Long-term therapy for spasmodic dysphonia: acoustic and aerodynamic outcomes.
OBJECTIVE
To evaluate the long-term aerodynamic, acoustic, and electromyographic effects of serial botulinum toxin (BT) injections in patients with adductor spasmodic dysphonia.


METHODS
Two-year, nonrandomized, controlled, before-after study.


METHODS
Ambulatory care clinic at a single academic medical center.


METHODS
A convenience sample of 91 patients with adductor spasmodic dysphonia evaluated and treated during 2 years and 64 age- and sex-matched controls.


METHODS
Injections of BT into the thyroarytenoid muscles in conjunction with electromyographic evaluation and acoustic and aerodynamic evaluation before and after serial BT injections.


METHODS
Translaryngeal airflow, jitter, shimmer, signal-to-noise ratio, fundamental frequency, standard deviation of fundamental frequency, maximum phonation time, and inappropriate muscle activity by electromyography.


RESULTS
Translaryngeal airflow, jitter, and shimmer improved significantly after serial BT treatments and showed sustained improvement over time. Fundamental frequency, standard deviation of fundamental frequency, and signal-to-noise ratio did not change significantly after BT treatment. Electromyographic data suggested decreased inappropriate muscle activity with repeated BT injections.


CONCLUSIONS
Treatment with BT provides ongoing relief of voice perturbations in patients with adductor spasmodic dysphonia who undergo long-term cumulative therapy.
Mehta
R P
RP
Division of Otolaryngology, University of California, San Diego School of Medicine, 200 W Arbor Dr, San Diego, CA 92103-8891, USA.
Goldman
S N
SN
Orloff
L A
LA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018726:Anti-Dyskinesia Agents / Q000627:therapeutic use*; D001905:Botulinum Toxins / Q000627:therapeutic use*; D004576:Electromyography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D014832:Voice Disorders / Q000188:drug therapy* / Q000503:physiopathology
D018726:Anti-Dyskinesia Agents; D001905:Botulinum Toxins