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Chapter 11 - Botulinum Neurotoxin Therapy of Laryngeal Muscle Hyperactivity Syndromes

Published online by Cambridge University Press:  02 November 2023

By
Daniel Truong ,
Arno Olthoff  and
Rainer Laskawi
Edited by
Daniel Truong ,
Dirk Dressler ,
Mark Hallett ,
Christopher Zachary  and
Mayank Pathak
Daniel Truong
Affiliation:
University of California, Riverside
Dirk Dressler
Affiliation:
Hannover Medical School
Mark Hallett
Affiliation:
National Institutes of Health (NIH)
Christopher Zachary
Affiliation:
University of California, Irvine
Mayank Pathak
Affiliation:
Truong Neuroscience Institute
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Summary

Spasmodic dysphonia is a focal dystonia characterized by task-specific, action-induced spasm of the vocal cords.

There are three types of spasmodic dysphonia: Adductor spasmodic dysphonia (ADSD) is characterized by a strained-strangled voice quality and intermittent voice stoppage or breaks, resulting in a staccato-like voice, caused by overadduction of the vocal folds.

Abductor spasmodic dysphonia (ABSD) is characterized by intermittent breathy breaks and associated with prolonged abduction folds during voiceless consonants in speech.

Mixed-type spasmodic dysphonia has features of both.

The efficacy of botulinum neurotoxin (BoNT) injection in the treatment of spasmodic dysphonia has been proven. This chapter enumerates the muscles involved in each type of spasmodic dysphonia, diagrams and describes different approaches for injection, along with the use of guidance techniques such as laryngoscopy and electromyography, and tabulates dose ranges of the different types of BoNT for each muscle.

Keywords

Botulinum neurotoxinBoNTspasmodic dysphoniaadductor spasmodic dysphoniaabductor spasmodic dysphoniathyroarytenoidlateral cricoarytenoidinterarytenoidposterior cricoarytenoidlaryngeal dyspneavocal tremor
Type
Chapter
Information
Manual of Botulinum Toxin Therapy , pp. 82 - 88
Publisher: Cambridge University Press
Print publication year: 2023

