PMID: 8948606Dec 1, 1996Paper

Alternating unilateral botulinum toxin type A (BOTOX) injections for spasmodic dysphonia

The Laryngoscope
M J KoriwchakR H Ossoff

Abstract

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.

References

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Citations

Feb 6, 2010·Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery·Seth R SchwartzMilesh M Patel
May 11, 2002·Journal of Voice : Official Journal of the Voice Foundation·Steven BielamowiczAlexis Godlewski
May 11, 2002·Journal of Voice : Official Journal of the Voice Foundation·Monica McHenryAnna Pou
Jan 19, 2006·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·D D Truong, R Bhidayasiri
Sep 28, 2000·The Annals of Otology, Rhinology, and Laryngology·M S CoureyJ L Netterville
Mar 2, 2018·Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery·Robert J StachlerLorraine C Nnacheta
Jul 22, 2004·The Cochrane Database of Systematic Reviews·C C W WattsC Nye
Jun 19, 2002·Journal of Speech, Language, and Hearing Research : JSLHR·Frank BoutsenBrenda Bender
Jun 13, 1998·The Journal of Laryngology and Otology·K S KimJ W Han

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