title: Longitudinal effects of Botox injections on voice-related quality of life (V-RQOL) for patients with adductory spasmodic dysphonia: part II.
abstract: OBJECTIVE
  To investigate the longitudinal effects of botulinum toxin type A (Botox) injections on voice-related quality of life (V-RQOL) for patients with adductory spasmodic dysphonia.
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  Academic tertiary care referral center.
  
  
  METHODS
  Forty-two patients who presented to our institution with dysphonia and were diagnosed as having adductory spasmodic dysphonia during a 38-month period.
  
  
  METHODS
  Patients received Botox injections into both thyroarytenoid muscles via the cricothyroid membrane. The typical starting dose was 1.0 U per vocal fold. If necessary, the dosage was adjusted in subsequent injections to reduce adverse effects or to enhance duration of benefit.
  
  
  METHODS
  Patients filled out questionnaires, including the V-RQOL Measure and a self-assessed overall voice rating, before each injection. Postinjection questionnaires were completed 6 to 8 weeks after each treatment. Mean pretreatment and posttreatment scores were calculated for each treatment.
  
  
  RESULTS
  The number of treatments per patient ranged from 1 to 7. Statistically significant improvements in mean total and domain V-RQOL scores were calculated for every injection (P<.01) (no postinjection questionnaires were available for the seventh injections). The magnitude of the effect remained constant for later injections. Eighty-two percent of the population recorded at least 1 category of improvement in overall self-assessed voice rating with each injection.
  
  
  CONCLUSIONS
  Botox has a significant beneficial effect on V-RQOL for at least 6 injection cycles. This study demonstrates the efficacy of Botox for treating patients with adductory spasmodic dysphonia and further illustrates the usefulness and validity of the V-RQOL Measure in evaluating patients with dysphonia.
authors.affiliation: Department of Otolaryngology, University of Michigan, Ann Arbor 48109-0312, USA.
authors.forename: Adam D
authors.initials: AD
authors.lastname: Rubin
authors.forename: Walter P
authors.initials: WP
authors.lastname: Wodchis
authors.forename: Constance
authors.initials: C
authors.lastname: Spak
authors.forename: Paul R
authors.initials: PR
authors.lastname: Kileny
authors.forename: Norman D
authors.initials: ND
authors.lastname: Hogikyan
mesh_terms: D000328:Adult; D000368:Aged; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage* / Q000009:adverse effects; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular; D008137:Longitudinal Studies; D008297:Male; D008824:Michigan; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D017060:Patient Satisfaction; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*; D019233:Retreatment; D016896:Treatment Outcome; D014827:Vocal Cords / Q000187:drug effects; D014832:Voice Disorders / Q000188:drug therapy*; D014833:Voice Quality / Q000187:drug effects*
chemical_list: D019274:Botulinum Toxins, Type A