Safety of Simultaneous Bilateral Botulinum Toxin Injections for Abductor Spasmodic Dysphonia | Laryngology | JAMA Otolaryngology–Head & Neck Surgery | JAMA Network
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Original Article
September 2005

Safety of Simultaneous Bilateral Botulinum Toxin Injections for Abductor Spasmodic Dysphonia

Author Affiliations

Author Affiliations: Department of Otolaryngology (Drs Stong and DelGaudio), and Emory Voice Center (Drs Hapner and Johns), Emory University, Atlanta, Ga.

Arch Otolaryngol Head Neck Surg. 2005;131(9):793-795. doi:10.1001/archotol.131.9.793
Abstract

Objective  To review the safety of simultaneous bilateral posterior cricoarytenoid muscle botulinum toxin injections.

Design  Retrospective case series review.

Setting  Tertiary care academic clinic.

Patients  Twenty-one patients with abductor spasmodic dysphonia.

Interventions  Patients received 100 simultaneous bilateral posterior cricoarytenoid muscle botulinum toxin injections for isolated abductor spasmodic dysphonia over a 6-year period.

Main Outcome Measures  Major and minor complications, injection dosing, and demographics.

Results  The total bilateral botulinum toxin injection dose per session ranged from 2.50 to 7.50 U, and the average total bilateral dose per patient was 4.70 U. There were no major complications, and minor complications were self-limited. There was a 5% incidence of significant dyspnea and a 2% incidence of dysphagia, and all patients were treated conservatively. The average doses at which dyspnea and dysphagia occurred were 4.97 and 5.56 U, respectively.

Conclusions  This case series demonstrates that simultaneous bilateral posterior cricoarytenoid muscle botulinum toxin injection is safe up to the highest doses reported. Complications with this approach are consistent with those previously reported using other methods. Prospective studies on vocal outcome measures are needed for simultaneous bilateral posterior cricoarytenoid muscle botulinum toxin injections to evaluate the efficacy of this technique.

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