Botulinum Toxin-A Dosing Trends for Adductor Spasmodic Dysphonia at a Single Institution Over 10 Years

Joseph P Bradley; Emily M Barrow; Edie R Hapner; Adam M Klein; Michael M Johns 3rd

doi:10.1016/j.jvoice.2016.09.022

Botulinum Toxin-A Dosing Trends for Adductor Spasmodic Dysphonia at a Single Institution Over 10 Years

J Voice. 2017 May;31(3):363-365. doi: 10.1016/j.jvoice.2016.09.022. Epub 2016 Nov 10.

Authors

Joseph P Bradley¹, Emily M Barrow², Edie R Hapner³, Adam M Klein², Michael M Johns 3rd⁴

Affiliations

¹ Department of Otolaryngology-Head & Neck Surgery, Washington University in St. Louis School of Medicine, St. Louis, Missouri.
² Department of Otolaryngology-Head & Neck Surgery, Emory Voice Center, Atlanta, Georgia.
³ Department of Otolaryngology-Head & Neck Surgery, University of Southern California Keck School of Medicine, Los Angeles, California.
⁴ Department of Otolaryngology-Head & Neck Surgery, University of Southern California Keck School of Medicine, Los Angeles, California. Electronic address: michaemj@usc.edu.

PMID: 27839987
DOI: 10.1016/j.jvoice.2016.09.022

Abstract

Objectives: This study aimed to identify the changes in dosing of botulinum toxin-A for adductor spasmodic dysphonia (ADSD) over a prolonged period.

Study design: This is a retrospective chart review.

Methods: One hundred thirteen subjects treated for ADSD from 2003 to 2013 were identified from a clinical database. Subject age, gender, and total injection dose amount were all recorded for all subjects who had at least 10 injections.

Results: Fifty-four subjects met criteria for inclusion. There were no age or gender differences in the starting dose for subjects. Dosing decreased significantly compared with the second dose (5.05 ± 1.623 Units), by the sixth dose (4.26 ± 1.698 Units), and continued through the 10th dose (4.08 ± 2.019 Units) (P < 0.005 for all).

Conclusions: Botulinum toxin-A dosing for ADSD decreases consistently over subsequent injections after the initial two dose titrations.

Keywords: Adductor spasmodic dysphonia; Botox; Botulinum toxin-A; Dosing; Laryngeal dystonia.

MeSH terms

Acetylcholine Release Inhibitors / administration & dosage*
Acetylcholine Release Inhibitors / adverse effects
Botulinum Toxins, Type A / administration & dosage*
Botulinum Toxins, Type A / adverse effects
Dysphonia / diagnostic imaging
Dysphonia / drug therapy*
Dysphonia / physiopathology
Female
Georgia
Humans
Injections, Intramuscular
Laryngeal Muscles / diagnostic imaging
Laryngeal Muscles / drug effects*
Laryngeal Muscles / physiopathology
Male
Middle Aged
Recovery of Function
Retrospective Studies
Stroboscopy
Time Factors
Treatment Outcome
Video Recording

Substances

Acetylcholine Release Inhibitors
Botulinum Toxins, Type A