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A, comparison of bilateral and unilateral botulinum toxin treatments for spasmodic dysphonia

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Summary

To assess the efficacy of bilateral or unilateral botulinum treatments for spasmodic dysphonia we injected botulinum toxin (type A) into the thyroarytenoid muscle of 24 patients with adductor type spasmodic dysphonia. Eleven patients underwent unilateral procedures and 13 bilateral procedures. Samples of sustained phonation were analyzed acoustically by a computer-assisted method and the air flow rates determined. All tests were conducted 1 week before injection and 1 week and 1 month after treatment. With unilateral injection, improvements in acoustic parameters occurred as early as 1 week after treatment. With bilateral injections, only the voice break factor was significantly reduced after 1 week, while standard deviations of fundamental frequency, jitter, shimmer and signal-to-noise-ratios were reduced 1 month after treatment. In comparison with unilateral injections, the mean air flow rate was twice as high 1 week after bilateral injections, with no significant differences found 1 month after treatment. Clinically, both injection modes resulted in the reduction of laryngeal spasms as early as within 48 h after injection.

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References

  1. Arnold GE (1959) Spastic dysphonia. I. Changing interpretations of a persistent affliction. Logos 2:3–14

    Google Scholar 

  2. Aronson AE (1990) Clinical voice disorders, 3rd edn. Thieme, New York

    Google Scholar 

  3. Aronson AE, De Santo LW (1983) Adductor spastic dyphonia: three years after recurrent laryngeal nerve resection. Laryngoscope 93:1–8

    Google Scholar 

  4. Aronson AE, Hartman DE (1981) Adductor spastic dysphonia as a sign of essential (voice) tremor. J Speech Hear Disord 46:52–58

    Google Scholar 

  5. Aronson AE, Brown JR, Litin EM, Pearson JS (1968) Spastic dysphonia. I. Voice, neurologic, and psychiatric aspects. J Speech Hear Disord 33:203–218

    Google Scholar 

  6. Aronson AE, Brown JR, Litin EM, Pearson JS (1968) Spastic dyphonia. II. Comparison with essential (voice) tremor and other neurologic and psychogenic dysphonias. J Speech Hear Disord 33:219–231

    Google Scholar 

  7. Blitzer A, Brin MF (1991) Laryngeal dystonia: a series with botulinum toxin therapy. Ann Otol Rhinol Laryngol 100:85–89

    Google Scholar 

  8. Blitzer A, Brin MIT, Fahn S, Lovelace RE (1988) Localized injections of botulinum toxin for the treatment of focal laryngeal dystonia (spastic dysphonia). Laryngoscope 96:193–197

    Google Scholar 

  9. Bloch CS, Hirano M, Gould WJ (1985) Symptom improvement of spasmodic dysphonia in response to phenatory tasks. Ann Otol Rhinol Laryngol 94:51–54

    Google Scholar 

  10. Freeman FJ, Cannito MP, Finitzo-Hieber T (1985) Getting to know spasmodic dysphonia patients. Tex J Audiol Speech Pathol 10:14–19

    Google Scholar 

  11. Kao I, Drachman DB, Price DL (1976) Botulinum toxin: mechanism of pre-synaptic blockade. Science 193:1256–1258

    Google Scholar 

  12. Ludlow CL, Naughton RF, Sedory SE, Schulz GM, Hallett M (1988) Effects of botulinum toxin injections on speech in adductor spasmodic dysphonia. Neurology 38:1220–1225

    Google Scholar 

  13. Ludlow CL, Hallett M, Sedory SE, Fujita M, Naunton RF (1990) The pathophysiology of spasmodic dysphonia and its modification by botulinum toxin. In: Berardelli A, Benecke R, Manfredi M, Marsden CD (eds) Motor disturbances II. Academic Press, Orlando, Fla., pp 274–288

    Google Scholar 

  14. Milenkovic P (1987) Least mean square measures of voice perturbation. J Speech Hear Res 30:529–538

    Google Scholar 

  15. Miller RH, Woodson GE, Jankovic J (1987) Botulinum toxin injection of the vocal fold for spasmodic dysphonia. A preliminary report. Arch Otolaryngol Head Neck Surg 113:603–605

    Google Scholar 

  16. Rabuzzi DD, McCall GN (1972) Spasmodic dysphonia: a clinical perspective. Trans Am Acad Ophthalmol Otolaryngol 76: 724–728

    Google Scholar 

  17. Robe E, Brulik J, Moore P (1960) A study of spastic dysphonia. Neurologic and electroencephalographic abnormalities. Laryngoscope 50:219–245

    Google Scholar 

  18. Schaefer SD (1983) Neuropathology of spasmodic dysphonia. Laryngoscope 93:1183–1204

    Google Scholar 

  19. Shipp T, Izdebski K, Reed C, Morrisey P (1985) Intrinsic laryngeal muscle activity in a spastic dysphonia patient. J Speech Hear Disord 50:54–79

    Google Scholar 

  20. Woodson GE, Zwirner P, Murry T, Swenson M (1991) Use of flexible fiberoptic laryngoscopy to assess patients with spasmodic dysphonia. J Voice 5:85–91

    Google Scholar 

  21. Zwirner P, Murry T, Swenson M, Woodson GE (1991) Acoustic changes in spasmodic dysphonia after botulinum toxin injection. J Voice 5:78–84

    Google Scholar 

  22. Zwirner P, Murry T, Swenson M, Woodson GE (1992) Effects of botulinum toxin therapy in patients with adductor spasmodic dysphonia: acoustic, aerodynamic and videoendoscopic findings. Laryngoscope 102:400–406

    Google Scholar 

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Authors and Affiliations

  1. Ear, Nose and Throat Department, Division of Phoniatry and Pedaudiology, Georg August University, Göttingen, Germany

    P. Zwirner

  2. Division of Head and Neck Surgery, University of California, San Diego

    T. Murry & G. E. Woodson

  3. Department of Otolaryngology, Head and Neck Surgery, VA Medical Center, San Diego, California, USA

    G. E. Woodson

Authors
  1. P. Zwirner
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  2. T. Murry
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  3. G. E. Woodson
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Additional information

Portions of this work were presented at the 63th Annual Meeting of the German Society of Oto-Rhino -Laryngology-Head and Neck Surgery, Garmisch-Partenkirchen, 30 May–3 June 1992

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Zwirner, P., Murry, T. & Woodson, G.E. A, comparison of bilateral and unilateral botulinum toxin treatments for spasmodic dysphonia. Eur Arch Otorhinolaryngol 250, 271–276 (1993). https://doi.org/10.1007/BF00186224

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  • DOI: https://doi.org/10.1007/BF00186224

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