Document Detail

Considerations for Initial Dosing of Botulinum Toxin in Treatment of Adductor Spasmodic Dysphonia.
MedLine Citation:
PMID:  23535709     Owner:  NLM     Status:  Publisher    
ObjectivesTo assess the effect on voice improvement and duration of breathiness based on initial dose of onabotulinum toxin A (BTX-A) in the management of adductor spasmodic dysphonia (SD) and to compare voice outcomes for initial bilaterally injected doses of 1.25 units (group A) vs 2.5 units (group B) of BTX-A.Study DesignCase series with chart review of patients with adductor SD treated at a tertiary care facility from 1990 to 2011.SettingAcademic subspecialty laryngology practice.MethodsDemographic data (age and sex), voice rating, duration of voice improvement, and breathiness were evaluated and compared between groups A and B using the Student t test and χ(2) analysis.ResultsOf 478 patients identified, 305 (223 in group A, 82 in group B) patients met inclusion criteria. The average age was 56.2 years in group A and 57.4 years in group B (P = .5). The female to male ratio was 2.91 for group A vs 3.56 for group B (P = .61). Good voice outcomes (grade 3 or 4) were reported by 91% of group A patients vs 94% of group B (P = .75). The average duration of voice improvement was 99.7 days for group A and 108.3 days for group B (P = .54). The average duration of breathiness was 10.88 days for group A vs 15.42 days for group B (P = .02).ConclusionPatients injected with 1.25 units bilaterally had a statistically significant shorter duration of breathiness without a statistically significant difference in clinical effectiveness or voice outcome. It is therefore recommended that a relatively low initial BTX-A dose be used with subsequent titration to achieve improved voice outcomes.
David E Rosow; Punam Parikh; Richard J Vivero; Roy R Casiano; Donna S Lundy
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-3-27
Journal Detail:
Title:  Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery     Volume:  -     ISSN:  1097-6817     ISO Abbreviation:  Otolaryngol Head Neck Surg     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-3-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8508176     Medline TA:  Otolaryngol Head Neck Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, USA.
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