Laryngeal Dystonia, New Approaches for Direct Botulinum Toxin Administration
American Journal of Psychiatry and Neuroscience
Volume 7, Issue 3, September 2019, Pages: 52-56
Received: Jun. 27, 2019; Accepted: Aug. 12, 2019; Published: Aug. 29, 2019
Views 67      Downloads 21
Authors
Luis Javier López Del Val, Neurology Service, Movement Disorders Unit, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
José Miguel Sebastián Cortes, Servicio de Otorrinolaringología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
Elena Bellosta Diago, Neurology Service, Movement Disorders Unit, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
Sonia Santos Lasaosa, Neurology Service, Movement Disorders Unit, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
Paúl Ricardo Vinueza Buitron, Neurology Service, Movement Disorders Unit, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
Yolanda Lois Ortega, Servicio de Otorrinolaringología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
Héctor Valles Varea, Servicio de Otorrinolaringología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
Elena López García, Neurology Service, Movement Disorders Unit, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
Article Tools
Follow on us
Abstract
To describe our experience in the treatment of laryngeal dystonia (in abduction and adduction), with special emphasis given to the technical aspects (approach procedure, dosage and type of botulinum toxin type A used), as well as treatment response and possible side effects. We conducted a cross-sectional descriptive study of a sample of patients with laryngeal dystonia treated by means of transoral administration of onabotulinumtoxinA or incobotulinumtoxinA over a period of 10 years (2007-2017). Data collected include demographic and clinical variables, treatment response (based on a self-rating scale), the duration of treatment and the appearance of side effects. Sample size: 15 patients (11 women; mean age: 44.06 years) with laryngeal dystonia (mean time since onset of 40 months; 12 patients with dystonia in adduction) and 174 administrations (92% incobotulinumtoxinA; average dosage of 5 U in each vocal cord). The procedure took an average of 11.7 minutes to perform. Response was good in 31% of the procedures and very good in 57.5%. Side effects were recorded in 14.4% of the procedures, although always mild and transitory, with a predominance of dysphagia and dysphonia. In our experience, transoral administration of botulinum toxin type A to treat laryngeal dystonia has proved to be a simple, quick, effective and safe technique.
Keywords
Botulinum Toxin A, Incobotulinumtoxin, Dystonia, Laryngeal Dystonia, Therapeutic Administration
To cite this article
Luis Javier López Del Val, José Miguel Sebastián Cortes, Elena Bellosta Diago, Sonia Santos Lasaosa, Paúl Ricardo Vinueza Buitron, Yolanda Lois Ortega, Héctor Valles Varea, Elena López García, Laryngeal Dystonia, New Approaches for Direct Botulinum Toxin Administration, American Journal of Psychiatry and Neuroscience. Vol. 7, No. 3, 2019, pp. 52-56. doi: 10.11648/j.ajpn.20190703.11
Copyright
Copyright © 2019 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
References
[1]
Tarsy D, Simon DK. Dystonia. N Engl J Med 2006; 355: 818-29.
[2]
L. J. López del Val, et al of botulinum toxin for the treatment of focal laryngeal dystonia (spastic dysphonia). Laryngoscope 1988; 98: 193-7.
[3]
Critchley M. Spastic dysphonia (‘inspiratory speech’). Brain. 1939; 62: 96-103.
[4]
Jankovic J, Fahn S. Dystonic disorders. In Jankovic J, Tolosa E, eds. Parkinson’s disease and movement disorders. 5 ed. Philadelphia: Williams & Wilkins; 2007. p. 331-57.
[5]
Bartolomé FM, Fanjul S, Cantarero S, Hernández J, García- Ruiz PJ. Distonías focales primarias: estudio descriptivo de 205 pacientes. Neurologia 2003; 18: 59-65.
[6]
García-Ruiz Espiga PJ. Distonía laríngea y faríngea. In López del Val LJ, Castro-García C, eds. Toxina botulínica. Aplicaciones terapéuticas en el siglo xxi. 2 ed. Barcelona: Elsevier Masson; 2010. p. 151-6.
