Quantitative laryngeal electromyography parameters may correlate with improved outcomes following botulinum toxin injection for spasmodic dysphonia

Background Despite use of qualitative laryngeal electromyography (LEMG) guided botulinum toxin A (BoNT‐A) injection for treatment of adductor spasmodic dysphonia (AdSD), unsatisfactory injections and complete “misses” remain problematic. We aimed to determine if the quantitative LEMG measure of numb...

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Bibliographic Details
Published in:Muscle & nerve 2021-04, Vol.63 (4), p.525-530
Main Authors: Dwyer, Christopher D., Leclerc, Andrée‐Anne, Nandedkar, Sanjeev D., Young, VyVy N., Rosen, Clark A.
Format: Article
Language:English
Subjects:
adductor spasmodic dysphonia
Aged
Aged, 80 and over
Botulinum toxin
Botulinum toxin type A
Botulinum Toxins, Type A - pharmacology
Current injection
Dysphonia - diagnosis
Dysphonia - drug therapy
Dysphonia - physiopathology
Electromyography
Electromyography - methods
Female
Humans
Injection
Injections, Intramuscular - methods
laryngeal dystonia
laryngeal electromyography
Laryngeal Muscles - drug effects
Laryngeal Muscles - physiopathology
Male
Middle Aged
Muscles
number of small segments
Patients
Phonation
Retrospective Studies
Toxins
Treatment Outcome
Voice
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Summary:Background Despite use of qualitative laryngeal electromyography (LEMG) guided botulinum toxin A (BoNT‐A) injection for treatment of adductor spasmodic dysphonia (AdSD), unsatisfactory injections and complete “misses” remain problematic. We aimed to determine if the quantitative LEMG measure of number of small segments (NSS) correlates with voice outcomes following (BoNT‐A injection for AdSD. Methods Automated quantitative LEMG analysis was performed during electromyography (EMG) ‐guided BoNT‐A injection into the thyroarytenoid‐lateral cricoarytenoid muscle complex for treatment of AdSD. Pre‐injection phonatory NSS values were correlated with clinical voice outcomes and patient reported injection results. Results Quantitative LEMG measures were obtained for 45 AdSD patients (28 female, mean age 60.8 ± 12.8 years) during EMG‐guided BoNT‐A injection. Mean sampled NSS during phonation immediately prior to BoNT‐A injection was 524 ± 323 (range: 2–904). Mean follow up was 36.5 ± 9.4 days; one patient was lost to follow‐up. In comparison to their previous BoNT‐A injection, the current injection was rated as worse, same, and better by 13 (29.5%), 25 (56.8%), and 6 (13.6%) patients, respectively. All 4 (9.1%) patients with NSS 
ISSN:0148-639X
1097-4598
DOI:10.1002/mus.27161