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

  • N K Nerurkar (a1) and T P Banu (a1)
Abstract
AbstractObjectives:

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.

Copyright
Corresponding author
Address for correspondence:Dr Nupur Kapoor Nerurkar, D-603 Simla House, Napean Sea Road, Mumbai – 400026, Maharashtra, India E-mail: nupurkapoor@yahoo.com
Footnotes
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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.

Footnotes
References
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1Cannito MP, Johnson JP. Spastic dysphonia: a continuum disorder. J Commun Disord 1981;14:215–33
2Adler CH, Edwards BW, Bansberg SF. Female predominance in spasmodic dysphonia. J Neurol Neurosurg Psychiatry 1997;63:688
3Erickson ML. Effects of voicing and syntactic complexity on sign expression in adductor spasmodic dysphonia. Am J Speech Lang Pathol 2003;12:416–24
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;108:1435–41
5Menon JR. Flaring of ala nasi: a reliable diagnostic sign for abductor spasmodic dysphonia. International Journal of Phonosurgery and Laryngology 2011;1:41–3
6Rodriquez AA, Ford CN, Bless DM, Harmon RL. Electromyographic assessment of spasmodic dysphonia patients prior to botulinum toxin injection. Electromyogr Clin Neurophysiol 1994;34:403–7
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;101:911–4
8Woodson GE, Zwirner P, Murry T, Swenson M. Use of flexible fiberoptic laryngoscopy to assess patients with spasmodic dysphonia. J Voice 1991;5:8591
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;113:602–12
10Simonyan K, Ludlow CL. Abnormal activation of the primary somatosensory cortex in spasmodic dysphonia: an fMRI study. Cereb Cortex 2010;20:2749–59
11Marsden CD, Obeso JA, Zarranz JJ, Lang AE. The anatomical basis of symptomatic hemidystonia. Brain 1985;108:463–83
12Blitzer A, Brin MF. Laryngeal dystonia: a series with botulinum toxin therapy. Ann Otol Rhinol Laryngol 1991;100:85–9
13Blitzer A, Sulica L. Botulinum toxin: basic science and clinical uses in otolaryngology. Laryngoscope 2001;111:218–26
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, 2005
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;148:1003–6
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;140:43–7
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The Journal of Laryngology & Otology
  • ISSN: 0022-2151
  • EISSN: 1748-5460
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