Adductor spasmodic dysphonia: Botulinum toxin a injections or laser thyroarytenoid myoneurectomy? A comparison from the patient perspective.
Laryngoscope
; 130(3): 741-746, 2020 03.
Article
en En
| MEDLINE
| ID: mdl-31169922
ABSTRACT
OBJECTIVES/HYPOTHESIS:
The current gold standard of therapy for adductor spasmodic dysphonia (AdSD) is injection of botulinum toxin A (BTX) in the adductor musculature. A surgical procedure could potentially offer more stable and long-lasting voice quality. In this study, we report the long-term results of endoscopic laser thyroarytenoid (TA) myoneurectomy versus BTX treatment in the same patients with AdSD. STUDYDESIGN:
Retrospective case series.METHODS:
Between July 2013 and September 2016, a total of 22 patients with AdSD were included. Voice outcomes were measured using the Voice Handicap Index and a Likert-scale patient-reported voice questionnaire. Data were obtained for each patient at four time points preoperatively with and without BTX and twice postoperatively at 3 months (short term) and 12 months (long term).RESULTS:
No statistically significant differences were found between voice outcome after BTX injection and the short- and long-term postoperative voice outcomes for the group as a whole. During postoperative follow-up, 10 of the 22 patients (45%) needed a second procedure after an average of 18 months (interquartile range, 13-22 months) due to recurrence of their original voice problem.CONCLUSIONS:
The TA myoneurectomy showed encouraging results, comparable to BTX after follow-up of 12 months for the group as a whole. However, after good results initially, voice deterioration was seen in 45% of the patients who all underwent a second procedure. These preliminary results provide important insights into the value of TA myoneurectomy as a potential definite treatment for a select group of patients with AdSD. Further research might explore long-term results after revision surgery. LEVEL OF EVIDENCE 4 Laryngoscope, 130741-746, 2020.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Toxinas Botulínicas Tipo A
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Terapia por Láser
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Disfonía
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Músculos Laríngeos
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Fármacos Neuromusculares
Tipo de estudio:
Observational_studies
Límite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Laryngoscope
Asunto de la revista:
OTORRINOLARINGOLOGIA
Año:
2020
Tipo del documento:
Article
País de afiliación:
Países Bajos