Abstract
Background: Electromyography (EMG)-guided botulinum injection is recommended in clinical practice guideline for spasmodic dysphonia. However, other alternative techniques have been practiced in absence of EMG machine. Comparison of techniques is limited in the literatures.
Objective: This pilot study aims to compare the effectiveness of treatment between the EMG-guided technique and the endoscopic-guided technique in adductor spasmodic dysphonia.
Method: Five patients who were diagnosed with Adductor spasmodic dysphonia (AdSD) were enrolled and then randomized into 2 groups. Patient data (before and after treatment) were collected. The outcome measurement included voice analysis, voice handicap index (VHI), duration aspiration, duration of breathiness, mean effective duration, and satisfaction score (VAS). The difference between the pretreatment data and the posttreatment data at 1 and 3 months was compared in mean difference with 95% CI, mean, and standard deviation.
Result: The mean effective duration of the EMG group was 8 weeks and 10 ± 3.46 weeks for the endoscopic group. The difference in the mean effective duration between the groups was not statistically significant (P > 0.05). There were no significant differences in voice analysis differences in the EMG group and the endoscopic group after botulinum toxin injection 1 month and 3 months after treatment. (P > 0.05). There were no significant differences in adverse effects between the two groups in both duration of breathiness and duration of aspiration. Satisfaction score among 2 groups, the z-score is 0.41779. The p-value is 0.67448. The result is not statistically significant. (p < 0.05)
Conclusion: Botulinum toxin injection under endoscopic guidance is a feasible technique for the treatment of adductor spasmodic dysphonia in the context of lack of EMG equipment. And endoscopic guidance is also a simple and inexpensive device, composed of materials at hand in every ENT unit. However, we suggest that the optimal injection technique would be determined by surgeon training, equipment availability, and preferences.
DOI
10.56808/2673-060X.5362
Recommended Citation
Praditthum, Manintorn and Sombuntham, Premsuda
(2024)
"Comparison study of Endoscopic-guided versus Electromyography-guided Botulinum toxin injection treatments in Adductor spasmodic dysphonia,"
Chulalongkorn Medical Journal: Vol. 68:
Iss.
1, Article 6.
DOI: https://doi.org/10.56808/2673-060X.5362
Available at:
https://digital.car.chula.ac.th/clmjournal/vol68/iss1/6