Skip to main content Accessibility help
×
Home
Hostname: page-component-768ffcd9cc-8zwnf Total loading time: 0.273 Render date: 2022-12-03T08:08:01.371Z Has data issue: true Feature Flags: { "useRatesEcommerce": false } hasContentIssue true

Spasmodic dysphonia: a seven-year audit of dose titration and demographics in the Indian population

Published online by Cambridge University Press:  07 July 2014

N K Nerurkar*
Affiliation:
Department of ENT, Bombay Hospital, Mumbai, India
T P Banu
Affiliation:
Department of ENT, Bombay Hospital, Mumbai, India
*
Address for correspondence:Dr Nupur Kapoor Nerurkar, D-603 Simla House, Napean Sea Road, Mumbai – 400026, Maharashtra, India E-mail: nupurkapoor@yahoo.com

Abstract

Objectives:

This study aimed to evaluate the demographics of spasmodic dysphonia in the Indian population and to analyse the optimum dose titration of botulinum toxin type A in this group. A comparative analysis with international studies was also performed.

Method:

The study involved a retrospective analysis and audit of botulinum toxin type A dose titration in spasmodic dysphonia patients who visited our voice clinic between January 2005 and January 2012.

Results:

The average total therapeutic dose required for patients with adductor spasmodic dysphonia was 4.2 U per patient per vocal fold (total 8.4 U per patient), and for patients with abductor spasmodic dysphonia, it was 4.6 U per patient.

Conclusion:

Our audit revealed that 80 per cent of the spasmodic dysphonia patients were male, which contrasts dramatically with international studies, wherein around 80 per cent of spasmodic dysphonia patients were female. Our study also revealed a higher dose titration of botulinum toxin for the Indian spasmodic dysphonia population in both adductor and abductor spasmodic dysphonia cases.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Presented as a poster (and awarded the David Howard prize for best poster presentation) at the Laryngology 2012 conference, 1–3 June 2012, Kuala Lumpur, Malaysia.

References

1Cannito, MP, Johnson, JP. Spastic dysphonia: a continuum disorder. J Commun Disord 1981;14:215–33CrossRefGoogle Scholar
2Adler, CH, Edwards, BW, Bansberg, SF. Female predominance in spasmodic dysphonia. J Neurol Neurosurg Psychiatry 1997;63:688CrossRefGoogle Scholar
3Erickson, ML. Effects of voicing and syntactic complexity on sign expression in adductor spasmodic dysphonia. Am J Speech Lang Pathol 2003;12:416–24CrossRefGoogle ScholarPubMed
4Blitzer, A, Brin, MF, Stewart, CF. Botulinum toxin management of spasmodic dysphonia (laryngeal dystonia): a 12-year experience in more than 900 patients. Laryngoscope 1998;108:1435–41CrossRefGoogle ScholarPubMed
5Menon, JR. Flaring of ala nasi: a reliable diagnostic sign for abductor spasmodic dysphonia. International Journal of Phonosurgery and Laryngology 2011;1:41–3Google Scholar
6Rodriquez, AA, Ford, CN, Bless, DM, Harmon, RL. Electromyographic assessment of spasmodic dysphonia patients prior to botulinum toxin injection. Electromyogr Clin Neurophysiol 1994;34:403–7Google ScholarPubMed
7Rontal, M, Rontal, E, Rolnick, M, Merson, R, Silverman, B, Truong, DD. A method for the treatment of abductor spasmodic dysphonia with botulinum toxin injections: a preliminary report. Laryngoscope 1991;101:911–4Google ScholarPubMed
8Woodson, GE, Zwirner, P, Murry, T, Swenson, M. Use of flexible fiberoptic laryngoscopy to assess patients with spasmodic dysphonia. J Voice 1991;5:8591CrossRefGoogle Scholar
9Klotz, DA, Maronian, NC, Waugh, PF, Shahinfar, A, Robinson, L, Hillel, AD. Findings of multiple muscle involvement in a study of 214 patients with laryngeal dystonia using fine wire electromyography. Ann Otol Rhinol Laryngol 2004;113:602–12CrossRefGoogle Scholar
10Simonyan, K, Ludlow, CL. Abnormal activation of the primary somatosensory cortex in spasmodic dysphonia: an fMRI study. Cereb Cortex 2010;20:2749–59CrossRefGoogle Scholar
11Marsden, CD, Obeso, JA, Zarranz, JJ, Lang, AE. The anatomical basis of symptomatic hemidystonia. Brain 1985;108:463–83CrossRefGoogle ScholarPubMed
12Blitzer, A, Brin, MF. Laryngeal dystonia: a series with botulinum toxin therapy. Ann Otol Rhinol Laryngol 1991;100:85–9CrossRefGoogle Scholar
13Blitzer, A, Sulica, L. Botulinum toxin: basic science and clinical uses in otolaryngology. Laryngoscope 2001;111:218–26CrossRefGoogle ScholarPubMed
14Pou, AM, Gadre, AK, Muller, CD. The Use of Botulinum Toxin in Otolaryngology: A Practical Guide. Alexandria, VA: American Academy of Otolaryngology – Head and Neck Surgery Foundation, 2005Google Scholar
15Rosow, DE, Parikh, P, Vivero, RJ, Casiano, RR, Lundy, DS. Considerations for initial dosing of botulinum toxin in treatment of adductor spasmodic dysphonia. Otolaryngol Head Neck Surg 2013;148:1003–6CrossRefGoogle ScholarPubMed
16Birkent, H, Maronian, N, Waugh, P, Merati, AL, Perkel, D, Hillel, AD. Dosage changes in patients with long-term botulinum toxin use for laryngeal dystonia. Otolaryngol Head Neck Surg 2009;140:43–7CrossRefGoogle ScholarPubMed
4
Cited by

Save article to Kindle

To save this article to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Spasmodic dysphonia: a seven-year audit of dose titration and demographics in the Indian population
Available formats
×

Save article to Dropbox

To save this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you used this feature, you will be asked to authorise Cambridge Core to connect with your Dropbox account. Find out more about saving content to Dropbox.

Spasmodic dysphonia: a seven-year audit of dose titration and demographics in the Indian population
Available formats
×

Save article to Google Drive

To save this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you used this feature, you will be asked to authorise Cambridge Core to connect with your Google Drive account. Find out more about saving content to Google Drive.

Spasmodic dysphonia: a seven-year audit of dose titration and demographics in the Indian population
Available formats
×
×

Reply to: Submit a response

Please enter your response.

Your details

Please enter a valid email address.

Conflicting interests

Do you have any conflicting interests? *