Botulinum Neurotoxin Therapy in the Clinical Management of Laryngeal Dystonia

Toxins (Basel). 2022 Dec 1;14(12):844. doi: 10.3390/toxins14120844.

Abstract

Laryngeal dystonia (LD), or spasmodic dysphonia (SD), is a chronic, task-specific, focal movement disorder affecting the larynx. It interferes primarily with the essential functions of phonation and speech. LD affects patients' ability to communicate effectively and significantly diminishes their quality of life. Botulinum neurotoxin was first used as a therapeutic agent in the treatment of LD four decades ago and remains the standard of care for the treatment of LD. This article provides an overview of the clinical application of botulinum neurotoxin in the management of LD, focusing on the classification for this disorder, its pathophysiology, clinical assessment and diagnosis, the role of laryngeal electromyography and a summary of therapeutic injection techniques, including a comprehensive description of various procedural approaches, recommendations for injection sites and dosage considerations.

Keywords: botulinum neurotoxin; electromyography; injection; laryngeal dystonia; spasmodic dysphonia.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Botulinum Toxins* / therapeutic use
  • Dysphonia* / drug therapy
  • Dystonia* / drug therapy
  • Humans
  • Larynx*
  • Quality of Life

Substances

  • Botulinum Toxins

Grants and funding

This research was supported by internal funding from the Dr Liang Voice Program, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2050, Australia.