title: Cricothyroid Muscle Botulinum Toxin Injection to Improve Airway for Bilateral Recurrent Laryngeal Nerve Paralysis, A Case Series.
abstract: Bilateral vocal fold paralysis most commonly results from iatrogenic trauma to the recurrent laryngeal nerve during surgical procedures in the anterior neck. Patients may require tracheostomy because of acute or gradual onset of dyspnea and airway compromise. The intralaryngeal injection of Botox has been considered as a possible therapy for these airway symptoms of bilateral vocal fold paralysis. Chronic unopposed activity of intact cricothyroid muscles could potentially result in gradual medialization of the vocal folds in patients with bilateral recurrent laryngeal nerve paralysis. This case series describes three patients who successfully underwent injections of botulinum toxin into the bilateral cricothyroid muscles to offer sustained relief of dyspnea resulting from bilateral vocal fold paralysis.
authors: Head and Neck Institute, The Cleveland Clinic, Cleveland, Ohio. Electronic address: benninm@ccf.org.
authors: Michael S
authors: MS
authors: Benninger
authors: Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio.
authors: Andrea
authors: A
authors: Hanick
authors: Head, Speech-Language Pathology, Head and Neck Institute, The Cleveland Clinic, Cleveland, Ohio.
authors: Douglas M
authors: DM
authors: Hicks
mesh_terms: D065087:Acetylcholine Release Inhibitors / Q000008:administration & dosage*; D000328:Adult; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular; D007821:Laryngeal Muscles / Q000187:drug effects* / Q000503:physiopathology; D007828:Laryngoscopy; D008875:Middle Aged; D020127:Recovery of Function; D012009:Recurrent Laryngeal Nerve / Q000187:drug effects* / Q000503:physiopathology; D016896:Treatment Outcome; D014826:Vocal Cord Paralysis / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D014827:Vocal Cords / Q000187:drug effects* / Q000294:innervation; D014833:Voice Quality; D055815:Young Adult
chemical_list: D065087:Acetylcholine Release Inhibitors; D019274:Botulinum Toxins, Type A
keywords: Bilateral recurrent laryngeal nerve paralysis; Bilateral vocal fold paralysis; Botox; Cricothyroid muscle injection