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http://dx.doi.org/10.22469/jkslp.2019.30.2.82

Clinical Application of Botulinum Toxin to Contact Granuloma and Vocal Nodule  

Lee, Seung Won (Department of Otolaryngology-Head and Neck Surgery, Soonchunhyang University College of Medicine)
Publication Information
Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics / v.30, no.2, 2019 , pp. 82-86 More about this Journal
Abstract
In the field of otolaryngology-head and neck surgery, botulinum toxins are widely used for the treatment of spasmodic dysphonia and vocal tremors. Recently, the applications of botulinum toxin have gradually expanded with time, to include vocal fold granuloma, mutational falsetto, bilateral vocal cord paralysis, and chemical reduction for arytenoid dislocation as an adjunctive modality. According to a nation-wide multicenter study conducted by the Korean Society of Laryngology, Phoniatrics and Logopedics for treatment modality of contact granuloma, among the various treatment modalities, botulinum toxin injection showed the highest response rate and lowest recurrence rate in both primary and refractory cases. Therefore, botulinum toxin could be reserved as a second-line treatment for contact granuloma in which the first treatment was not effective, but also could be used as a first-line treatment depending on the patient's and institution's situation. For recalcitrant nodules, injection of botulinum toxin into the bilateral thyroarytenoid muscle will reduce glottal contact force and result in a forceful chemical voice rest. In special situations, botulinum toxin injection could be one of the alternative treatment options for recalcitrant vocal nodules.
Keywords
Granuloma; Dysphonia; Botulinum toxin;
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1 Blitzer A, Brin MF. Laryngeal dystonia: a series with botulinum toxin therapy. Ann Otol Rhinol Laryngol 1991;100(2):85-9.   DOI
2 Blitzer A, Sulica L. Botulinum toxin: basic science and clinical uses in otolaryngology. Laryngoscope 2001;111(2):218-26.   DOI
3 Gibbs SR, Blitzer A. Botulinum toxin for the treatment of spasmodic dysphonia. Otolaryngol Clin North Am 2000;33(4):879-94.   DOI
4 Hoffman HT, Overholt E, Karnell M, McCulloch TM. Vocal process granuloma. Head Neck 2001;23(12):1061-74.   DOI
5 Carroll TL, Gartner-Schmidt J, Statham MM, Rosen CA. Vocal process granuloma and glottal insufficiency: an overlooked etiology? Laryngoscope 2010;120(1):114-20.   DOI
6 Orloff LA, Goldman SN. Vocal fold granuloma: successful treatment with botulinum toxin. Otolaryngol Head Neck Surg 1999;121(4):410-3.   DOI
7 Mitchell G, Pearson CR, Henk JM, Rhys-Evans P. Excision and lowdose radiotherapy for refractory laryngeal granuloma. J Laryngol Otol 1998;112(5):491-3.   DOI
8 Lee SW, Hong HJ, Choi SH, Sun DI, Park YH, Lee BJ, et al. Comparison of treatment modalities for contact granuloma: a nationwide multicenter study. Laryngoscope 2014;124(5):1187-91.   DOI
9 Damrose EJ, Damrose JF. Botulinum toxin as adjunctive therapy in refractory laryngeal granuloma. J Laryngol Otol 2008;122(8):824-8.   DOI
10 Lee SW, Park KN. Long-term efficacy of percutaneous steroid injection for treating benign vocal fold lesions: a prospective study. Laryngoscope 2016;126(10):2315-9.   DOI
11 Woo JH, Kim DY, Kim JW, Oh EA, Lee SW. Efficacy of percutaneous vocal fold injections for benign laryngeal lesions: prospective multicenter study. Acta Otolaryngol 2011;131(12):1326-32.   DOI
12 Allen JE, Belafsky PC. Botulinum toxin in the treatment of vocal fold nodules. Curr Opin Otolaryngol Head Neck Surg 2009;17(6):427-30.   DOI