title: Botulinum Toxin-A Dosing Trends for Adductor Spasmodic Dysphonia at a Single Institution Over 10 Years.
abstract: OBJECTIVE
  This study aimed to identify the changes in dosing of botulinum toxin-A for adductor spasmodic dysphonia (ADSD) over a prolonged period.
  
  
  METHODS
  This is a retrospective chart review.
  
  
  METHODS
  One hundred thirteen subjects treated for ADSD from 2003 to 2013 were identified from a clinical database. Subject age, gender, and total injection dose amount were all recorded for all subjects who had at least 10 injections.
  
  
  RESULTS
  Fifty-four subjects met criteria for inclusion. There were no age or gender differences in the starting dose for subjects. Dosing decreased significantly compared with the second dose (5.05 ± 1.623 Units), by the sixth dose (4.26 ± 1.698 Units), and continued through the 10th dose (4.08 ± 2.019 Units) (P < 0.005 for all).
  
  
  CONCLUSIONS
  Botulinum toxin-A dosing for ADSD decreases consistently over subsequent injections after the initial two dose titrations.
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, Washington University in St. Louis School of Medicine, St. Louis, Missouri.
authors.forename: Joseph P
authors.initials: JP
authors.lastname: Bradley
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, Emory Voice Center, Atlanta, Georgia.
authors.forename: Emily M
authors.initials: EM
authors.lastname: Barrow
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, University of Southern California Keck School of Medicine, Los Angeles, California.
authors.forename: Edie R
authors.initials: ER
authors.lastname: Hapner
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, Emory Voice Center, Atlanta, Georgia.
authors.forename: Adam M
authors.initials: AM
authors.lastname: Klein
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, University of Southern California Keck School of Medicine, Los Angeles, California. Electronic address: michaemj@usc.edu.
authors.forename: Michael M
authors.initials: MM
authors.lastname: Johns
mesh_terms: D065087:Acetylcholine Release Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage* / Q000009:adverse effects; D055154:Dysphonia / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D005845:Georgia; D006801:Humans; D007273:Injections, Intramuscular; D007821:Laryngeal Muscles / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D012189:Retrospective Studies; D049489:Stroboscopy; D013997:Time Factors; D016896:Treatment Outcome; D014741:Video Recording
chemical_list: D065087:Acetylcholine Release Inhibitors; D019274:Botulinum Toxins, Type A
keywords: Adductor spasmodic dysphonia; Botox; Botulinum toxin-A; Dosing; Laryngeal dystonia