Treatment for spasmodic dysphonia: limitations of current approaches

Ludlow, Christy L.

doi:10.1097/moo.0b013e32832aef6f

Cited by 78 publications

(63 citation statements)

References 67 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In this study, we propose a surgical access to the TAb of ILN through the thyroid cartilage, that may be used in patients with adductor spasmodic dysphonia [10][11][12] or other pathophysiological conditions that involve the TA muscle. Chemical denervation of the TA muscle with botulinum toxin injection is currently the treatment of choice of adductor spasmodic dysphonia in most centers, but as the effect is time-limited, it requires periodic injections 13 .…”

Section: Discussionmentioning

confidence: 99%

Surgical approach to the thyroarytenoid branch of the inferior laryngeal nerve through the thyroid cartilage

Sperandio

Imamura

Tsuji³

et al. 2016

Acta Cir. Bras.

View full text Add to dashboard Cite

Brazil. Scientific, intelectual, conception and design of the study; manuscript preparation; critical revision; final approval. ABSTRACT PURPOSE:To describe the anatomical course of the intralaryngeal portion of the inferior laryngeal nerve (ILN) and to standardize the surgical access to its thyroarytenoid branch (TAb) through the thyroid cartilage. METHODS:Under surgical microscopy, 33 adult human excised larynges were dissected, to expose the intralaryngeal portion of ILN. The point of entry of TAb, ILN's terminal branch, in the thyroarytenoid (TA) muscle was determined and correlated with thyroid cartilage dimensions. RESULTS:After entering the larynx, the ILN consistently traveled between the thyroid cartilage and the lateral cricoarytenoid muscle in an anterior and slightly cranial course. The distance from the point of entry of the TAb in the TA muscle to the midline (TAb-H) and to the inferior border (TAb-V) of the thyroid cartilage differed according to gender. In females, mean distances of TAb-H and TAb-V were 20.5mm and 5.2mm and in males, 22.3mm and 5.9mm, respectively. CONCLUSION:The intralaryngeal course of the inferior laryngeal nerve presents low variability and measures from landmarks in the thyroid cartilage help to estimate the point of entry of thyroarytenoid branch in thyroarytenoid muscle.

show abstract

Section: Discussionmentioning

confidence: 99%

Surgical approach to the thyroarytenoid branch of the inferior laryngeal nerve through the thyroid cartilage

Sperandio

Imamura

Tsuji³

et al. 2016

Acta Cir. Bras.

View full text Add to dashboard Cite

show abstract

“…Involuntary muscle contraction of the vocal folds produces vocal strain, breathiness and phonatory breaks. 44 Laryngeal dystonia can be classified as adductor type, abductor type, mixed type or adductor laryngeal breathing dystonia. 1 The adductor type accounts for 80% of laryngeal dystonia and results from spasms of vocal fold adductor muscles resulting in inappropriate closing of the vocal folds with speech.…”

Section: Laryngeal Dystoniasmentioning

confidence: 99%

Dystonia of the Oromandibular, Lingual and Laryngeal Areas

O’Dell¹,

Sinha²

2012

Dystonia - The Many Facets

View full text Add to dashboard Cite

“…Limited myectomy produces less benefit with more frequent symptom recurrence after 6 months necessitating BoNT, while complete myectomy or myectomy with neurectomy leads to a longer lasting improvement, but with adverse breathing impairment. Facial nerve lysis in BSP and recurrent laryngeal nerve section in SD have been abandoned since the arrival and efficacy of BoNT [Ludlow, 2009]. …”

mentioning

confidence: 99%

Current and future medical treatment in primary dystonia

Delnooz

Warrenburg

2012

Ther Adv Neurol Disord

View full text Add to dashboard Cite

Dystonia is a hyperkinetic movement disorder, characterized by involuntary and sustained contractions of opposing muscles causing twisting movements and abnormal postures. It is often a disabling disorder that has a significant impact on physical and psychosocial wellbeing. The medical therapeutic armamentarium used in practice is quite extensive, but for many of these interventions formal proof of efficacy is lacking. Exceptions are the use of botulinum toxin in patients with cervical dystonia, some forms of cranial dystonia (in particular, blepharospasm) and writer's cramp; deep brain stimulation of the pallidum in generalized and segmental dystonia; and high-dose trihexyphenidyl in young patients with segmental and generalized dystonia. In order to move this field forward, we not only need better trials that examine the effect of current treatment interventions, but also a further understanding of the pathophysiology of dystonia as a first step to design and test new therapies that are targeted at the underlying biologic and neurophysiologic mechanisms. http://tan.sagepub.com dystonia are given intramuscularly, often under electromyography (EMG) guidance, and need to be repeated every 3-6 months. Contraindications for the use of BoNT include history of neuromuscular disease, e.g. myasthenia gravis, LambertEaton syndrome or motor neuron disease, and a history of hypersensitivity to BoNT, albumin or saline. BoNT injections are also contraindicated in combination with aminoglycoside, penicillamine, quinine and calcium-channel blockers as the effect of these drugs may be potentiated. As teratogenicity of BoNT is still unknown, it is advised not to use BoNT during pregnancy and lactation. Keywords Cervical dystoniaBoNT injections are the first-line therapy for cervical dystonia (CD). Meta-analysis of several double-blind, placebo-controlled trials have demonstrated a beneficial effect of the BoNT type A (BoNT-A) versus placebo on multiple domains, such as dystonia severity, pain and the patient's and physician's subjective judgement. Adverse events are usually transient and mild. The most relevant side effects, of increasing frequency with higher doses and therefore dose-limiting, are neck weakness, dysphagia, dry mouth/sore throat and voice changes/hoarseness. Others are doseindependent and include pain at the site of injection, malaise, upper respiratory infection and headache [Costa et al. 2005b].BoNT also has proven long-term safety and efficacy. Several large case series have shown treatment efficacy up to 10 years, without longterm adverse effects [Blackie and Lees, 1990;Haussermann et al. 2004]. The occurrence of a secondary nonresponse, likely due to antibodies to BoNT or other components, was rare (1-2%) [Kessler et al. 1999;Haussermann et al. 2004;Brin et al. 2008]. Also primary nonresponse is seen, but reports documenting its occurrence are sparse [Truong et al. 2005]. A comparison of efficacy and safety between two preparations of BoNT-A, (onabotulinumtoxinA [Botox ® ] and rimabotulinumtoxin...

show abstract

Treatment for spasmodic dysphonia: limitations of current approaches

Cited by 78 publications

References 67 publications

Surgical approach to the thyroarytenoid branch of the inferior laryngeal nerve through the thyroid cartilage

Surgical approach to the thyroarytenoid branch of the inferior laryngeal nerve through the thyroid cartilage

Dystonia of the Oromandibular, Lingual and Laryngeal Areas

Current and future medical treatment in primary dystonia

Contact Info

Product

Resources

About