  
Spasmodic Dysphonia ◽  
Adductor Spasmodic Dysphonia ◽  
Wide Range ◽  
Glottal Flow ◽  
Vocal Quality ◽  
The Voice

Following Botulinum Toxin Type A injection, glottal competency of an adductor spasmodic dysphonia patient is thought to vary over a wide range. This study quantifies variability in laryngeal adduction for one such patient over a 10-week period. Analyses of kinematic and aerodynamic measures were used to track the voice weekly. The measures included the electroglottographic waveform width (EGGW50), nondimensional electroglottographic slope quotient (SLQ), glottal flow open quotient (FOQ), dc glottal flow, and nondimensional glottal flow peak quotient (FPQ). The results suggested that change in degree of glottal adduction over time can be observed even when vocal instability is present within each recording session. Perceptual ratings of vocal quality (breathy to pressed) were related to the laryngeal measures. The coefficient of variation for EGGW50 and the percentage of dichrotic phonations reached minima during sessions with predominantly breathy and hypoadducted phonation. The methods used in this study show potential to aid decisions about dose level and sources of perceptual adductor spasmodic dysphonia symptoms for a given patient.

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.

Botulinum toxin treatment of adductor spasmodic dysphonia: Longitudinal functional outcomes

2011 ◽  
Vol 121 (3) ◽  
pp. 606-612 ◽  
Author(s):  
Daniel Novakovic ◽  
Heather H. Waters ◽  
Joanna B. D'Elia ◽  
Andrew Blitzer
Keyword(s):  
Botulinum Toxin ◽  
Functional Outcomes ◽  
Spasmodic Dysphonia ◽  
Adductor Spasmodic Dysphonia ◽  
Botulinum Toxin Treatment

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.

Botulinum Toxin A and B: A Comparative Dosing Study for Spasmodic Dysphonia

2005 ◽  
Vol 133 (6) ◽  
pp. 836-838 ◽  
Author(s):  
Andrew Blitzer
Keyword(s):  
Botulinum Toxin ◽  
Safety Profile ◽  
Conversion Factor ◽  
Botulinum Toxin A ◽  
Spasmodic Dysphonia ◽  
Type B ◽  
Onset Of Action ◽  
Safety And Efficacy ◽  
Laryngeal Muscles ◽  
Adductor Spasmodic Dysphonia

OBJECTIVE: The purpose of this study was to find the conversion factor, safety, and efficacy of type A to type B toxin for laryngeal muscles. METHODS: Thirty-two patients with adductor spasmodic dysphonia with stable doses of A toxin to manage their symptom were given type B toxin starting at a conversion of 1 Uof BTX-A to 50 U of BTX-B. The patients were followed for 1 year, and doses adjusted according to response. RESULTS: The conversion factor was found to be 52.3 U:1 U. The onset of action of type B was more rapid (2.09 days vs 3.2 days [ P = 0.028]), with a shorter duration of benefit (10.8 weeks vs 17 weeks [ P = 0.002). The safety profile for A and B toxin appeared the same, with 3 patients receiving Myobloc reporting dry mouth. CONCLUSION: This study shows that a conversion factor of 52.3:1 Myobloc (BTX-B) to Botox (BTX-A) and that Myobloc is an effective alternative to Botox (BTX-A) for patients with spasmodic dysphonia. EBM RATING: B-2

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