Botulinum toxin therapy of laryngeal muscle hyperactivity syndromes: comparing different botulinum toxin preparations.
Spasmodic dysphonia (SD) is a focal dystonia characterized by a strained, strangled voice. Botulinum toxin is a symptomatic treatment for SD and has become the mainstay of therapy over the last two decades. In this manuscript, we briefly review different laryngeal muscle hyperactivity syndromes, their injection techniques and toxins currently available. Adductor SD is the most common indication for botulinum toxin treatment in the larynx. All studies report similar results with regard to improvement, patient satisfaction and side effects. We describe different injection techniques to treat this disorder such as the percutaneous, transoral, transnasal, point-touch techniques. In abductor SD, a subtype of SD, the treatment is aimed at the posterior cricoarytenoid muscle. Other applications of botulinum toxin in the larynx include spasmodic laryngeal dyspnea and voice tremors. We also review injection techniques, the different toxin types used, and toxin doses.
Truong
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DD
The Parkinson's and Movement Disorder Institute, Fountain Valley, CA 92708, USA. dtruong@pmdi.org
Bhidayasiri
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R
D018726:Anti-Dyskinesia Agents / Q000627:therapeutic use*; D001905:Botulinum Toxins / Q000145:classification / Q000627:therapeutic use*; D004333:Drug Administration Routes; D020821:Dystonic Disorders / Q000188:drug therapy*; D006801:Humans; D006948:Hyperkinesis / Q000188:drug therapy*; D007818:Laryngeal Diseases / Q000188:drug therapy*; D007821:Laryngeal Muscles / Q000187:drug effects; D007830:Larynx / Q000187:drug effects; D016896:Treatment Outcome
D018726:Anti-Dyskinesia Agents; D001905:Botulinum Toxins