EMG Guided Botulinum Toxin Injection for Adductor Spasmodic Dysphonia

Video Type: CVideo
  • 2-5 min videos of a particular surgery or technique. These again show major events in the surgery
  • Clearly annotated and narration is a must in these videos
  • These have clear but concise abstracts are not able to be indexed in PubMed
  • Distributed in newsletters, featured on our website and social media
  • Peer reviewed

Author: Hagit Shoffel-Havakuk
Published:
Specialties: Laryngology, Otolaryngology
Schools: University of Southern California
1 vote, average: 5.00 out of 51 vote, average: 5.00 out of 51 vote, average: 5.00 out of 51 vote, average: 5.00 out of 51 vote, average: 5.00 out of 5 (1 votes, average: 5.00 out of 5)
You need to be a registered member to rate this post.
Loading...
Basic Info

Contributors: Christian Lava, Hagit Shoffel-havakuk, and Michael M Johns Iii

Adductor spasmodic dysphonia is the most common form of laryngeal dystonia, causing inappropriate glottic closure and strangled choppy voice. This video demonstrates step by step, the standard treatment for adductor spasmodic dysphonia: bilateral, EMG-guided, percutaneous botulinum toxin injections to the TA-LCA (thyroarytenoid and lateral cricoarytenoid) muscles.

Advanced

Procedure

In office EMG guided Botulinum Toxin injection for Adductor Spasmodic Dysphonia, in an awake patient.

Indications

The general indication is Adductor Spasmodic Dysphonia. However, there are several other indications such as, essential voice tremor with glottal stops and vocal fold granuloma.

Contraindications

- Known Hypersensitivity to Botulinum Toxin. - Pregnancy - Breast feeding - Neuromuscular junction diseases such as myasthenia gravis. - Aminoglycoside treatment

Instrumentation

Setup

An in office procedure, the patient is seated in a comfortable chair. EMG machine is operated by the assistant, reference and ground electrodes are attached to the patient¢ïïs skin using surface electrodes. Insulated 26G needle electrode is used for the injection of Botulinum Toxin.

Preoperative Workup

- Perceptual assessment of voice. - Careful laryngoscopic examination with videostroboscopy in order to exclude other laryngeal pathology. - Through neurologic physical examination and evaluation.

Anatomy and Landmarks

Thyroid cartilage; cricoid cartilage; cricothyroid membrane.

Advantages/Disadvantages

Patients' cooperation is required. In general the procedure should be repeated every 3 months. There is no standard botulinum toxin dose, the ideal dosage differ between patients. Advantages: in office procedure, effective treatment.

Complications/Risks

Patients should be advised of breathiness and dysphagia to liquids during initial period after injection.

Disclosure of Conflicts

None.

Acknowledgements

None.

References

None.

Share
0 replies

Leave a Reply

Want to join the discussion?
Feel free to contribute!

Leave a Reply