Botox Treatment in Adductor Spasmodic Dysphonia

Abstract

Over the years many studies have been conducted to document the treatment effects of Botulinum toxin type A in adductor spasmodic dysphonia. The results of these studies have led to the view that overall Botulinum toxin treatment is moderately effective. This study reviews efficacy research qualitatively and quantitatively to determine the extent to which this conclusion is fully supported by the data. Although the data indicate moderate overall improvement as a result of Botulinum toxin treatment, they also suggest significant variation across patients, measurements, and treatment conditions. This result, together with methodological limitations and lack of standardization in BT efficacy research, justifies caution when making inferences regarding BT treatment benefit in adductor spasmodic dysphonia.

Proteomic changes in rat thyroarytenoid muscle induced by botulinum neurotoxin injection

“…Seven BoNT serotypes are known to exist (A-G), all of which are produced by strains of the bacterium Clostridium botulinum. BoNT causes the paralytic syndrome botulism, but also holds therapeutic application in the treatment of dystonias [3][4][5][6], spasticity [7,8], facial rhytides [9], axillary hyperhidrosis [10,11], and some pain syndromes [12,13].…”

“…This form of treatment is successful in alleviating voice symptoms temporarily [3]; however, as a peripheral (and symptom) based treatment for a central nervous system disorder, it does not provide a cure. Therefore, BoNT therapy must be readministered periodically.…”

Current and future medical treatment in primary dystonia

“…For spasmodic dysphonia (SD), there is data from several clinical studies and meta-analyses [Wong et al 1995;Brin et al 1998;Whurr et al 1998;Finnegan et al 1999;Boutsen et al 1998;Watts et al 2006Watts et al , 2008Blitzer, 2010]. One double-blind, placebo-controlled study examined the effects of BoNT-A versus saline in 13 adductor SD patients and revealed significant effects of BoNT-A on voice quality, perceived voice improvement and acoustic measurements [Troung et al 1991].…”

Avaliação vocal e da qualidade de vida em pacientes com distonia laríngea em tratamento com toxina botulínica

“…O uso de TB é considerado o tratamento mais utilizado para a DLAD (Ludlow et al, 1988;Aronson et al, 1993;Adams et al, 1995;Woodson, 1995;Wong et al, 1995a;Inagi et al, 1996;Lindestad et al, 1997;Zwirner et al, 1997;Finnegan et al, 1999;Ludlow, 2000;Galardi et al, 2001;Langeveld et al, 2001;Boutsen et al, 2002;Tish et al, 2003;Adler et al, 2004;Cannito et al, 2004;Blitzer, 2005;Wingate et al, 2005;Baylor et al, 2007;Cannito et al, 2008;Ludlow et al, 2008;Paniello et al, 2009;Blitzer, 2010;Elmiyeh et al, 2010;Novakovic et al, 2011;Fulmer et al, 2011;Cannito et al, 2012ab;Dejonckere et al, 2012;Gama et al, 2012;Damrose, 2012;Hu et al, 2013;Rosow et al, 2013), sendo aplicado, principalmente, no músculo TA, apresentando alívio dos síntomas no segundo ou terceiro dia. Após a ação do medicamento, o tratamento atinge a estabilidade após duas semanas, quando se percebe melhora na qualidade da voz (Ludlow et al, 1988;Boutsen et al, 2002;Blitzer, 2010;Cannito et al, 2012a). Embora os principais estudos apresentem a aplicação da TB no músculo TA como método de escolha, existe referência na literatura da aplicação nos músculos TA e CAL (Inagi et al, 1996)...…”

“…Os indivíduos que que recebem a injeção de TB relatam presença de picos de fraqueza muscular entre o segundo e terceiro dia após o procedimento, diminuindo na segunda semana, obtendo ótima função vocal (Ludlow et al, 1988;Boutsen et al, 2002;Meyer, 2012).…”