Effect of Botulinum Toxin Injection in Patients with Adductor Spasmodic Dysphonia

Choi, Hong Shik; Moon, Hyoung Jin; Kim, Hong Youn; Kim, Shi Chan; Kim, Kwang Moon

Abstract

In the treatment of spasmodic dysphonia, local injection of botulinum toxin A has been reported to be successful. The treatment of adductor type spasmodic dysphonia using botulinum toxin type A was conducted in 31 patients. These patients were given toxins in the vocal fold(s), unilaterally or bilaterally, under telelaryngoscopic guidance with 23 gauge scalp needle attached by laryngeal forceps. Before the above procedure, laryngeal anesthesia was done with 2% pontocain instillation. Among the 31 patients, 30 patients were given the toxin successfully. Telephone interview were made at 2 weeks and then at 4 weeks post injection. Among the above 30 patients, 90% reported that the injection was of significant benefit. The functional status of the patient's disorder was classified into four grades. The mean pre-injection grade for the patients in this study was 2.10 and it was significantly lowered to 1.13 after the injection(p<0.01). As a self assessment method, the patients were asked to rate their voice on a scale of 100. In this study, the mean pre-injection score was 40 and it was significantly improved to 69.8 after the injection(p<0.01). In conclusion, botulinum toxin injection using telelaryngoscope is a safe and effective method for the treatment of adductor type spasmodic dysphonia.