title: Voice failure after tracheoesophageal puncture: management with botulinum toxin.
abstract: Primary or secondary tracheoesophageal puncture with a speaking prosthesis has provided rehabilitation of speech in most patients after total laryngectomy. Persistent constrictor spasm is thought to be responsible for a small percentage of these patients' inability to speak with the prosthesis. Management of these patients has included bougienage and pharyngeal myotomy and/or pharyngeal neurectomy. Botulinum toxin injections of the cricopharyngeus muscle complex in six patients have been successfully used diagnostically and therapeutically for tracheoesophageal puncture failures. The assessment, technique, and results are discussed.
authors.affiliation: New York Center for Voice and Swallowing Disorders, Department of Otolaryngology, New York, New York, USA.
authors.forename: A
authors.initials: A
authors.lastname: Blitzer
authors.forename: A
authors.initials: A
authors.lastname: Komisar
authors.forename: S
authors.initials: S
authors.lastname: Baredes
authors.forename: M F
authors.initials: MF
authors.lastname: Brin
authors.forename: C
authors.initials: C
authors.lastname: Stewart
mesh_terms: D000368:Aged; D001905:Botulinum Toxins / Q000008:administration & dosage / Q000627:therapeutic use*; D004947:Esophagus / Q000601:surgery*; D006801:Humans; D007267:Injections; D007825:Laryngectomy / Q000534:rehabilitation; D007831:Larynx, Artificial; D008297:Male; D008875:Middle Aged; D010609:Pharyngeal Muscles; D011183:Postoperative Complications; D011677:Punctures; D013035:Spasm / Q000188:drug therapy* / Q000209:etiology; D013071:Speech, Alaryngeal; D014132:Trachea / Q000601:surgery*; D016896:Treatment Outcome; D014832:Voice Disorders / Q000188:drug therapy
chemical_list: D001905:Botulinum Toxins