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References

Adler, CH, Edwards, BW, Bansberg, SF (1997). Female predominance in spasmodic dysphonia. J Neurol Neurosurg Psychiatry, 63, 688.CrossRefGoogle ScholarPubMed
Adler, CH, Bansberg, SF, Hentz, JG et al. (2004a). Botulinum toxin type A for treating voice tremor. Arch Neurol, 61, 1416–20.CrossRefGoogle ScholarPubMed
Adler, CH, Bansberg, SF, Krein-Jones, K, Hentz, JG (2004b). Safety and efficacy of botulinum toxin type B (Myobloc) in adductor spasmodic dysphonia. Mov Disord, 19, 1075–9.CrossRefGoogle ScholarPubMed
Aronson, AE, Brown, JR, Litin, EM, Pearson, JS (1968). Spastic dysphonia. II. Comparison with essential (voice) tremor and other neurologic and psychogenic dysphonias. J Speech Hear Disord, 33, 219–31.CrossRefGoogle ScholarPubMed
Bielamowicz, S, Stager, SV, Badillo, A, Godlewski, A (2002). Unilateral versus bilateral injections of botulinum toxin in patients with adductor spasmodic dysphonia. J Voice, 16, 117–23.CrossRefGoogle ScholarPubMed
Blitzer, A, Brin, MF, Stewart, C, Aviv, JE, Fahn, S (1992). Abductor laryngeal dystonia: a series treated with botulinum toxin. Laryngoscope, 102, 163–7.CrossRefGoogle ScholarPubMed
Blitzer, A, Sulica, L (2001). Botulinum toxin basic science and clinical uses in otolaryngology. Laryngoscope 111, 218–26.Google Scholar
Brin, MF, Fahn, S, Moskowitz, C et al. (1988a). Localized injections of botulinum toxin for the treatment of focal dystonia and hemifacial spasm. Adv Neurol, 50, 599–608.Google ScholarPubMed
Brin, MF, Blitzer, A, Stewart, C (1988b). Laryngeal dystonia (spasmodic dysphonia): observations of 901 patients and treatment with botulinum toxin. Adv Neurol, 78, 237–52.Google Scholar
Brin, MF, Blitzer, A, Fahn, S, Gould, W, Lovelace, RE (1989). Adductor laryngeal dystonia (spastic dysphonia): treatment with local injections of botulinum toxin (Botox). Mov Disord, 4, 287–96.Google Scholar
Ford, CN, Bless, DM, Lowery, JD (1990). Indirect laryngoscopic approach for injection of botulinum toxin in spasmodic dysphonia. Otolaryngol Head Neck Surg, 103, 752–8.CrossRefGoogle ScholarPubMed
Green, DC, Berke, GS, Ward, PH, Gerratt, BR (1992). Point-touch technique of botulinum toxin injection for the treatment of spasmodic dysphonia. Ann Otol Rhinol Laryngol, 101, 883–7.CrossRefGoogle ScholarPubMed
Guntinas-Lichius, O (2003). Injection of botulinum toxin type B for the treatment of otolaryngology patients with secondary treatment failure of botulinum toxin type A. Laryngoscope, 113, 743–5.CrossRefGoogle ScholarPubMed
Klotz, DA, Maronian, NC, Waugh, PF et al. (2004). Findings of multiple muscle involvement in a study of 214 patients with laryngeal dystonia using fine-wire electromyography. Ann Otol Rhinol Laryngol, 113, 602–12.CrossRefGoogle Scholar
Koda, J, Ludlow, CL (1992). An evaluation of laryngeal muscle activation in patients with voice tremor. Otolaryngol Head Neck Surg, 107, 684–96.Google Scholar
Ludlow, CL, Naunton, RF, Sedory, SE, Schulz, GM, Hallett, M (1988). Effects of botulinum toxin injections on speech in adductor spasmodic dysphonia. Neurology, 38, 1220–5.CrossRefGoogle ScholarPubMed
Meleca, RJ, Hogikyan, ND, Bastian, RW (1997). A comparison of methods of botulinum toxin injection for abductory spasmodic dysphonia. Otolaryngol Head Neck Surg, 117, 487–92.CrossRefGoogle ScholarPubMed
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, 603–5.Google Scholar
Rhew, K, Fiedler, DA, Ludlow, CL (1994). Technique for injection of botulinum toxin through the flexible nasolaryngoscope. Otolaryngol Head Neck Surg, 111, 787–94.CrossRefGoogle ScholarPubMed
Sapienza, CM, Walton, S, Murry, T (2000). Adductor spasmodic dysphonia and muscular tension dysphonia: acoustic analysis of sustained phonation and reading. J Voice, 14, 502–20.CrossRefGoogle ScholarPubMed
Schonweiler, R, Wohlfarth, K, Dengler, R, Ptok, M (1998). Supraglottal injection of botulinum toxin type A in adductor type spasmodic dysphonia with both intrinsic and extrinsic hyperfunction. Laryngoscope, 108, 55–63.CrossRefGoogle ScholarPubMed
Schweinfurth, JM, Billante, M, Courey, MS (2002). Risk factors and demographics in patients with spasmodic dysphonia. Laryngoscope, 112, 220–23.CrossRefGoogle ScholarPubMed
Truong, D, Bhidayasiri, R. Botulinum toxin in laryngeal dystonia (2006). Eur J Neurl, 13(Suppl 1), 36–41.CrossRefGoogle Scholar
Truong, DD, Rontal, M, Rolnick, M, Aronson, AE, Mistura, K (1991). Double-blind controlled study of botulinum toxin in adductor spasmodic dysphonia. Laryngoscope, 101, 630–4.CrossRefGoogle Scholar
Zwirner, P, Dressler, D, Kruse, E (1997). Spasmodic laryngeal dyspnea: a rare manifestation of laryngeal dystonia. Eur Arch Otorhinolaryngol, 254, 242–5.Google Scholar

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