Quantitative laryngeal electromyography parameters may correlate with improved outcomes following botulinum toxin injection for spasmodic dysphonia
Background Despite use of qualitative laryngeal electromyography (LEMG) guided botulinum toxin A (BoNT‐A) injection for treatment of adductor spasmodic dysphonia (AdSD), unsatisfactory injections and complete “misses” remain problematic. We aimed to determine if the quantitative LEMG measure of numb...
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| Veröffentlicht in: | Muscle & nerve 2021-04, Vol.63 (4), p.525-530 |
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| creator | Dwyer, Christopher D. Leclerc, Andrée‐Anne Nandedkar, Sanjeev D. Young, VyVy N. Rosen, Clark A. |
| description | Background
Despite use of qualitative laryngeal electromyography (LEMG) guided botulinum toxin A (BoNT‐A) injection for treatment of adductor spasmodic dysphonia (AdSD), unsatisfactory injections and complete “misses” remain problematic. We aimed to determine if the quantitative LEMG measure of number of small segments (NSS) correlates with voice outcomes following (BoNT‐A injection for AdSD.
Methods
Automated quantitative LEMG analysis was performed during electromyography (EMG) ‐guided BoNT‐A injection into the thyroarytenoid‐lateral cricoarytenoid muscle complex for treatment of AdSD. Pre‐injection phonatory NSS values were correlated with clinical voice outcomes and patient reported injection results.
Results
Quantitative LEMG measures were obtained for 45 AdSD patients (28 female, mean age 60.8 ± 12.8 years) during EMG‐guided BoNT‐A injection. Mean sampled NSS during phonation immediately prior to BoNT‐A injection was 524 ± 323 (range: 2–904). Mean follow up was 36.5 ± 9.4 days; one patient was lost to follow‐up. In comparison to their previous BoNT‐A injection, the current injection was rated as worse, same, and better by 13 (29.5%), 25 (56.8%), and 6 (13.6%) patients, respectively. All 4 (9.1%) patients with NSS |
| doi_str_mv | 10.1002/mus.27161 |
| format | Article |
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Despite use of qualitative laryngeal electromyography (LEMG) guided botulinum toxin A (BoNT‐A) injection for treatment of adductor spasmodic dysphonia (AdSD), unsatisfactory injections and complete “misses” remain problematic. We aimed to determine if the quantitative LEMG measure of number of small segments (NSS) correlates with voice outcomes following (BoNT‐A injection for AdSD.
Methods
Automated quantitative LEMG analysis was performed during electromyography (EMG) ‐guided BoNT‐A injection into the thyroarytenoid‐lateral cricoarytenoid muscle complex for treatment of AdSD. Pre‐injection phonatory NSS values were correlated with clinical voice outcomes and patient reported injection results.
Results
Quantitative LEMG measures were obtained for 45 AdSD patients (28 female, mean age 60.8 ± 12.8 years) during EMG‐guided BoNT‐A injection. Mean sampled NSS during phonation immediately prior to BoNT‐A injection was 524 ± 323 (range: 2–904). Mean follow up was 36.5 ± 9.4 days; one patient was lost to follow‐up. In comparison to their previous BoNT‐A injection, the current injection was rated as worse, same, and better by 13 (29.5%), 25 (56.8%), and 6 (13.6%) patients, respectively. All 4 (9.1%) patients with NSS < 200 rated their BoNT‐A injection result as worse than previous, and change in Voice Handicap Index‐10 (VHI‐10) scores were worse or without change.
Conclusions
Aiming for an NSS value greater than 200 during phonation prior to BoNT‐A toxin injection for AdSD may reduce unfavorable voice outcomes.</description><identifier>ISSN: 0148-639X</identifier><identifier>EISSN: 1097-4598</identifier><identifier>DOI: 10.1002/mus.27161</identifier><identifier>PMID: 33382480</identifier><language>eng</language><publisher>Hoboken, USA: John Wiley & Sons, Inc</publisher><subject>adductor spasmodic dysphonia ; Aged ; Aged, 80 and over ; Botulinum toxin ; Botulinum toxin type A ; Botulinum Toxins, Type A - pharmacology ; Current injection ; Dysphonia - diagnosis ; Dysphonia - drug therapy ; Dysphonia - physiopathology ; Electromyography ; Electromyography - methods ; Female ; Humans ; Injection ; Injections, Intramuscular - methods ; laryngeal dystonia ; laryngeal electromyography ; Laryngeal Muscles - drug effects ; Laryngeal Muscles - physiopathology ; Male ; Middle Aged ; Muscles ; number of small segments ; Patients ; Phonation ; Retrospective Studies ; Toxins ; Treatment Outcome ; Voice</subject><ispartof>Muscle & nerve, 2021-04, Vol.63 (4), p.525-530</ispartof><rights>2020 Wiley Periodicals LLC</rights><rights>2020 Wiley Periodicals LLC.</rights><rights>2021 Wiley Periodicals, LLC.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3531-b6013e7aeb0954749963714702a82c34a206c2ed368043ec6358f836a67d3d0e3</citedby><cites>FETCH-LOGICAL-c3531-b6013e7aeb0954749963714702a82c34a206c2ed368043ec6358f836a67d3d0e3</cites><orcidid>0000-0002-4417-7700 ; 0000-0003-2398-8018</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fmus.27161$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fmus.27161$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27903,27904,45553,45554</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33382480$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dwyer, Christopher D.</creatorcontrib><creatorcontrib>Leclerc, Andrée‐Anne</creatorcontrib><creatorcontrib>Nandedkar, Sanjeev D.</creatorcontrib><creatorcontrib>Young, VyVy N.</creatorcontrib><creatorcontrib>Rosen, Clark A.</creatorcontrib><title>Quantitative laryngeal electromyography parameters may correlate with improved outcomes following botulinum toxin injection for spasmodic dysphonia</title><title>Muscle & nerve</title><addtitle>Muscle Nerve</addtitle><description>Background
Despite use of qualitative laryngeal electromyography (LEMG) guided botulinum toxin A (BoNT‐A) injection for treatment of adductor spasmodic dysphonia (AdSD), unsatisfactory injections and complete “misses” remain problematic. We aimed to determine if the quantitative LEMG measure of number of small segments (NSS) correlates with voice outcomes following (BoNT‐A injection for AdSD.
