연축성 발성장애(Spasmodic Dysphonia)에 대한 보톡스 주입치료

Botox Injection for the Management of Spasmodic Dysphonia

Spasmodic dysphonia is a chronic, focal, movement-induced, action-specific dystonia of the laryngeal musculature during speech. It can have a profound effect on quality of life, severely limiting people's communication, especially via telephone and in noisy backgrounds. Spasmodic dysphonia (SD) is usually of the adductor type characterized by glottic contractions causing tightness and voice breaks with forced-strangled voice, but it may also be abductor type or, much less commonly, mixed. Treatment options for adductor spasmodic dysphonia (ADSD) include voice therapy, surgical procedures, and botulinum toxin injections (Botox). The use of Botox injected into the laryngeal muscles remains the "gold standard" treatment for reducing the vocal symptoms of ADSD and Botox induces a temporary paresis of the laryngeal muscles and provides short-term relief of symptoms. Repeated injections of the laryngeal muscles, generally every 3-4 months, are required for continuous relief of symptoms. Improvement in vocal function has been reported after use of Botox injections, though a completely normal voice is rarely achieved. In this hospital, 1,030 patients have been enrolled for Botox injection therapy so far (May, 2012). In this review article, I'd like to present my personal experience of management of spasmodic dysphonia mainly by Botox injection.