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Comparison of botulinum toxin and propranolol for essential and dystonic vocal tremors
- Source :
- Clinics, Volume: 73, Article number: e87, Published: 16 JUL 2018, Clinics; v. 73 (2018); e87, Clinics; Vol. 73 (2018); e87, Clinics, Universidade de São Paulo (USP), instacron:USP, Clinics, Vol 73, Iss 0 (2018)
- Publication Year :
- 2018
- Publisher :
- Faculdade de Medicina / USP, 2018.
-
Abstract
- OBJECTIVES: Vocal tremors, which cause social difficulties for patients, may be classified as resting or action tremors. Of the vocal action tremors, essential and dystonic tremors are the most common. Botulinum toxin and oral medications have been used to treat vocal tremors, but no comparative clinical trials have been performed. The aim of this study was to compare the effects of botulinum toxin injection and the oral administration of propranolol in the treatment of essential and dystonic vocal tremors. METHODS: This clinical trial recruited 15 patients, divided into essential and dystonic vocal tremor groups. Patients in both groups received successive treatment with botulinum toxin and propranolol. The treatments were administered at different times; the order of treatment was randomly selected. Patients were assessed with flexible nasofibrolaryngoscopy and with perceptual and acoustic voice evaluations. A statistical significance level of 0.05 (5%) was used. RESULTS: Botulinum toxin produced statistically significant improvements in perceptual measures of vocal instability in patients with dystonic vocal tremors compared with baseline values and treatment with propranolol. The acoustic measure of variability in the fundamental frequency was significantly lower in patients with dystonic vocal tremors after treatment with botulinum toxin. CONCLUSION: Essential and dystonic vocal tremors responded differently to treatment. Dystonic vocal tremors responded significantly to treatment with botulinum toxin but not oral propranolol. Essential vocal tremors did not respond significantly to either treatment, perhaps due to the small number of patients, which is a limitation of this research.
- Subjects :
- Adrenergic beta-Antagonists
Botulinum Toxin
Propranolol
Electromyography
Vocal Tremor
Injections, Intramuscular
Statistics, Nonparametric
law.invention
03 medical and health sciences
0302 clinical medicine
Randomized controlled trial
law
Tremor
otorhinolaryngologic diseases
Medicine
Humans
Botulinum Toxins, Type A
030223 otorhinolaryngology
lcsh:R5-920
Voice Disorders
medicine.diagnostic_test
business.industry
Vocal tremor
Reproducibility of Results
General Medicine
Dystonic Tremor
Action tremor
Botulinum toxin
nervous system diseases
Treatment Outcome
Neuromuscular Agents
Dystonic Disorders
Anesthesia
Laryngeal Muscle
Original Article
Laryngeal Muscles
lcsh:Medicine (General)
business
030217 neurology & neurosurgery
Dystonic disorder
medicine.drug
Subjects
Details
- Language :
- English
- ISSN :
- 19805322 and 18075932
- Database :
- OpenAIRE
- Journal :
- Clinics, Volume: 73, Article number: e87, Published: 16 JUL 2018, Clinics; v. 73 (2018); e87, Clinics; Vol. 73 (2018); e87, Clinics, Universidade de São Paulo (USP), instacron:USP, Clinics, Vol 73, Iss 0 (2018)
- Accession number :
- edsair.doi.dedup.....9b2f68befc63f197d2bde704f79848bf