• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.8 no.2
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• pp.199-203
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• 1997

In the treatment of spasmodic dysphonia, local injection of botulinum toxin A has been reported to be successful. The treatment of adductor type spasmodic dysphonia with botulinum toxin type A injection using a flexible nasopharyngoscope was conducted in 29 patients and using a telearyngoscope in 31 patients. These patients were given toxins in the vocal fold(s), unilaterally or bilaterally, under flexible nasopharyngoscopic guidance with sclerosing needle or telelaryngoscopic guidance with 23 gauge scalp needle attached by laryngeal forceps. Before the above procedure, laryngeal anesthesia was done with 2% pontocain instillation. Among the 60 patients, 59 patients were given the toxin successfully. Telephone interview were made at 2weeks and then at 4 weeks post injection. Among 29 patients using a flexible nasopharyngoscope, 75.8% and among 31 patients using a telelaryngoscope, 90.0% reported that the patients' symptom was improved. The functional status of the patient's disorder was classified into four grades. The mean pre-injection grade fir the patients using flexible nasopharyngoscope and telelaryngoscope was 1.6 and 2.1 respectively. And it was lowered to 0.7 and 1.1 respectively after the injection. The result was similar(p<0.05). As a self assessment method, the patients were asked to rate their voice on a scale of 100. In this study, the mean pre-injection score was 44 and 40 respectively. And it was improved to 77.7 and 69.8 respectively after the injection. The result was similar(p<0.05). In conclusion, botulinum toxin injection using a flexible nasopharyngoscope is also an effective method for the treatment of adductor type spasmodic dysphonia as using a telelaryngoscope.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.8 no.2
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• pp.204-209
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• 1997

In the treatment of spasmodic dysphonia, laryngeal injection of botulinum toxin has been reported to be successful. The treatment of adductor type spasmodic dysphonia with botulinum toxin type A injection using EMG was conducted in 24 patients and it's effect was compared with results from flexible nasopharyngoscopy guided injection(29 patients) and telelaryngoscopy guided injection(31 patients). Sixty two point five percent(62.5%) of patients using EMG and 75.8% of patients using flexible nasopharyngoscope and 90.0% of patients using telelaryngoscope reported that the patient's symptom was improved. The functional status of the patient's disorder was classified into low grades. The mean pre-injection grade for patients using EMG, flexible nasopharyngoscope and telelaryngoscope was 1.7, 1.6 and 2.1 respectively. And it was lowered to 1.0, 0.7 and 1.1 respectively after the injection. Results were similar(p＜0.05). As a self assessment method, patients were asked to rate their voice on a scale of 100. In this study, the mean pre-injection score was 66.3, 44.0 and 40.0 respectively. And it was improved to 74.8, 77.7 and 69.8 respectively after the injection. Among 23 patients who undergone above 3method, 17 patients(73.9%) told that EMG-guided botulinum injection was preferable method in its convenience and effectiveness. In conclusion, EMG guided botulinum toxin injection is an another effective method for the treatment of adductor type spasmodic dysphonia similar to telelaryngoscopy-guided injection and flexible nasopharyngoscopy guided injection.