title: Spasmodic dysphonia: a seven-year audit of dose titration and demographics in the Indian population.
abstract: OBJECTIVE
  This study aimed to evaluate the demographics of spasmodic dysphonia in the Indian population and to analyse the optimum dose titration of botulinum toxin type A in this group. A comparative analysis with international studies was also performed.
  
  
  METHODS
  The study involved a retrospective analysis and audit of botulinum toxin type A dose titration in spasmodic dysphonia patients who visited our voice clinic between January 2005 and January 2012.
  
  
  RESULTS
  The average total therapeutic dose required for patients with adductor spasmodic dysphonia was 4.2 U per patient per vocal fold (total 8.4 U per patient), and for patients with abductor spasmodic dysphonia, it was 4.6 U per patient.
  
  
  CONCLUSIONS
  Our audit revealed that 80 per cent of the spasmodic dysphonia patients were male, which contrasts dramatically with international studies, wherein around 80 per cent of spasmodic dysphonia patients were female. Our study also revealed a higher dose titration of botulinum toxin for the Indian spasmodic dysphonia population in both adductor and abductor spasmodic dysphonia cases.
authors.affiliation: Department of ENT,Bombay Hospital,Mumbai,India.
authors.forename: N K
authors.initials: NK
authors.lastname: Nerurkar
authors.affiliation: Department of ENT,Bombay Hospital,Mumbai,India.
authors.forename: T P
authors.initials: TP
authors.lastname: Banu
mesh_terms: D019274:Botulinum Toxins, Type A / Q000008:administration & dosage*; D054869:Clinical Audit / Q000379:methods*; D004305:Dose-Response Relationship, Drug; D055154:Dysphonia / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D007273:Injections, Intramuscular; D007821:Laryngeal Muscles; D007826:Laryngismus / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology; D007828:Laryngoscopy; D008297:Male; D009465:Neuromuscular Agents / Q000008:administration & dosage; D011159:Population Surveillance / Q000379:methods*; D012189:Retrospective Studies; D013997:Time Factors; D014827:Vocal Cords; D014833:Voice Quality
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A