title: Outcomes assessment following treatment of spasmodic dysphonia with botulinum toxin.
abstract: Spasmodic dysphonia (SD), a disabling focal dystonia involving the laryngeal musculature, is most commonly treated by the intramuscular injection of botulinum toxin (BTX). Although the treatment is well tolerated and generally produces clinical voice improvement, it has never been statistically shown to alter the patient's perception of voice quality or general health. Declining resources for medical care mandate that treatment outcomes be documented. A prospective analysis of the effects of BTX on the patient's perception of voice and general health was undertaken. The Voice Handicap Index (VHI) and Short Form 36 (SF-36) surveys were administered to patients before treatment and 1 month after. Pretreatment and posttreatment scores were analyzed with a Student's t-test. On the VHI, improvements in the patients' perception of their functional, physical, and emotional voice handicap reached statistical significance (p < or = .0005). On the SF-36, patients had statistically significant improvements in mental health (p < or = .03) and social functioning (p < or = .04). Treatment of SD with BTX significantly lessened the patients' perception of dysphonia. In addition, it improved their social functioning and their perception of their mental health. These outcome measures justify the continued treatment of SD with BTX.
authors.affiliation: Department of Otolaryngology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
authors.forename: M S
authors.initials: MS
authors.lastname: Courey
authors.forename: C G
authors.initials: CG
authors.lastname: Garrett
authors.forename: C R
authors.initials: CR
authors.lastname: Billante
authors.forename: R E
authors.initials: RE
authors.lastname: Stone
authors.forename: M D
authors.initials: MD
authors.lastname: Portell
authors.forename: T L
authors.initials: TL
authors.lastname: Smith
authors.forename: J L
authors.initials: JL
authors.lastname: Netterville
mesh_terms: D000328:Adult; D000368:Aged; D001905:Botulinum Toxins / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007821:Laryngeal Muscles / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009465:Neuromuscular Agents / Q000627:therapeutic use*; D017060:Patient Satisfaction; D011446:Prospective Studies; D012720:Severity of Illness Index; D013035:Spasm / Q000150:complications / Q000503:physiopathology*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014832:Voice Disorders / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D014833:Voice Quality
chemical_list: D009465:Neuromuscular Agents; D001905:Botulinum Toxins