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Surgery or Botulinum Toxin for Adductor Spasmodic Dysphonia: A Comparative Study.
- Source :
-
Annals of Otology, Rhinology & Laryngology . Apr2012, Vol. 121 Issue 4, p231-238. 8p. 3 Charts, 2 Graphs. - Publication Year :
- 2012
-
Abstract
- Objectives: Currently, botulinum toxin (Botox) injection is the standard of treatment for adductor spasmodic dysphonia (ADSD). We sought to compare the outcome of selective laryngeal adductor denervation-reinnervation (SLAD-R) surgery for ADSD to that of Botox injections. Methods: Patient-oriented measures (VHI-10) and objective single-blinded gradings of digital voice recordings were utilized as outcome measures. The surgical cohort, recruited by retrospective patient selection, consisted of 77 patients with a mean follow-up time of 7.54 ± 2.55 years (range, 2.2 to 14.2 years). The injection cohort, recruited prospectively, inciuded 28 patients with a mean follow-up time of 46.37 ±5.51 days (range, 36 to 54 days). Results: As measured by the VHI-10, the surgical patients had significantly improved voice handicap outcome scores (mean, 14.4 ± 13.6) as compared to the patients who had Botox injection (mean, 26.5 ± 12.1; p = 0.001). Aside from VHI- 10 item 2, the surgical group demonstrated significantly improved voice-related function on each VHI-10 component (p = 0.01). Within the injection subgroup, 88% agreed that Botox successfully treats their ADSD, yet only 63% agreed that Botox improves their speech consistently. Within the surgical subgroup, 82% would recommend this surgery to others, and 78% agreed that their voice was actually better after surgery than after Botox. Objective voice ratings demonstrated similar levels of breathiness and overall voice quality in the treatment subgroups. Conclusions: When indicated, the SLAD-R surgery for ADSD demonstrates outcomes equal to or superior to those of the current standard of Botox injections. [ABSTRACT FROM AUTHOR]
- Subjects :
- *BOTULINUM toxin
*THERAPEUTICS
*CHI-squared test
*COMPARATIVE studies
*CONFIDENCE intervals
*STATISTICAL correlation
*FISHER exact test
*HEALTH outcome assessment
*SCALES (Weighing instruments)
*SOUND recordings
*STATISTICS
*T-test (Statistics)
*U-statistics
*DATA analysis
*TREATMENT effectiveness
*BLIND experiment
*RETROSPECTIVE studies
*DATA analysis software
*SPASMODIC dysphonia
*DESCRIPTIVE statistics
Subjects
Details
- Language :
- English
- ISSN :
- 00034894
- Volume :
- 121
- Issue :
- 4
- Database :
- Academic Search Index
- Journal :
- Annals of Otology, Rhinology & Laryngology
- Publication Type :
- Academic Journal
- Accession number :
- 74628309
- Full Text :
- https://doi.org/10.1177/000348941212100408