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DOI: 10.1055/s-0038-1640767
Botulinum toxin therapy for spamodic dysphonia: Retrospective data analysis of 349 treatments in 48 patients
Objectives:
Botulinum toxin A (BoNT-A) poses the standard therapy in spasmodic dysphonia (SpD). Aim of this retrospective study was to analyze the duration of effect and evolution of dosage of BoNT-A during 16 years in our department.
Methods:
The charts of patients, who were treated for SpD from 1998 to 2014, were assessed. Three brands of BoNT-A were available for therapy. Constant amount of BoNT-A was injected in both vocalis muscles, either endoscopically controlled or transcervically EMG-controlled. Patients consulted our department for the next treatment as soon as they felt disturbed by recurring symptoms. Time intervals between treatments and injected toxin dosages were assessed.
Results:
During 16 years, 48 patients with SpD underwent 349 treatments. SpD was the third leading diagnosis in our consultation (12%; 48/438 patients). In 36/48 patients BoNT was injected more than twice, in average 7,4 ± 11,1 times per patient (median 3,5). The median time interval between treatments was stable with 5,5 ± 7,0 months (p = 0,69). Onabotulinumtoxin A (Botox) was injected in 38%, Abotulinumtoxin A (Dysport) in 52% and Incobotulinumtoxin A (Xeomin) in 11% of all treatments. We observed a significant increase in dosage of Botox (mean 5,1 ± 3,2U per side; p = 0,002), and a significant decrease in dosage of Dysport (mean 20,0 ± 44U per side; p < 0,0001) during the 16 years. There was no significant change in dosage for Xeomin (mean 6,6 ± 2,5U per side; p = 0,27).
Conclusion:
Duration of effect of BoNT-A for treatment for SpD was stable with no significantly different time intervals between treatments. The dose of BoNT-A varied significantly between different brands.
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No conflict of interest has been declared by the author(s).
Publication History
Publication Date:
18 April 2018 (online)
© 2018. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).
Georg Thieme Verlag KG
Stuttgart · New York