A comparison of injection techniques using botulinum toxin injection for treatment of the spasmodic dysphonias

Ludlow, Christy L.; Bagley, Jo; Yin, Sheng; Koda, Junji

doi:10.1016/s0892-1997(05)80038-4

Cited by 32 publications

(25 citation statements)

References 13 publications

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“…The effects of disease and treatment on social life and communicative abilities in general are, of course, very important. Short-term effects of botulinum toxin treatment have previously been described in several studies (2,3, 10) and our study is in agreement with those. The present study is different in the sense that it addresses social function over a longer period of time, asking the patients to take into account the disadvantages of undergoing treatment, including voice deterioration before and just after injection, etc.…”

Section: Discussionsupporting

confidence: 94%

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Effects of botulinum toxin treatment for adductor spasmodic dysphonia on voice and social function

Lindestad

Hertegård

Ylitalo

1997

Logopedics Phoniatrics Vocology

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Log Phon Vocol 1997; 22: 129-134Thirty-nine patients with adductor spasmodic dysphonia currently under treatment with botulinum toxin estimated their vocal and social function before and during treatment in percentage of normal. Subjective symptoms and side effects were registered. All patients had positive effects. Mean improvement was 45 per cent for voice function and 47 per cent for social function. Eleven patients (28 per cent) claimed they had a completely normal voice for a short period between injections. Thirty-three patients (85 per cent) reported a considerably breathy voice quality lasting several weeks after injection on one or more occasions. Sixteen patients had experienced slight deglutition problems. In spite of these side effects, the results confirm that the overall efficacy of treatment of adductor spasmodic dysphonia with botulinum toxin is very high.

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Section: Discussionsupporting

confidence: 94%

“…In the long run, however, the period of clinical effect of bilateral injections may decrease after a series of injections. Moreover, it appears that females may benefit longer from unilateral than from bilateral treatment (10).…”

Section: Introductionmentioning

confidence: 99%

Effects of botulinum toxin treatment for adductor spasmodic dysphonia on voice and social function

Lindestad

Hertegård

Ylitalo

1997

Logopedics Phoniatrics Vocology

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“…In 1990, Ford et al 8 described a unilateral transoral injection protocol, titrating to the lowest effective dose. In 1992, Ludlow et al 9 reported that compared with women who were given bilateral injections, women receiving unilateral injections enjoyed a longer duration of benefit. In this study, total doses for unilateral injection ranged from 15 to 60 units.…”

Section: Discussionmentioning

confidence: 99%

“…Since the initial reports in 1987 1 and 1988, 2 the efficacy of these injections for spasmodic dysphonia has been demonstrated in larger reviews 3,4 and in prospective, randomized double‐blinded studies 5 . However, despite their success, botulinum toxin type A injections have shortcomings, such as the interval of weak, breathy voice that usually follows the injections and lasts an average of 14 to 16 days 6 . Other drawbacks include the need for repeated injections and the variable, unpredictable response to serial injections 7…”

Section: Introductionmentioning

confidence: 99%

Alternating Unilateral Botulinum Toxin Type A (BOTOX^®) Injections for Spasmodic Dysphonia

et al. 1996

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Injection of botulinum toxin type A (BOTOX) into both thyroarytenoid muscles is an accepted treatment for spasmodic dysphonia. The authors of this study identified patients who could not tolerate the interval of breathy voice that immediately follows bilateral injections. These patients were offered a protocol in which the injection side was alternated on subsequent treatments. Eighteen patients who received at least two bilateral injections and two unilateral injections were reviewed. Alternating unilateral injections yielded a shorter breathy interval by an average of 12.7 days (P=.0007) and a shorter duration of return of spasmodic symptoms by an average of 26.0 days (P=.0006). Compared with bilateral injections, alternating unilateral injections yielded an average (median) of 3.2 more days of strong voice per day of breathy voice (P=.001). However, unilateral injections had a shorter average interval of strong voice (27.4 days; P=.007), as well as a slightly higher failure rate (4.9% vs. 1.1%). The authors conclude that alternating unilateral botulinum toxin type A injections are useful in patients with spasmodic dysphonia who have difficulty with the breathy voice that follows bilateral injection.

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“…Changes in symptoms and side effects were scored on a scale from Ϫ3 to ϩ3 (Ϫ3 ϭ very much worse; Ϫ2 ϭ much worse; Ϫ1 ϭ worse; 0 ϭ no change; 1 ϭ improved; 2 ϭ much improved; 3 ϭ very much improved). 9 The study protocol specified a maximum of four cohorts. The dose was doubled for the next 3 patients if no more than 1 patient showed improvement in spasms at 8 weeks and if no more than 1 patient showed a dose-limiting adverse event; 7 additional patients were then enrolled at the optimal dose for a total of 10 patients at that dose.…”

Section: All Adsd Patients Not Treated Previously Withmentioning

confidence: 99%

Safety and efficacy of botulinum toxin type B (Myobloc) in adductor spasmodic dysphonia

et al. 2004

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This single-site, open-label, dose-finding study evaluated the safety and efficacy of botulinum toxin type B (BoNT-B; Myobloc) for the treatment of adductor spasmodic dysphonia (AdSD) in 13 patients. Three patients received a total of 50 U (25 U per vocal fold); the same three subsequently received 100 U, and then 10 more received 200 U. The primary measure of efficacy was the patient's rating of the change in the severity of spasms on a scale from -3 to +3. There were seven secondary measures of efficacy, including blinded ratings of the sound of voice recorded on audiotape. At Week 8 after injection, spasms improved in 0 of 3 patients who received 50 U, 1 of 3 patients who received 100 U, and 8 of 10 patients who received 200 U. The mean (+/- standard deviation [SD]) score for the change in spasm severity at Week 8 in the 200 U group was 1.4 (+/-1.2) points (P = 0.004). All seven secondary measures also showed improvement. Breathiness was the most common side effect but was mild in intensity and of short duration. We conclude that BoNT-B is safe and effective for the treatment of adductor spasmodic dysphonia.

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A comparison of injection techniques using botulinum toxin injection for treatment of the spasmodic dysphonias

Cited by 32 publications

References 13 publications

Effects of botulinum toxin treatment for adductor spasmodic dysphonia on voice and social function

Effects of botulinum toxin treatment for adductor spasmodic dysphonia on voice and social function

Alternating Unilateral Botulinum Toxin Type A (BOTOX^®) Injections for Spasmodic Dysphonia

Safety and efficacy of botulinum toxin type B (Myobloc) in adductor spasmodic dysphonia

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A comparison of injection techniques using botulinum toxin injection for treatment of the spasmodic dysphonias

Cited by 32 publications

References 13 publications

Effects of botulinum toxin treatment for adductor spasmodic dysphonia on voice and social function

Effects of botulinum toxin treatment for adductor spasmodic dysphonia on voice and social function

Alternating Unilateral Botulinum Toxin Type A (BOTOX®) Injections for Spasmodic Dysphonia

Safety and efficacy of botulinum toxin type B (Myobloc) in adductor spasmodic dysphonia

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Product

Resources

About

Alternating Unilateral Botulinum Toxin Type A (BOTOX^®) Injections for Spasmodic Dysphonia