Botulinum neurotoxin injection after total laryngectomy

Area of Science:

• Otolaryngology
• Speech Pathology
• Surgical Innovation

Background:

• Pharyngoesophageal (PE) segment dysfunction is a key factor in tracheoesophageal (TEP) speech failure post-total laryngectomy.
• Current management strategies for TEP speech failure are limited.

Purpose of the Study:

• To evaluate the efficacy of botulinum neurotoxin (Botox) injections for improving TEP speech in patients with PE segment dysfunction.
• To introduce a novel chemical denervation approach for PE segment relaxation.

Main Methods:

• Retrospective and prospective analysis of eight patients undergoing Botox injections for TEP speech issues.
• Standardized injection techniques and subjective speech assessments by a speech pathologist.
• Objective pressure readings at the tracheostoma site during speech in a subset of patients.

Main Results:

• Seven out of eight patients demonstrated improved TEP speech after Botox injection.
• Five patients experienced substantial speech improvement, with three regaining speech ability.
• Botox injections were well-tolerated with no reported adverse events.

Conclusions:

• Botulinum neurotoxin (Botox) injection is a safe and effective treatment for TEP speech failure caused by PE segment dysfunction.
• This minimally invasive approach offers a viable option for selected patients.
• Further research may explore long-term outcomes and optimal dosing strategies.