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At the recent meeting of the American Laryngological Association meeting in San Francisco, Calif, Dr Andrew Blitzer, New York, NY, reported his experiences with 120 patients who underwent botulinum toxin injection for adductor laryngeal dystonia (spastic dysphonia). The injections are performed percutaneously and are now done as an outpatient procedure, repeated every 3 to 4 months. The study group included eight patients in whom spasm had returned after recurrent laryngeal nerve transection and electromyographic testing demonstrated chronic denervation.
Dr Blitzer suggested that the injection for failed recurrent nerve transection should be performed in the contralateral (innervated) cord. He also felt that botulinum should now be considered as a primary treatment for the disorder, since it has demonstrated no long-term disability, and since the recurrence rate seems problematically high in patients undergoing nerve section.
CRUMLEY RL. Botulinum Toxin Therapy for Recurrent Laryngeal Nerve Section Failure for Adduction Laryngeal Dystonia. Arch Otolaryngol Head Neck Surg. 1989;115(11):1279. doi:10.1001/archotol.1989.01860350013003
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