Treatment efficacy of electromyography versus fiberscopy-guided botulinum toxin injection in adductor spasmodic dysphonia patients: a prospective comparative study.
BACKGROUND
This study prospectively evaluates and compares the treatment efficacy of botulinum toxin injection under electromyography guidance (EMG group) and percutaneous botulinum toxin injection under flexible fiberscopic guidance (fiberscopy group).


METHODS
Thirty patients with adductor spasmodic dysphonia (ADSD), who had never received treatment, were randomly allocated into EMG- or fiberscopy-guided botulinum toxin injections between March 2008 and February 2010. We assessed acoustic and aerodynamic voice parameters, and the voice handicap index (VHI) before injection and at 1, 3, and 6 months after injection.


RESULTS
The mean total dosage of botulinum toxin was similar for both groups: 1.7 ± 0.5 U for the EMG group and 1.8 ± 0.4 U for the fiberscopy group (P > 0.05). There were no significant differences in outcomes between the two groups in either the duration of effectiveness or complications such as breathy voice and aspiration.


CONCLUSIONS
Botulinum toxin injection under fiberscopic guidance is a viable alternative to EMG-guided botulinum toxin injection for the treatment of adductor spasmodic dysphonia when EMG equipment is unavailable.
Department of Otolaryngology-Head and Neck Surgery, Soonchunhyang University College of Medicine, 1174 Jung-Dong, Bucheon 420-021, Republic of Korea.
Jae Wook
JW
Kim
Department of Otolaryngology-Head and Neck Surgery, Soonchunhyang University College of Medicine, 1174 Jung-Dong, Bucheon 420-021, Republic of Korea.
Jae Hong
JH
Park
Department of Otolaryngology-Head and Neck Surgery, Soonchunhyang University College of Medicine, 1174 Jung-Dong, Bucheon 420-021, Republic of Korea.
Ki Nam
KN
Park
Department of Otolaryngology-Head and Neck Surgery, Soonchunhyang University College of Medicine, 1174 Jung-Dong, Bucheon 420-021, Republic of Korea.
Seung Won
SW
Lee
D000328:Adult; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage*; D055154:Dysphonia / Q000188:drug therapy* / Q000473:pathology; D004576:Electromyography; D005260:Female; D006801:Humans; D007821:Laryngeal Muscles / Q000187:drug effects* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
D019274:Botulinum Toxins, Type A