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

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 b...

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Bibliographic Details
Published in:Journal of laryngology and otology 2003-07, Vol.117 (7), p.544-548
Main Authors: Ramachandran, K., Arunachalam, P. S., Hurren, Anne, Marsh, R. L., Samuel, P. R.
Format: Article
Language:English
Subjects:
(RF) Otorhinolaryngology
Aged
Anti-Dyskinesia Agents - administration & dosage
Aphonia - etiology
Aphonia - therapy
Artificial
Barium
Biological and medical sciences
Botulinum toxin
Botulinum Toxins
Botulinum Toxins - administration & dosage
Carcinoma, Squamous Cell - complications
Carcinoma, Squamous Cell - surgery
Diseases of the upper aerodigestive tract
Dysphagia
Ent and stomatology
Esophageal Spasm, Diffuse - complications
Female
Fistula
Humans
Laryngeal Neoplasms - complications
Laryngeal Neoplasms - surgery
Laryngectomy
Larynx
Larynx, Artificial
Male
Medical sciences
Middle Aged
Patients
Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)
Spasticity
Speech, Alaryngeal - methods
Speech, Esophageal - methods
Treatment Outcome
Voice Disorders - complications
Voice Disorders - therapy
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Summary: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.
ISSN:0022-2151
1748-5460
DOI:10.1258/002221503322112978