Botulinum toxin injection for failed tracheo-oesophageal voice in laryngectomees: the Sunderland experience.

Abstract

Spasm of the pharyngo-oesophageal segment is one of the important causes of tracheo-oesophageal voice failure. Traditionally it has been managed by either prolonged speech therapy, surgical pharyngeal myotomy or pharyngeal plexus neurectomy with varying degrees of success. Botulinum neurotoxin has been found to be effective in relieving pharyngo-oesophageal segment spasm. Since 1995, we have used botulinum toxin injection on 10 laryngectomees with either aphonia or hypertonicity due to pharyngo-oesophageal segment spasm. Early results were analysed by the Sunderland Surgical Voice Restoration Rating scale. Seven of the 10 patients, who were previously completely aphonic, developed voice following this therapy and are using their valve choice as their only method of communication. Out of the three patients who were treated for hypertonic voice, two did derive some benefit from the procedure. One patient developed a hypotonic voice, which lasted for a few months.

• Authors: K Ramachandran, P S Arunachalam, Anne Hurren, R L Marsh, P R Samuel
• Journal: The Journal of laryngology and otology (J Laryngol Otol) Vol. 117 Issue 7 Pg. 544-8 (Jul 2003) ISSN: 0022-2151 [Print] England
• PMID: 12901809 (Publication Type: Journal Article)

Chemical References

• Anti-Dyskinesia Agents
• Botulinum Toxins

Topics

• Aged
• Anti-Dyskinesia Agents (administration & dosage)
• Aphonia (etiology, therapy)
• Botulinum Toxins (administration & dosage)
• Carcinoma, Squamous Cell (complications, surgery)
• Esophageal Spasm, Diffuse (complications)
• Female
• Humans
• Laryngeal Neoplasms (complications, surgery)
• Laryngectomy
• Larynx, Artificial
• Male
• Middle Aged
• Speech, Alaryngeal (methods)
• Speech, Esophageal (methods)
• Treatment Outcome
• Voice Disorders (complications, therapy)