caa a22 4500 445356235 CHVBK 20180317142901.0 cr unu---uuuuu 170323e20110601xx s 000 0 eng 10.1007/s10072-011-0560-1 doi (NATIONALLICENCE)springer-10.1007/s10072-011-0560-1 Botulinum toxin type A: an effective treatment to restore phonation in laryngectomized patients unable to voice [Elektronische Daten] [Luigi Bartolomei, Sandro Zambito Marsala, Gian Pighi, Valentina Cristofori, Giuseppe Pagano, Massimo Pontarin, Manuela Gioulis, Corrado Marchini] We evaluated the efficacy of Botulinum toxin type A (BTXA) as an alternative to surgical intervention to facilitate phonation in 34 laryngectomized patients (31 males and 3 women) who were unable to produce tracheoesophageal voice because of spasm of the middle and inferior pharyngeal constrictor muscles (PCM). EMG was recorded to confirm activity in these muscles during attempted vocalization. Parapharyngeal nerve block (Carbocaine 2%, 5cc) was used to demonstrate short-term fluent voice after relaxation of the pharyngeal constrictor muscle. At a later occasion, 100U of Botox (Allergan) in ten patients and 50U in two patients were injected unilaterally at one location in the PCM percutaneously under EMG guidance. All patients then underwent a voice therapy program. In 11 out of 12 patients an improvement of phonation was evident after 24-48h and it was long lasting. This result was also seen in a patient previously myotomized without improvement. Only one patient needed to be reinjected every 3months. At a follow-up after 3months the EMG recorded in four patients showed a low-amplitude or complete absence of activity in the treated muscle. No side effects developed. BTX therapy, especially when associated with the speech therapy, is efficacious in restoring voice to laryngectomees who are unable to voice because of spasm of the PCMs. Our results confirm previous reports. This method is our approach of choice in managing PCM spasm because it is non-invasive, not painful, has few or no side effects, and is frequently long-lasting. Springer-Verlag, 2011 Botulinum toxin nationallicence Laryngectomy nationallicence Pharyngeal constrictor muscles spasm nationallicence Electromyography nationallicence Bartolomei Luigi Neurology, San Bortolo Hospital, Vicenza, Italy aut Zambito Marsala Sandro Neurology, San Martino Hospital, Ospedale San Martino di Belluno Viale Europa 22, Belluno, Italy aut Pighi Gian Otorinolaringoiatry, San Bortolo Hospital, Vicenza, Italy aut Cristofori Valentina Otorinolaringoiatry, San Bortolo Hospital, Vicenza, Italy aut Pagano Giuseppe Otorinolaringoiatry, San Martino Hospital, Belluno, Italy aut Pontarin Massimo Otorinolaringoiatry, San Bortolo Hospital, Vicenza, Italy aut Gioulis Manuela Neurology, San Martino Hospital, Ospedale San Martino di Belluno Viale Europa 22, Belluno, Italy aut Marchini Corrado Neurology, San Martino Hospital, Ospedale San Martino di Belluno Viale Europa 22, Belluno, Italy aut Neurological Sciences Springer Milan 32/3(2011-06-01), 443-447 1590-1874 32:3<443 2011 32 10072 https://doi.org/10.1007/s10072-011-0560-1 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10072-011-0560-1 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Bartolomei Luigi Neurology, San Bortolo Hospital, Vicenza, Italy aut NATIONALLICENCE 700 1- Zambito Marsala Sandro Neurology, San Martino Hospital, Ospedale San Martino di Belluno Viale Europa 22, Belluno, Italy aut NATIONALLICENCE 700 1- Pighi Gian Otorinolaringoiatry, San Bortolo Hospital, Vicenza, Italy aut NATIONALLICENCE 700 1- Cristofori Valentina Otorinolaringoiatry, San Bortolo Hospital, Vicenza, Italy aut NATIONALLICENCE 700 1- Pagano Giuseppe Otorinolaringoiatry, San Martino Hospital, Belluno, Italy aut NATIONALLICENCE 700 1- Pontarin Massimo Otorinolaringoiatry, San Bortolo Hospital, Vicenza, Italy aut NATIONALLICENCE 700 1- Gioulis Manuela Neurology, San Martino Hospital, Ospedale San Martino di Belluno Viale Europa 22, Belluno, Italy aut NATIONALLICENCE 700 1- Marchini Corrado Neurology, San Martino Hospital, Ospedale San Martino di Belluno Viale Europa 22, Belluno, Italy aut NATIONALLICENCE 773 0- Neurological Sciences Springer Milan 32/3(2011-06-01), 443-447 1590-1874 32:3<443 2011 32 10072 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer