Safety of simultaneous bilateral botulinum toxin injections for abductor spasmodic dysphonia.
OBJECTIVE
To review the safety of simultaneous bilateral posterior cricoarytenoid muscle botulinum toxin injections.


METHODS
Retrospective case series review.


METHODS
Tertiary care academic clinic.


METHODS
Twenty-one patients with abductor spasmodic dysphonia.


METHODS
Patients received 100 simultaneous bilateral posterior cricoarytenoid muscle botulinum toxin injections for isolated abductor spasmodic dysphonia over a 6-year period.


METHODS
Major and minor complications, injection dosing, and demographics.


RESULTS
The total bilateral botulinum toxin injection dose per session ranged from 2.50 to 7.50 U, and the average total bilateral dose per patient was 4.70 U. There were no major complications, and minor complications were self-limited. There was a 5% incidence of significant dyspnea and a 2% incidence of dysphagia, and all patients were treated conservatively. The average doses at which dyspnea and dysphagia occurred were 4.97 and 5.56 U, respectively.


CONCLUSIONS
This case series demonstrates that simultaneous bilateral posterior cricoarytenoid muscle botulinum toxin injection is safe up to the highest doses reported. Complications with this approach are consistent with those previously reported using other methods. Prospective studies on vocal outcome measures are needed for simultaneous bilateral posterior cricoarytenoid muscle botulinum toxin injections to evaluate the efficacy of this technique.
Stong
Benjamin C
BC
Department of Otolaryngology, Emory University, Atlanta, Ga., USA.
DelGaudio
John M
JM
Hapner
Edie R
ER
Johns
Michael M
MM
D000328:Adult; D018726:Anti-Dyskinesia Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001905:Botulinum Toxins / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular; D007821:Laryngeal Muscles / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D014827:Vocal Cords / Q000187:drug effects*; D014832:Voice Disorders / Q000188:drug therapy*
D018726:Anti-Dyskinesia Agents; D001905:Botulinum Toxins