Abstract
Botulinum neurotoxin (BoNT) has existed for thousands of years; however, it was not medically utilized until investigations into its therapeutic use began in sincerity during the late 1970s and 1980s. This, coupled with the reclassification of spasmodic dysphonia as a focal dystonia, led to the use of chemodenervation for this disorder, which has since become a refined technique. Indeed, due to its safety and efficacy, BoNT has been investigated in multiple neurolaryngology disorders, including spasmodic dysphonia, vocal tremor, and muscle tension dysphonia. BoNT has been shown to be a useful and safe adjunct in the treatment for these disorders and may reduce or eliminate oral pharmacotherapy and/or prevent the need for a surgical intervention. We present the historical background, development, proposed mechanisms of action, uses, and techniques for administering BoNT for laryngeal disorders, with a particular focus on spasmodic dysphonia.
Highlights
Fischer reported a case of hoarse and spastic dysphonia that developed in a patient with an active typhus infection, which subsequently self-resolved when she recovered from typhus, a case which would likely be reclassified as muscle-tension dysphonia in the present day
Toxins 2017, 9, 356 accepted and reclassified as a focal dystonia. This was aided in part by investigations of spastic dysphonia by laryngeal electromyography (LEMG) which showed that most cases represented a focal cranial dystonia [10,11]
Spasmodic dysphonia (SD) is a focal laryngeal dystonia, which is due to disordered central motor processing that manifests as action-induced involuntary spasms of laryngeal muscles
Summary
Spasmodic dysphonia (SD) had long been described as a psychogenic disorder in the early 19th and 20th centuries and it wasn’t until the late 20th century that it underwent a reclassification as a focal dystonia. Fischer reported a case of hoarse and spastic dysphonia that developed in a patient with an active typhus infection, which subsequently self-resolved when she recovered from typhus, a case which would likely be reclassified as muscle-tension dysphonia in the present day. This same case, which was termed a “Spastische. Toxins 2017, 9, 356 accepted and reclassified as a focal dystonia This was aided in part by investigations of spastic dysphonia by laryngeal electromyography (LEMG) which showed that most cases represented a focal cranial dystonia [10,11].
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