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Using botulinum toxin A to improve speech and swallowing function following total laryngectomy
1Department of Communicative Disorders, College of Health Professions, University of Florida Health Science Center, Gainesville, USA.
Archives of Otolaryngology--Head & Neck Surgery
|July 1, 1996
Summary
Botulinum toxin injections can improve voice and swallowing after laryngectomy by reducing pharyngoesophageal segment spasm. This minimally invasive technique offers functional benefits without significant complications.
Area of Science:
- Otolaryngology
- Speech Pathology
- Gastroenterology
Background:
- Laryngectomy can lead to pharyngoesophageal segment (PES) spasm, causing voice and swallowing difficulties.
- Current management options for PES spasm post-laryngectomy may be limited.
Purpose of the Study:
- To evaluate the efficacy of botulinum toxin A injections for reducing PES spasm in post-laryngectomy patients.
- To assess improvements in voice and swallowing function following the intervention.
Main Methods:
- Eight outpatients with post-laryngectomy voice/swallowing complaints underwent videofluoroscopic examination.
- Lidocaine was injected to identify and temporarily relax spasm, followed by transcutaneous botulinum toxin A injection.
- Patient-reported outcomes and videofluoroscopic PES function were assessed.
Main Results:
- Six of eight patients showed improved PES function after lidocaine.
- Four of five patients receiving botulinum toxin A injections experienced improved swallowing and/or voice.
- Three patients underwent repeat botulinum toxin A injections with no serious complications.
Conclusions:
- Transcutaneous botulinum toxin A injection under videofluoroscopic guidance is a safe and effective technique for improving voice and swallowing in post-laryngectomy patients with PES spasm.
- Further research is needed to optimize dosage and technique for sustained benefits.