Electromyography-Guided Botulinum Toxin Injection Into the Cricothyroid Muscles in Bilateral Vocal Fold Abductor Paralysis

Şahin, Mustafa; Aydoğdu, İbrahim; Akyıldız, Serdar; Erdinç, Münevver; Öztürk, Kerem; Öğüt, Fatih

doi:10.21053/ceo.2016.00241

Cited by 6 publications

(4 citation statements)

References 25 publications

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“…While this technique was described in a larger case series with promising results in adults, there was an insufficient number of cases with this technique in children to be included in our analysis. 79 Owing to the complexity of the procedure, bilateral recurrent laryngeal nerve reinnervation of the posterior cricoarytenoid muscle is seldom performed for treatment of BVFP. 9 This technique was used in 1 case series of 6 children who previously underwent tracheostomy, of whom half failed to be decannulated.…”

Section: Discussionmentioning

confidence: 99%

“…Botulinum toxin injection into the cricothyroid muscle was used in 5 patients in 1 included case series, all of whom had favorable outcomes. While this technique was described in a larger case series with promising results in adults, there was an insufficient number of cases with this technique in children to be included in our analysis 79 . Owing to the complexity of the procedure, bilateral recurrent laryngeal nerve reinnervation of the posterior cricoarytenoid muscle is seldom performed for treatment of BVFP 9 .…”

Section: Discussionmentioning

confidence: 99%

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Surgical Management of Bilateral Vocal Fold Paralysis in Children: A Systematic Review and Meta‐analysis

Thorpe

Kanotra

2020

Otolaryngol.--head neck surg.

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Objectives To examine and compare the outcomes of various types of glottic widening surgery (GWS) for initial management of bilateral vocal fold paralysis (BVFP) in children, the outcomes of different GWS procedures in children who underwent initial tracheostomy, and the rate of decannulation in children who underwent tracheostomy alone versus tracheostomy followed by GWS. Data Sources PubMed, Web of Science, Cochrane Library, and Embase were searched following the PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-analyses) on September 9, 2019, with no date restriction. Review Methods Articles focusing on GWS or tracheostomy for initial management of BVFP were included. Articles describing patients who received no surgical intervention for BVFP were excluded. Results A total of 5989 articles were reviewed: 67 articles met inclusion criteria, and 240 patients were incorporated into the analysis. Patients who underwent primary GWS had an eventual tracheostomy rate of 6.0% (5/83). There were no statistically significant differences in the rate of tracheostomy, reoperation, or mortality among cricoid split, suture lateralization, and cordectomy/cordotomy. Patients who underwent primary tracheostomy failed to achieve decannulation in 36.9% (58/157) of cases. Decannulation was more likely in tracheostomized children who received GWS than those who did not (odds ratio, 6.336; P < .0001). Conclusions Most children who undergo primary GWS for BVFP avoid tracheostomy or reoperation. These data demonstrated no differences in surgical outcomes among the most common types of GWS for BVFP. For children who receive a tracheostomy as their first intervention for BVFP, GWS is associated with a significantly improved rate of decannulation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Surgical Management of Bilateral Vocal Fold Paralysis in Children: A Systematic Review and Meta‐analysis

Thorpe

Kanotra

2020

Otolaryngol.--head neck surg.

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“…We felt that it was important to study a patient population with baseline pulmonary impairment because many patients who are treated with botulinum toxin type A will have pulmonary comorbidities. Another study examined botulinum toxin injection into the cricothyroid muscles for the treatment of bilateral vocal fold abductor paralysis [ 17 ]. In that study, the goal was to inhibit the cricothyroid muscle to permit repositioning of the vocal folds and ultimately improve ventilation.…”

Section: Discussionmentioning

confidence: 99%

Safety and Stability of Pulmonary Function in Patients with Decreased Respiratory Function Treated for Spasticity with OnabotulinumtoxinA

Ayyoub

Brashear

Banach

et al. 2020

Toxins

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Two randomized, placebo-controlled studies evaluated the pulmonary function safety of onabotulinumtoxinA (onabotA) for treatment of upper and/or lower limb spasticity. Patients with stable baseline respiratory status received one or two treatments with placebo, 240 U, or 360 U of onabotA. Pulmonary function tests, adverse events, and efficacy were measured at least every 6 weeks for 18 weeks (Study 1) or 30 weeks (Study 2). Study 1 enrolled 109 patients (n = 36–37/group) and Study 2 enrolled 155 patients (n = 48–54/group). Mean baseline forced vital capacity (FVC) was 76–78% of predicted per group in Study 1 and 71% of predicted per group in Study 2. In Study 1, change from baseline FVC values were significantly (p < 0.05) decreased vs. placebo at weeks 3 (240 U −57 mL vs. placebo +110 mL) and 12 (360 U −6 mL vs. +167 mL placebo). In Study 2, change from baseline FVC values were significantly decreased in the 360 U group vs. placebo at weeks 6 (−78 mL vs. +49 mL placebo), 13 (−60 mL vs. +119 mL placebo), 18 (−128 mL vs. +80 mL placebo), and 24 (−82 mL vs. +149 mL placebo). Individual pulmonary function-related adverse events were not correlated with PFT decreases. The most frequent pulmonary-related adverse events were nasopharyngitis (Study 1) and upper respiratory tract infection (Study 2). Ashworth scores were significantly improved at multiple time points in both studies. Injection of onabotA for spasticity in patients with decreased pulmonary function, at single and repeated doses of up to 360 U, was associated with small but statistically significant decreases in FVC or forced expiratory volume 1 s (FEV1) (>12% and 200 mL) that were subclinical and not correlated with any adverse clinical pulmonary events.

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“…Ventilation markedly improved in four patients. According to Sahim et al, bilateral injection of botulinum REVIEW toxin provides temporary relief in dyspnoea in patients in whom the prognosis concerning vocal fold mobility restoration remains unclear [68].…”

Section: Botulinum Toxin Injectionsmentioning

confidence: 99%

Methods of surgical treatment of bilateral vocal fold paralysis.

Czesak

Osuch‐Wójcikiewicz

Niemczyk

2020

Endokrynologia Polska

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Bilateral vocal fold paralysis presents as their complete or partial immobilisation. The median or paramedian position of vocal folds contributes to the narrowing of the airway at the level of the glottis and manifests as inspiratory dyspnoea. For many years iatrogenic injury of recurrent laryngeal nerves during thyroidectomy has been viewed as the most common underlying reason. It is very often a lifethreatening condition requiring not only corticosteroid administration and intubation, which only constitute a short-term symptomatic therapy, but also surgical intervention, including tracheostomy. The most common surgical methods implemented in bilateral vocal fold paralysis include posterior cordectomy, arytenoidectomy, and, more and more commonly, re-innervation. Other techniques used in restoring airway patency include laterofixation, botulinum toxin injection, and laryngeal stimulation, which is still under research. Stem cell and gene therapy are also being researched. Notably, the main purpose of surgical treatment is the provision of airway patency with the preservation of the phonatory and protective functions of the larynx.

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Electromyography-Guided Botulinum Toxin Injection Into the Cricothyroid Muscles in Bilateral Vocal Fold Abductor Paralysis

Cited by 6 publications

References 25 publications

Surgical Management of Bilateral Vocal Fold Paralysis in Children: A Systematic Review and Meta‐analysis

Surgical Management of Bilateral Vocal Fold Paralysis in Children: A Systematic Review and Meta‐analysis

Safety and Stability of Pulmonary Function in Patients with Decreased Respiratory Function Treated for Spasticity with OnabotulinumtoxinA

Methods of surgical treatment of bilateral vocal fold paralysis.

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