title: Frozen versus fresh reconstituted botox for laryngeal dystonia.
abstract: OBJECTIVE
  To compare the efficacy and side effects of frozen versus fresh reconstituted botulinum toxin type A (BTX-A) in the treatment of laryngeal dystonia.
  
  
  METHODS
  Prospective open-label crossover study; 43 adult patients with adductor spasmodic dysphonia were randomly treated with fresh or refrozen reconstituted BTX-A at a private voice center. Treatment outcomes were assessed by duration of action and self-rated satisfaction (7 point Likert scale). Side effects of breathiness and dysphagia for liquids were assessed as well.
  
  
  RESULTS
  There was no statistically significant difference in the duration of action (mean, 16.2 +/- 8.5 vs 16.0 +/- 7.6 weeks) and self-rated satisfaction of the treatment (median, 6.0 vs 6.0 points). The side effects were similar for both BTX-A injection types. In addition, there were no instances of infection for refrozen injections.
  
  
  CONCLUSIONS
  BTX-A may be safely used after being reconstituted and frozen or refrozen without a significant loss of effectiveness or additional side effects. In our experience, the period of freezing was on 2 occasions for up to 8 weeks.
  
  
  CONCLUSIONS
  Refrozen BTX-A may be a cost-effective use of an expensive drug.
  
  
  METHODS
  B-2b.
authors.affiliation: Voice center, 909 NW 18th Avenue, Portland, OR 97209-2324, USA. thomas@voicedoctor.net
authors.forename: James P
authors.initials: JP
authors.lastname: Thomas
authors.forename: Nora
authors.initials: N
authors.lastname: Siupsinskiene
mesh_terms: D000328:Adult; D000368:Aged; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D018592:Cross-Over Studies; D020821:Dystonic Disorders / Q000188:drug therapy*; D005260:Female; D005615:Freezing; D006801:Humans; D007818:Laryngeal Diseases / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009465:Neuromuscular Agents / Q000627:therapeutic use*
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A