Videostroboscopy of the Pharyngoesophageal Segment in Laryngectomy Patients Treated With Botulinum Toxin

Meleca, Robert J.; Dworkin, James Paul; Zormeier, Michele M.; Simpson, Mark; Shibuya, Terry Y.; Mathog, Robert H.

doi:10.1067/mhn.2000.106400

Cited by 15 publications

(10 citation statements)

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“…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. Tracheal APMs are considered to correlate closely with the effort required to produce trans-oesophageal speech.…”

Section: Discussionmentioning

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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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%

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

Wilkie

et al. 2015

annals

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“…Existen varios estudios prospectivos [28][29][30] , el más grande y reciente 31 incluye 34 pacientes en que se inyectó toxina botulínica (Botox ® ) bajo EMG a un solo lado del músculo constrictor faríngeo en dosis de 100 UI y dos pacientes con 50 UI. Este estudio mostró que, combinado con terapia vocal, los pacientes presentan una mejoría sostenida de la producción de la voz.…”

Section: ) Patología Laríngeaunclassified

Evidencia y uso actual de toxina botulínica en patología otorrinolaringológica

2015

Rev. Otorrinolaringol. Cir. Cabeza Cuello

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“…The diagnosis is made by esophagoscopy or insufflation trial via the voice prosthesis. Granulations are removed; in cases of too high pressure with spasm in the pharyngo-esophageal segment it may be helpful to inject botulinum [160], [161], [162], [163], [164], [165]. Moricz et al refer to endoscopy-based balloon dilation as a non-traumatic method that can be easily performed [166].…”

Section: Voice Prostheses and Their Applicationmentioning

confidence: 99%