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Botox injections restore voices, confidence to voice disorder patients

ANN ARBOR, MI -- An injection that's best known for smoothing wrinkles also helps restore the voices -- and the confidence -- of people with a voice disorder caused by spasms in their vocal cord muscles, a new University of Michigan study finds.

Botulinum toxin type A, known as Botox, has been used off-label for years to help people with spasmodic dysphonia, a rare and often-misdiagnosed voice disorder that makes the voice sound strained, broken or breathy. The shots relax the muscles in the vocal cords, just as they do to the muscles in the furrowed foreheads of those who use Botox for cosmetic reasons.

But until now, no long-term data have been available on how the repeated injections affect both patients' voices, and the emotional, social and physical functioning issues that collectively make up what experts call voice-related quality of life, or V-RQOL. Those answers are being published by a team from the U-M Health System's Vocal Health Center and Department of Otolaryngology -- and the effect is striking.

In the April issue of the Archives of Otolaryngology, Head and Neck Surgery, the team reports results from a prospective study of 36 patients with the adductory form of spasmodic dysphonia who were treated with Botox up to six times.

Nearly all showed dramatic and reproducible improvement on a standardized questionnaire that measured their V-RQOL. On a scale of 100, with 100 being perfect, the patients went from an average score of 30 before the first injection to an average score of around 80 afterward.

Patients entered the study at the time of their diagnosis with spasmodic dysphonia, and began treatment soon after. Following an initial injection, they returned for re-injection when their voice symptoms had gradually come back. The average time between injections for study participants was 25 weeks. The biggest jump in scores occurred from baseline to after the first treatment. But even after six injections, the d
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Contact: Kara Gavin
kegavin@umich.edu
734-764-2220
University of Michigan Health System
19-Apr-2004


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