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The point-touch technique for botulinum toxin injection in adductor spasmodic dysphonia: quality of life assessment

  • S Morzaria (a1) and E J Damrose (a1)
  • DOI: http://dx.doi.org/10.1017/S0022215111000739
  • Published online: 27 April 2011
Abstract
AbstractBackground:

Botulinum toxin injection under electromyographic guidance is the ‘gold standard’ for adductor spasmodic dysphonia treatment. The point-touch technique, an alternative injection method which relies on anatomical landmarks, is cheaper, quicker and more accessible, but has not yet gained widespread acceptance due to concerns about patient satisfaction.

Objective:

To assess swallowing and voice-related quality of life following point-touch botulinum toxin injection in adductor spasmodic dysphonia patients.

Setting:

Stanford University Voice and Swallowing Center.

Design:

Prospective case series (evidence level four).

Methods:

Consecutive adductor spasmodic dysphonia patients with a stable botulinum toxin dose–response relationship were recruited prospectively. The Eating Assessment Tool and Voice-Related Quality of Life questionnaires were completed pre-treatment and at 10 and 30 per cent completion of the injection cycle, respectively.

Results:

Thirty-seven patients completed follow up. The mean total botulinum toxin dose was 0.88 units. Pre-treatment Voice-Related Quality of Life questionnaire results reflected the burden of disease. Post-treatment Eating Assessment Tool and Voice-Related Quality of Life questionnaire results were collected at 2.53 and 7.84 weeks, respectively; the former showed an increase in dysphagia, albeit statistically insignificant, while the latter showed significantly improved scores (both domain and total).

Conclusion:

The point-touch technique is a viable alternative for botulinum toxin injection in the treatment of adductor spasmodic dysphonia.

Copyright
Corresponding author
Address for correspondence: Dr Sanjay Morzaria, Clinical Instructor, University of British Columbia, Department of Otolaryngology-Head and Neck Surgery, 103–8556 120th Street, Surrey, BC V3W 3N5, Canada Fax: (778) 565 3249, E-mail: Morzaria@yahoo.com
Footnotes
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Presented at the Canadian Society of Otolaryngology – Head and Neck Surgery Meeting, 23–26 May 2010, Niagara Falls, Ontario, Canada

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This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

1L Sulica . Contemporary management of spasmodic dysphonia. Curr Opin Otolaryngol Head Neck Surg 2004;12:543–8

2A Blitzer , MF Brin , CF Stewart . Botulinum toxin management of spasmodic dysphonia (laryngeal dystonia): a 12-year experience in more than 900 patients. Laryngoscope 1998;108:1435–41

10C Ford , DM Bless , JD Lowery . Indirect laryngoscopic approach for injection of botulinum toxin in spasmodic dysphonia. Otolaryngol Head Neck Surg 1990;103:752–8

11D Green , GS Berke , PH Ward , BR Gerratt . Point-touch technique of botulinum toxin injection for the treatment of spasmodic dysphonia. Ann Otol Rhinol Laryngol 1992;101:883–7

13R Paniello , J Barlow , JS Serna . Longitudinal follow-up of adductor spasmodic dysphonia patients after botulinum toxin injection: quality of life results. Laryngoscope 2008;118:564–8

14N Hogikyan , G Sethuraman . Validation of an instrument to measure voice-related quality of life (V-RQOL). J Voice 1999;13:557–69

16A Rubin , WP Wodchis , C Spak , PR Kileny , ND Hogikyan . Longitudinal effects of Botox injections on voice-related quality of life (V-RQOL) for patients with adductory spasmodic dysphonia: part II. Arch Otolaryngol Head Neck Surg 2004;130:415–20

18N Hogikyan , WP Wodchis , C Spak , PR Kileny . Longitudinal effects of botulinum toxin injections on voice-related quality of life (V-RQOL) for patients with adductory spasmodic dysphonia. J Voice 2001;15:576–86

20ND Hogikyan , WP Wodchis , JE Terrell , CR Bradford , RM Esclamado . Voice-related quality of life (V-RQOL) following type I thyroplasty for unilateral vocal fold paralysis. J Voice 2000;14:378–86

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