Botulinum toxin A prolongs functional durability of voice prostheses in laryngectomees with pharyngoesophageal spasm.
OBJECTIVE
Laryngectomized patients with pharyngoesophageal spasm frequently have poor voice quality and dysphagia. Local botulinum toxin A (BTA) injection can relieve muscular hypertonicity and improve symptoms. This procedure should also prolong the functional life span of the tracheoesophageal voice prosthesis.


METHODS
This study evaluates 33 BTA treatments in 11 laryngectomees. All patients were having poor voice quality; 6 patients had additional dysphagia. In 10 patients, the BTA injection has been carried out during rigid pharyngoscopy under general anesthesia. One patient was treated in local anesthesia.


RESULTS
A subjective improvement of voice quality was reported in 94%. This lasted on average for 20 weeks. The swallowing function improved moderately. For the first time, the functional life span of voice prostheses was examined. After treatment of pharyngoesophageal spasm, their durability was almost tripled. The BTA therapy has a significant effect.


CONCLUSIONS
The BTA treatment improves voice quality and prolongs functional durability of voice prostheses in laryngectomees with pharyngoesophageal spasm. The success of treatment is of limited duration but can be repeated in the long-term.
Krause
Eike
E
Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Ludwig-Maximilians-University Munich, Munich, Germany. eike.krause@med.uni-muenchen.de
Hempel
John-Martin
JM
Gürkov
Robert
R
D000368:Aged; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage / Q000627:therapeutic use*; D003680:Deglutition Disorders / Q000188:drug therapy / Q000209:etiology; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular; D007822:Laryngeal Neoplasms / Q000150:complications / Q000601:surgery; D007825:Laryngectomy / Q000009:adverse effects*; D007831:Larynx, Artificial; D008297:Male; D008875:Middle Aged; D009122:Muscle Hypertonia / Q000188:drug therapy / Q000209:etiology; D009128:Muscle Spasticity / Q000188:drug therapy* / Q000209:etiology; D009465:Neuromuscular Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D010609:Pharyngeal Muscles / Q000187:drug effects; D011788:Quality of Life; D012189:Retrospective Studies; D013072:Speech, Esophageal; D016896:Treatment Outcome; D014832:Voice Disorders / Q000188:drug therapy / Q000209:etiology
D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A