Treatment efficacy of electromyography versus fiberscopy-guided botulinum toxin injection in adductor spasmodic dysphonia patients: a prospective comparative study.

Jae Wook Kim,Seung Won Lee,Jae Hong Park,Ki Nam Park

doi:10.1155/2014/327928

Jae Wook Kim, Seung Won Lee + Show 2 more

Open Access

https://doi.org/10.1155/2014/327928

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Journal: TheScientificWorldJournal	Publication Date: Jan 1, 2014
Citations: 18	License type: CC BY 3.0

Affiliation: Soonchunhyang University

Abstract

Introduction. This study prospectively evaluates and compares the treatment efficacy of botulinum toxin injection under electromyography guidance (EMG group) and percutaneous botulinum toxin injection under flexible fiberscopic guidance (fiberscopy group). Methods. Thirty patients with adductor spasmodic dysphonia (ADSD), who had never received treatment, were randomly allocated into EMG- or fiberscopy-guided botulinum toxin injections between March 2008 and February 2010. We assessed acoustic and aerodynamic voice parameters, and the voice handicap index (VHI) before injection and at 1, 3, and 6 months after injection. Results. The mean total dosage of botulinum toxin was similar for both groups: 1.7 ± 0.5 U for the EMG group and 1.8 ± 0.4 U for the fiberscopy group (P > 0.05). There were no significant differences in outcomes between the two groups in either the duration of effectiveness or complications such as breathy voice and aspiration. Conclusion. Botulinum toxin injection under fiberscopic guidance is a viable alternative to EMG-guided botulinum toxin injection for the treatment of adductor spasmodic dysphonia when EMG equipment is unavailable.

Highlights

This study prospectively evaluates and compares the treatment efficacy of botulinum toxin injection under electromyography guidance (EMG group) and percutaneous botulinum toxin injection under flexible fiberscopic guidance
Botulinum toxin injection is widely accepted as an effective treatment modality for controlling the symptoms of adductor spasmodic dysphonia (ADSD) [1]
Botulinum toxin injection under EMG guidance is the standard technique for delivering botulinum toxin to the TA muscle, not all otolaryngology departments have EMG equipment, due to its high cost

Summary

Introduction

This study prospectively evaluates and compares the treatment efficacy of botulinum toxin injection under electromyography guidance (EMG group) and percutaneous botulinum toxin injection under flexible fiberscopic guidance (fiberscopy group). Thirty patients with adductor spasmodic dysphonia (ADSD), who had never received treatment, were randomly allocated into EMG- or fiberscopy-guided botulinum toxin injections between March 2008 and February 2010. Botulinum toxin injection under fiberscopic guidance is a viable alternative to EMG-guided botulinum toxin injection for the treatment of adductor spasmodic dysphonia when EMG equipment is unavailable. Botulinum toxin injection is widely accepted as an effective treatment modality for controlling the symptoms of adductor spasmodic dysphonia (ADSD) [1]. There are a variety of injection approaches to deliver botulinum toxin to the thyroarytenoid (TA) muscle, including EMG guidance, the point-touch technique, a transnasal or transoral approach, and percutaneous fiberscopic guidance [2,3,4,5]. The selection of injection technique may be determined by equipment availability, surgeon preference, and/or training, without reference of clinical evidence

Methods

Results

Conclusion