Botulinum toxin in the treatment of vocal fold nodules.
OBJECTIVE
Promising new techniques in the management of vocal fold nodules have been developed in the past 2 years. Simultaneously, the therapeutic use of botulinum toxin has rapidly expanded. This review explores the use of botulinum toxin in treatment of vocal nodules and summarizes current therapeutic concepts.


RESULTS
New microsurgical instruments and techniques, refinements in laser technology, radiosurgical excision and steroid intralesional injections are all promising new techniques in the management of vocal nodules. Botulinum toxin-induced 'voice rest' is a new technique we have employed in patients with recalcitrant nodules. Successful resolution of nodules is possible with this technique, without the risk of vocal fold scarring inherent in dissection/excision techniques. Botulinum toxin usage is exponentially increasing, and large-scale, long-term studies demonstrate its safety profile.


CONCLUSIONS
Targeted vocal fold temporary paralysis induced by botulinum toxin injection is a new, well tolerated and efficacious treatment in patients with persistent vocal fold nodules.
Centre for Voice and Swallowing, University of California, Davis, UC Davis Medical Centre, Sacramento, California 95817, USA. Jacqueline.Allen@ucdmc.ucdavis.edu
Jacqui E
JE
Allen
Peter C
PC
Belafsky
D001905:Botulinum Toxins / Q000627:therapeutic use*; D006801:Humans; D007818:Laryngeal Diseases / Q000188:drug therapy*; D014827:Vocal Cords / Q000187:drug effects
D001905:Botulinum Toxins