Use of botulinum toxin in voice restoration after laryngectomy

Khemani, Sameer; Govender, Roganie; Arora, Anand; O’Flynn, Paul; Vaz, Francis

doi:10.1017/s0022215109990430

Cited by 12 publications

(3 citation statements)

References 27 publications

(61 reference statements)

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“…In confirming objective efficacy, these findings are in accordance with those reported previously. 8,9 However, comparison between studies is impeded by the considerable variation in outcome measurements. 14,15 The largest study to dateby Hamaker and Blom 16 used intra-tracheal phonation pressures in a similar manner to our study to assess outcomes in 62 patients.…”

Section: Discussionmentioning

confidence: 99%

“…2 Several studies have evaluated objectively use of botulinum for PES spasm, and demonstrated its efficacy in the context of dysphonia and dysphagia. 8,9 However, there is ENT Ann R Coll Surg Engl 2015; 97: 508-512 doi 10.1308/rcsann.2015.0011 a paucity of data relating to patient-reported outcome measures and treatment of PES spasm-induced CVL. We sought to evaluate objective and patient-perceived outcomes with respect to dysphagia, dysphonia and CVL.…”

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confidence: 99%

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Injection of botulinum toxin for the treatment of post-laryngectomy pharyngoesophageal spasm-related disorders

Wilkie

et al. 2015

annals

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Introduction Pharyngoesophageal spasm (PES) can cause dysphagia, central valve leak (CVL), and dypshonia in post-laryngectomy patients. Botulinum toxin has been used effectively for the treatment of PES, but data regarding patient-reported outcomes and efficacy for CVL are limited. We evaluated the results of botox injection for PES spasm using subjective and objective measures. Methods Data were collected prospectively (February 2010 to August 2013) on 13 patients undergoing botox injection for PES as identified by video fluoroscopy. We collected digital voice recordings, air-pressure measurements (APMs) for speech, and quality of life (QoL) data before and after the procedure: University of Washington QoL questionnaire (UW-QoL), MD Anderson Swallowing Inventory (MDADI) and the Voice Handicap Index (VHI-30). Results APMs for a sustained vowel decreased by 18% after botox injection, whereas maximum phonatory times increased by 63% (mean increase, 8 to 13 seconds). Sustained vowel amplitude decreased (mean, 87db to 83db) with an associated reduction in sustained vowel frequency (117Hz to 77Hz). MDADI scores improved by 10.2% overall, and UW-QoL scores showed an improvement in score of 7.6%. Mean scores for VHI-30 deteriorated by 2% overall but, when considering only those patients experiencing dysphonia, an improvement of 9.4% was seen. There was an overall net reduction for the CVL cohort of 12 speech valves in the year after injection. Conclusions Our series confirm the safety and objective efficacy of botox injection for PES. QoL measurements were less convincing, and this disparity between subjective and objective measurements must be considered when treating such patients.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Injection of botulinum toxin for the treatment of post-laryngectomy pharyngoesophageal spasm-related disorders

Wilkie

et al. 2015

annals

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“…Bu konuda yap›lan bir meta-analizde 1966-2009 y›llar› aras›nda Medline'da yay›nlanm›fl 9 klinik çal›flma ve 134 olgu incelenmifl; objektif ses kalitesi de¤erlendirildi¤inde baflar› oran›n›n %70-100 oldu¤u bildirilmifltir. Yazarlar larenjekomiden sonra faringoözefageal segmentte hipertonisite ve/veya spazm oldu¤u kan›tlanm›fl hastalarda BTX'un güvenli ve maliyet etkin bir flekilde kullan›labilece¤i sonucuna varm›fllard›r (45).…”

Section: Larenjektomize Ses Protezi Tak›lan Hastalarunclassified

Larengeal Botulinum Toksini Uygulamaları

Orhan¹,

Başaran²,

Ulusan³

et al. 2011

Npa

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Y Ya az z› ›fl flm ma a A Ad dr re es si i/ /A Ad dd dr re es ss s f fo or r C Co or rr re es sp po on nd de en nc ce e: : Dr. Kadir Serkan Orhan, ‹stanbul Üniversitesi ‹stanbul T›p Fakültesi KBB Hastal›klar› Anabilim Dal›, ‹stanbul, Türkiye E-posta: ksorhan@istanbul.edu.tr 4 43 3. . U Ul lu us sa al l P Ps si ik ki iy ya at tr ri i K Ko on ng gr re es si i' 'n nd de e P Po os st te er r S Su un nu um mu u y ya ap p› ›l lm m› ›fl flt t› ›r r. . Ö ÖZ ZE ET TLarenksin temel ifllevi alt hava yolu proteksiyonunu sa¤lamakt›r; ayr›ca respirasyon ve fonasyona da yard›mc› olur. Çeflitli sebeplere ba¤l› olarak bu kaslarda hipertonisite ve/veya spazm geliflimi, solunum, yutma ve ses problemlerine yol açabilir. Larenksin adduktor spazmodik disfonilerinin tedavisinde botulinum toksini uzun y›llard›r baflar› ile kullan›lmaktad›r. Krikofarengeal disfajiler, larengeal tikler, larengeal granülom ve paradoksal vokal kord hareketi gibi hastal›klar di¤er kullan›m alanlar›n› oluflturur. Botulinum tokisininin geri dönüflümlü etkisi destrüktif cerrahi giriflimlere karfl› avantaj sa¤lam›fl, t›bbi pratikte güvenli ve yayg›n kullan›m›n› mümkün k›lm›flt›r. Bu yaz›da k›saca larenks anatomi ve fizyolojisi hakk›nda bilgi verilmifl, larengeal botulinum toksini uygulamalar› gözden geçirilmifltir. (Nöropsikiyatri Arflivi 2010; 47 Özel Say›: 30-4) Anahtar kelimeler: Larenks, botulinum toksini, spazmodik disfoni, krikofarengeal disfaji A AB BS ST TR RA AC CT T The primary function of the larynx is protection of the lower respiratory system and, in addition, it facilitates respiration and phonation. Hypertonicity and/or spasm of the laryngeal muscles due to several reasons can cause abnormalities in respiration, digestion and voice. Botulinum toxin has been used successfully in the treatment of adductor spasmodic dysphonia (laryngeal dystonia) for several years. Cricopharyngeal dysphagia, laryngeal tics, laryngeal granulomas and paradoxical vocal cord motions are the other areas, where botulinum toxin can be used. Because of its reversible effects, botulinum toxin is superior to the destructive surgical techniques. In this article, the anatomy and physiology of the larynx is described briefly and botulinum toxin applications in the larynx are discussed. (Archives of Neuropsychiatry 2010; 47 Supplement: 30-4)

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Voice Restoration with the Tracheoesophageal Voice Prosthesis: The Current State of the Art

Graville

Palmer

Bolognone

2019

Clinical Care and Rehabilitation in Head and Neck Cancer

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Use of botulinum toxin in voice restoration after laryngectomy

Abstract: Botulinum toxin can be used as a safe and cost-effective treatment in patients with confirmed pharyngoesophageal segment hypertonicity and/or spasm following laryngectomy, to obtain an improvement in voice quality.

Cited by 12 publications

References 27 publications

Injection of botulinum toxin for the treatment of post-laryngectomy pharyngoesophageal spasm-related disorders

Injection of botulinum toxin for the treatment of post-laryngectomy pharyngoesophageal spasm-related disorders

Larengeal Botulinum Toksini Uygulamaları

Voice Restoration with the Tracheoesophageal Voice Prosthesis: The Current State of the Art

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