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Related Experiment Video

Updated: Jan 9, 2026

Ultrasound-guided Botulinum Toxin-A Injections: A Method of Treating Sialorrhea
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Botulinum Toxin for Pediatric Vocal Cord Dysfunction: A Case Series.

Ahmed H Ali1, German P Digoy2

  • 1Otolaryngology, Creighton University School of Medicine, Omaha, USA.

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|December 8, 2025
PubMed
Summary

Botulinum toxin (BTX) effectively treats pediatric vocal cord dysfunction (VCD), especially in complex cases. This study shows BTX improves airway function and aids decannulation in children with VCD.

Keywords:
botulinum toxinlaryngeal dystoniaparadoxical vocal fold motionpediatrictracheostomyvocal cord dysfunction

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Area of Science:

  • Otolaryngology
  • Pediatric Pulmonology
  • Neurology

Background:

  • Vocal cord dysfunction (VCD) in children is a rare disorder.
  • It often presents with refractory symptoms and neurologic comorbidities.
  • Current treatments like voice therapy may be insufficient.

Purpose of the Study:

  • To evaluate the efficacy and safety of botulinum toxin (BTX) for pediatric VCD.
  • To assess BTX's impact on airway obstruction, dysphagia, and decannulation rates.

Main Methods:

  • Retrospective case series of 10 pediatric patients with VCD treated with BTX.
  • Pre- and post-treatment laryngoscopy and swallowing evaluations (FEES/MBSS) were performed.
  • BTX doses were titrated targeting specific laryngeal muscles.

Main Results:

  • 90% of patients showed improved glottic opening post-treatment.
  • BTX facilitated decannulation in all 4 patients with tracheostomies.
  • Significant improvements in dyspnea and swallowing were observed in non-tracheostomized patients.

Conclusions:

  • BTX is effective for pediatric VCD, particularly in neurologically complex or refractory cases.
  • Objective measures confirm improved glottic function and airway patency.
  • BTX aids in decannulation and improving quality of life for selected pediatric VCD patients.