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Use of botulinum toxin in voice restoration after laryngectomy

Published online by Cambridge University Press:  16 July 2009

S Khemani ,
R Govender ,
A Arora ,
P E O'Flynn  and
F M Vaz
S Khemani*
Affiliation:
Head and Neck Centre, University College Hospital, London, UK
R Govender
Affiliation:
Head and Neck Centre, University College Hospital, London, UK
A Arora
Affiliation:
Head and Neck Centre, University College Hospital, London, UK
P E O'Flynn
Affiliation:
Head and Neck Centre, University College Hospital, London, UK
F M Vaz
Affiliation:
Head and Neck Centre, University College Hospital, London, UK
*
Address for correspondence: Mr Sameer Khemani, Specialist Registrar in Otolaryngology, Head and Neck Centre, University College Hospital, 235 Euston Road, London NW1 2PQ, UK. E-mail: drsamk@hotmail.com
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Abstract

Background:

Following laryngectomy, a distinct population of patients fails to achieve successful tracheoesophageal voice. These patients' voices range from strained and effortful to none at all. Such patients may present with severe hypertonicity or spasm of the pharyngoesophageal segment. Botulinum toxin has been used to chemically denervate the pharyngeal musculature, and is an alternative to invasive surgical procedures. The aim of this article is to review the evidence for using botulinum toxin to achieve an improvement in post-laryngectomy voice.

Methods:

A Medline literature review (1966 to January 2009) and a search of the Cochrane database were performed. Foreign language articles and those not pertaining to post-laryngectomy voice restoration were excluded.

Results:

Nine articles reporting a total of 134 patients were identified. Although there were differences in the outcome measures used, objective improvement in voice production occurred in between 70 and 100 per cent of cases.

Conclusion:

Botulinum toxin can be used as a safe and cost-effective treatment in patients with confirmed pharyngoesophageal segment hypertonicity and/or spasm following laryngectomy, to obtain an improvement in voice quality.

Keywords

Botulinum ToxinsBotulinum Toxin Type ALaryngectomyVoiceSpeech
Type
Review Articles
Information
The Journal of Laryngology & Otology , Volume 123 , Issue 12 , December 2009 , pp. 1308 - 1313
Copyright
Copyright © JLO (1984) Limited 2009

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