Botulinum toxin treatment for spasmodic dysphonia (adductor laryngeal dystonia) Experience with 31 patients

Abstract

Laryngeal dystonia is a syndrome characterized by involuntary spasms of the laryngeal muscles. Most patients have involvement of the adductor laryngeal muscles (spasmodic dysphonia) producing uncontrolled spasms, pitch breaks and slow, effortful speech. Treatment with a variety of therapies including speech and pharmacotherapy have shown minimal improvement. Injections with botulinum toxin (Botox) bilaterally into the vocalis muscles is a comparatively new treatment for patients with spasmodic dysphonia. Since May 1991 we have treated 31 patients with spasmodic dysphonia with botulinum toxin. 21 patients (68%) showed voice improvement within 24–72 hours, with a lasting effect from 2–28 months (average 4 months). Most of the patients developed a breathy voice and a mild sensation of dysphagia the first 2 weeks after the injection.

Key Words:

• spasmodic dysphonia
• botulinum toxin
• evaluation of results.