[7]
Blitzer A, Brin MF, Stewart CF. Botulinum toxin management of spasmodic dysphonia (laryngeal dystonia): a 12-year experience in more than 900 patients. Laryngoscope 1988; 108: 1435-41.
[8]
Ludlow C. Treatment of laryngeal disorders and oromandibular dystonia. In: Toxins 2012: basic science and clinical aspects of botulinum and other neurotoxins. Miami Beach; 2012.
[9]
Jankovic J, Schwartz K. Clinical correlates of response to botulinum toxin injections. Arch Neurol 1991; 48: 1253-6.
[10]
Novakovic D, Waters HH, D’Elia JB, Blitzer A. Botulinum toxin treatment of adductor spasmodic dysphonia: longitudinal functional outcomes. Laryngoscope 2011; 121: 606-12.
[11]
Elmiyeh B, Prasad VM, Upile T, Saunders N, Youl BD, Epstein R, et al. A single-centre retrospective review of unilateral and bilateral Dysport injections in adductor spasmodic dysphonia. Logoped Phoniatr Vocol 2010; 35: 39-44.
[12]
Fulmer SL, Merati AL, Blumin JH. Efficacy of laryngeal botulinum toxin injection: comparison of two techniques. Laryngoscope 2011; 121: 1924-8.
[13]
López-García E, Martínez-Martínez L, Lopez del Val LJ. Distonía laríngea: actualización del tratamiento con toxina botulinica. Revista Española de Trastornos del Movimiento 2013; 5: 20-2.
[14]
Blitzer A. Spasmodic dysphonia and botulinum toxin: experience from the largest treatment series. Eur J Neurol 2010; 17 (Suppl 1): S28-30.
[15]
García-Ruiz C, Cenjor-Español R, Sánchez-Pernaute R, Astarioa V, Sánchez-Bernados J, García de Yébenes P. Distonía laríngea. Tratamiento con toxina botulínica mediante técnica transcutánea y transoral. Estudio comparativo. Neurologia 1996; 11: 216-9.
[16]
García-Ruiz PJ, Sánchez del Río M, Cenjor-Español C, Sanabria-Brassart J, Sánchez-Bernados V, Astarloa-Gómez R, et al. Disfonía espástica de aducción: clínica y tratamiento. Rev Clin Esp 1998; 198: 156-8.
[17]
Rhew K, Fiedler DA, Ludlow CL. Technique for injection of botulinum toxin through the flexible nasolaryngoscope. Otolaryngol Head Neck Surg 1994; 111: 787-94.
[18]
García-Ruiz PJ, Cenjor-Español C, Sánchez-Bernardos V, Astarloa R, Sanabria J, García de Yébenes J. Botulinum toxin treatment for spasmodic dysphonia: percutaneous versus transoral approach. Clin Neuropharmacol 1998; 21: 196-8.
[19]
Vasconcelos S, Birkent H, Sardesai MG, Merati AL, Hillel AD. Influence of age and gender on dose and effectiveness of botulinum toxin for laryngeal dystonia. Laryngoscope 2009; 119: 2004-7.
[20]
García-Torres MA, Echeverría-Urabayen A, Contreras A, Carnal-Martín P, García-Ruiz E. Evolución a largo plazo de la dosis de toxina botulínica en las distonías laríngea y cervical. Rev Neurol 2005; 41: 525-6.
[21]
García-Ruiz PJ, Sanz-Cartagena P, Martínez-Castrillo JC, Ares-Pensado B, Avilés-Olmos I, Blázquez-Estrada M, et al. Mitos y evidencias en el empleo de la toxina botulínica: neurofarmacología y distonías. Rev Neurol 2018; 66: 163‑72.
[22]
Brin MF, Blitzer A, Stewart A, Diamond B, Lovelace RE. Botulinum toxin for spasmodic dysphonia: double blind placebo-controlled assessment of dose and technique. Mov Disord 1995; 10: 135-7.
ADDRESS
Science Publishing Group
1 Rockefeller Plaza,
10th and 11th Floors,
New York, NY 10020
U.S.A.
Tel: (001)347-983-5186