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.

scholarly journals Anatomic direction of entry for botulinum toxin injection to treat the adductor spasmodic dysphonia in Thais

2010 ◽  
Vol 4 (4) ◽  
pp. 641-644
Author(s):  
Patchareeporn Saeseow ◽  
Akkararat Sartsungnern ◽  
Supaporn Srirompotong ◽  
Kowit Chaisiwamongkol ◽  
Thanarat Chantaupalee
Keyword(s):  
Botulinum Toxin ◽  
Sagittal Plane ◽  
Botulinum Toxin Injection ◽  
Three Dimensional ◽  
Needle Insertion ◽  
Spasmodic Dysphonia ◽  
Male And Female ◽  
Adductor Spasmodic Dysphonia ◽  
The Mean ◽  
Botulinum Toxin Injections

Abstract Background: Botulinum toxin injections into the thyroarytenoid (TA) muscle of the larynx is the most popular treatment for adductor spasmodic dysphonia. Injection is usually done by percutaneous transcricothyroid membrane with either electromyography (EMG) or fiberoptic laryngoscopy (FOL) to verify placement of the needle within the TA muscle. This procedure requires a working knowledge of three-dimensional anatomy of the larynx to establish the direction for the accurate placement of the needle. Objective: Find out the appropriate angles and depth of the needle for placement of percutaneous transcricothyroid membrane method of botulinum toxin injection by means of studying the larynges of Thai cadavers. Methods: The descriptive study was performed in 45 Thai freshly thawed cadavers. The angle of the needle from midline sagittal plane, the angle in superior relation to tracheal plane, and the depth from midline cricothyroid (CT) membrane to midlength of TA muscle were measured from the two views of photographs, anteroposterior and lateral. Results: The mean angle of 24.2±6.76° (mean±SD) from the midline sagittal plane in male and 24.9±7.6° in female were worked out. A mean angle in superior relation to the tracheal plane was 47.7±7.8° and 51.4±9.6° in male and female, respectively. The mean depth was 1.7±0.2 and 1.4±0.1 cm in male and female, respectively. Conclusion: The mean angles and depth of the needle insertion from the midline of CT membrane to the center of TA muscle in Thai laryngeal specimens were evaluated. These values were different from the studies in Caucasians, but it could provide a direct relationship to the build of the races. This knowledge may help laryngologists do this procedure more accurately with better outcome, especially in hospitals that have no EMG or FOL guide.

Vocal Exercise versus Voice Rest following Botulinum Toxin Injections: A Randomized Crossover Trial

2010 ◽  
Vol 119 (11) ◽  
pp. 759-763
Author(s):  
Randal C. Paniello ◽  
Julia D. Edgar ◽  
Joel S. Perlmutter
Keyword(s):  
Botulinum Toxin ◽  
Primary Outcome ◽  
Botulinum Toxin Injection ◽  
Primary Outcome Measure ◽  
Adductor Spasmodic Dysphonia ◽  
Related Quality ◽  
Botulinum Toxin Injections ◽  
The Voice ◽  
Dose Injection

Objectives: The intensity of muscle activity immediately following intramuscular botulinum toxin injection may affect the clinical efficacy of the injection. We tested this effect in patients who underwent botulinum toxin injections for adductor spasmodic dysphonia. Methods: Patients were studied over 3 to 5 injection cycles. Cycle 1 was the baseline control; cycle 2 was randomized between a 1-hour reading aloud task (“exercise”) and a 24-hour period of complete voice rest. For cycle 3, the patient completed the task not performed in cycle 2. Patients who were willing to continue for cycles 4 and 5 repeated the experiment at one half the injection dosage. Efficacy was determined with a battery of voice recordings and clinical outcomes instruments administered via telephone at 2- to 4-week intervals. The primary outcome measure was the result of the Voice-Related Quality of Life (VRQOL) instrument. Results: Nine patients (8 women, 1 man) with a mean age of 60.8 years (range, 42 to 76 years) completed at least 3 injection cycles. The VRQOL results were significantly higher for cycles that followed the exercise task. The patients reported subjectively that these were some of the best injection cycles they had ever experienced. Some achieved equivalent results with the half-dose injection plus exercise. The VRQOL results after voice rest cycles were not significantly different from the patients' baseline cycles. Conclusions: These results support the conclusion that a period of intense vocalization immediately following laryngeal botulinum toxin injections improves the efficacy of the injection. Possible mechanisms are proposed.

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.

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

Transoral Electromyographic Recordings in Botulinum Toxin—Injected Rat Larynges

1997 ◽  
Vol 106 (11) ◽  
pp. 956-964 ◽  
Author(s):  
Katsuhide Inagi ◽  
Charles N. Ford ◽  
Arthur A. Rodriquez ◽  
Dennis M. Heisey
Keyword(s):  
Botulinum Toxin ◽  
Muscle Function ◽  
Vocal Fold ◽  
Human Subjects ◽  
Botulinum Toxin Injection ◽  
Objective Assessment ◽  
Spasmodic Dysphonia ◽  
Treatment Regimens ◽  
Botulinum Toxin Injections ◽  
Selection Of

Objective assessment of muscle function following botulinum toxin injections in laryngeal muscles is difficult in human subjects. We developed a rat laryngeal model for the study of botulinum toxin injection. A new laryngoscopic technique has made it possible to observe the rat larynx endoscopically and to obtain electromyographic measurements during and after injection of toxin. The electromyographic interference pattern, fibrillation potentials, and vocal fold movement were used for analyzing dose and volume effects of injected toxin. We conclude that the lowest dosage able to produce the maximal duration of functional laryngeal impairment is 0.07 U in a volume of 0.4 μL. This model will enable us to obtain physiologic and histologic parameters that can be used to assess the selection of optimal treatment regimens with botulinum toxin for the treatment of patients with spasmodic dysphonia.

Sign in / Sign up

Export Citation Format

Share Document