title: A comparison of methods of botulinum toxin injection for abductory spasmodic dysphonia.
abstract: Treatment of abductory spasmodic dysphonia with botulinum toxin injection into the posterior cricoarytenoid muscles often results in only partial symptom relief. In contrast, excellent results can be achieved after thyroarytenoid injection for the adductory type of spasmodic dysphonia. One reason for disappointing results may be inaccurate placement of the botulinum toxin into the posterior cricoarytenoid muscles. We describe a new approach to posterior cricoarytenoid injection used in 18 patients for treatment of abductory spasmodic dysphonia. Of the 30 patients treated for abductory spasmodic dysphonia at Loyola University-Chicago, 6 underwent both a retrocricoid approach and the newer transcricoid method, thus allowing patient and clinician comparison of techniques. We and all six of our patients preferred the transcricoid approach because of less discomfort, equivalent or better voice results, and fewer side effects.
authors.affiliation: Department of Otolaryngology, Loyola University-Chicago, Maywood, Illinois 60153, USA.
authors.forename: R J
authors.initials: RJ
authors.lastname: Meleca
authors.forename: N D
authors.initials: ND
authors.lastname: Hogikyan
authors.forename: R W
authors.initials: RW
authors.lastname: Bastian
mesh_terms: D000328:Adult; D018726:Anti-Dyskinesia Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001905:Botulinum Toxins / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D004576:Electromyography; D005260:Female; D005500:Follow-Up Studies; D006406:Hematoma / Q000209:etiology; D006801:Humans; D007273:Injections, Intramuscular / Q000009:adverse effects / Q000379:methods; D007821:Laryngeal Muscles; D008297:Male; D008875:Middle Aged; D009135:Muscular Diseases / Q000209:etiology; D010146:Pain / Q000517:prevention & control; D017060:Patient Satisfaction; D013035:Spasm / Q000188:drug therapy; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014831:Voice / Q000502:physiology; D014832:Voice Disorders / Q000188:drug therapy*
chemical_list: D018726:Anti-Dyskinesia Agents; D001905:Botulinum Toxins