Use of botulinum toxin in pediatric otolaryngology and laryngology

Andrea, Shogan; Rogers, Derek J.; Hartnick, Christopher J.; Kerschner, Joseph E.

doi:10.1016/j.ijporl.2014.06.026

Cited by 14 publications

(11 citation statements)

References 22 publications

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“…Based on the nature of the spasm, SD is characterized as adductor SD (AdSD), abductor SD (AbSD), or the rare mixed SD (MSD). AdSD is most common (occurs in 87% of cases) [ 15 , 16 ] and manifests with hyperadduction spasms during phonation, which results in a strained voice quality as well as voice breaks. AbSD is present in approximately 13% of SD patients [ 16 ] and is characterized by a breathy, effortful hypophonic voice with abrupt termination, causing many aphonic or whispered speech segments.…”

Section: Spasmodic Dysphoniamentioning

confidence: 99%

Chemodenervation of the Larynx

Kaye

Blitzer

2017

Toxins

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Botulinum neurotoxin (BoNT) has existed for thousands of years; however, it was not medically utilized until investigations into its therapeutic use began in sincerity during the late 1970s and 1980s. This, coupled with the reclassification of spasmodic dysphonia as a focal dystonia, led to the use of chemodenervation for this disorder, which has since become a refined technique. Indeed, due to its safety and efficacy, BoNT has been investigated in multiple neurolaryngology disorders, including spasmodic dysphonia, vocal tremor, and muscle tension dysphonia. BoNT has been shown to be a useful and safe adjunct in the treatment for these disorders and may reduce or eliminate oral pharmacotherapy and/or prevent the need for a surgical intervention. We present the historical background, development, proposed mechanisms of action, uses, and techniques for administering BoNT for laryngeal disorders, with a particular focus on spasmodic dysphonia.

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Section: Spasmodic Dysphoniamentioning

confidence: 99%

Chemodenervation of the Larynx

Kaye

Blitzer

2017

Toxins

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“…This treatment has been found to be a very effective treatment for refractory sialorrhea, but it necessitates repeated injections, as the effect is only temporary. 6 Typical response duration to botulinum toxin has been reported as being on average 4 months. 7…”

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confidence: 99%

Safety of Ultrasound‐Guided Botulinum Toxin Injections for Sialorrhea as Performed by Pediatric Otolaryngologists

Shariat-Madar

Chun

Sulman

et al. 2016

Otolaryngol.--head neck surg.

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Objective. To evaluate incidence of complications and hospital readmission as a result of ultrasound-guided botulinum toxin injections to manage sialorrhea.Study Design. Case series with chart review.Setting. Children's Hospital of Wisconsin.Subjects and Methods. A case series with chart review was performed of all cases of ultrasound-guided injection of botulinum toxin by pediatric otolaryngologists from March 5, 2010, to September 26, 2014,. Primary outcomes included complications such as dysphagia, aspiration pneumonia, and motor paralysis. Secondary outcomes included hospitalization, intubation, and nasogastric tube placement.Results. There were 48 patients, 111 interventions, and 306 intraglandular injections identified. Botulinum toxin type A and type B were utilized in 4 and 107 operative interventions, respectively. Type A was injected into 4 parotid and 4 submandibular glands, utilizing doses of 20 U per parotid and 30 U per submandibular gland. Type B was injected into 98 parotid and 200 submandibular glands, with average dosing of 923 U per parotid and 1170 U per submandibular gland, respectively. There were 2 instances of subjectively worsening of baseline dysphagia that self-resolved. No cases were complicated by aspiration pneumonia or motor paralysis. No patients required hospital readmission, intubation, or nasogastric tube placement.Conclusion. Prior published data indicated 16% complication incidence with ultrasound-guided injection of botulinum toxin. Our study found a low complication rate (0.6%) with ultrasound-guided injections of botulinum toxin to manage sialorrhea, without cases of aspiration pneumonia or motor paralysis. Of 306 intraglandular injections, there were 2 cases of worsening baseline subjective dysphagia that self-resolved.

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“…Immaturity of the interstitial cells of Cajal may explain why there have been reports of spontaneous resolution of CPA seen in infants [ 42 ]. CPA has also associated with gastro-esophageal reflux disease and CNS abnormalities [ 21 , 22 , 41 , 42 , 43 , 44 ].…”

Section: Esophageal Applicationsmentioning

confidence: 99%

Treatment of Gastrointestinal Sphincters Spasms with Botulinum Toxin A

Brisinda

Sivestrini

Bianco

et al. 2015

Toxins

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Botulinum toxin A inhibits neuromuscular transmission. It has become a drug with many indications. The range of clinical applications has grown to encompass several neurological and non-neurological conditions. One of the most recent achievements in the field is the observation that botulinum toxin A provides benefit in diseases of the gastrointestinal tract. Although toxin blocks cholinergic nerve endings in the autonomic nervous system, it has also been shown that it does not block non-adrenergic non-cholinergic responses mediated by nitric oxide. This has promoted further interest in using botulinum toxin A as a treatment for overactive smooth muscles and sphincters. The introduction of this therapy has made the treatment of several clinical conditions easier, in the outpatient setting, at a lower cost and without permanent complications. This review presents current data on the use of botulinum toxin A in the treatment of pathological conditions of the gastrointestinal tract.

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Use of botulinum toxin in pediatric otolaryngology and laryngology

Cited by 14 publications

References 22 publications

Chemodenervation of the Larynx

Chemodenervation of the Larynx

Safety of Ultrasound‐Guided Botulinum Toxin Injections for Sialorrhea as Performed by Pediatric Otolaryngologists

Treatment of Gastrointestinal Sphincters Spasms with Botulinum Toxin A

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