Methods
Automated quantitative LEMG analysis was performed during electromyography (EMG) ‐guided BoNT‐A injection into the thyroarytenoid‐lateral cricoarytenoid muscle complex for treatment of AdSD. Pre‐injection phonatory NSS values were correlated with clinical voice outcomes and patient reported injection results.
Results
Quantitative LEMG measures were obtained for 45 AdSD patients (28 female, mean age 60.8 ± 12.8 years) during EMG‐guided BoNT‐A injection. Mean sampled NSS during phonation immediately prior to BoNT‐A injection was 524 ± 323 (range: 2–904). Mean follow up was 36.5 ± 9.4 days; one patient was lost to follow‐up. In comparison to their previous BoNT‐A injection, the current injection was rated as worse, same, and better by 13 (29.5%), 25 (56.8%), and 6 (13.6%) patients, respectively. All 4 (9.1%) patients with NSS < 200 rated their BoNT‐A injection result as worse than previous, and change in Voice Handicap Index‐10 (VHI‐10) scores were worse or without change.
Conclusions
Aiming for an NSS value greater than 200 during phonation prior to BoNT‐A toxin injection for AdSD may reduce unfavorable voice outcomes.</description><subject>adductor spasmodic dysphonia</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Botulinum toxin</subject><subject>Botulinum toxin type A</subject><subject>Botulinum Toxins, Type A - pharmacology</subject><subject>Current injection</subject><subject>Dysphonia - diagnosis</subject><subject>Dysphonia - drug therapy</subject><subject>Dysphonia - physiopathology</subject><subject>Electromyography</subject><subject>Electromyography - methods</subject><subject>Female</subject><subject>Humans</subject><subject>Injection</subject><subject>Injections, Intramuscular - methods</subject><subject>laryngeal dystonia</subject><subject>laryngeal electromyography</subject><subject>Laryngeal Muscles - drug effects</subject><subject>Laryngeal Muscles - physiopathology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Muscles</subject><subject>number of small segments</subject><subject>Patients</subject><subject>Phonation</subject><subject>Retrospective Studies</subject><subject>Toxins</subject><subject>Treatment Outcome</subject><subject>Voice</subject><issn>0148-639X</issn><issn>1097-4598</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kEtv1DAURi0EotPCgj-ALLFikdaPxHaWqOJRqQhVpRK7yOPcmfHIj2A7HfI7-ocxTGHX1d0cne_qIPSGknNKCLvwcz5nkgr6DK0o6WXTdr16jlaEtqoRvP9xgk5z3hNCqBLyJTrhnCvWKrJCDzezDsUWXew9YKfTEragHQYHpqTol7hNetoteNJJeyiQMvZ6wSamBE4XwAdbdtj6KcV7GHGci4keMt5E5-LBhi1exzI7G2aPS_xlA7ZhX902hsoknCedfRytweOSp10MVr9CLzbaZXj9eM_Q3aeP3y-_NNffPl9dfrhuDO84bdaCUA5Sw5r0XSvbvhdc0lYSphUzvNWMCMNg5EKRloMRvFMbxYUWcuQjAX6G3h299fefM-Qy7OOcQp0cWEcYY72QolLvj5RJMecEm2FK1tdQAyXDn_xDzT_8zV_Zt4_Gee1h_E_-612BiyNwsA6Wp03D17vbo_I3I9yTKg</recordid><startdate>202104</startdate><enddate>202104</enddate><creator>Dwyer, Christopher D.</creator><creator>Leclerc, Andrée‐Anne</creator><creator>Nandedkar, Sanjeev D.</creator><creator>Young, VyVy N.</creator><creator>Rosen, Clark A.</creator><general>John Wiley & Sons, Inc</general><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TK</scope><scope>7TM</scope><scope>7TS</scope><scope>7U7</scope><scope>7U9</scope><scope>C1K</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><orcidid>https://orcid.org/0000-0002-4417-7700</orcidid><orcidid>https://orcid.org/0000-0003-2398-8018</orcidid></search><sort><creationdate>202104</creationdate><title>Quantitative laryngeal electromyography parameters may correlate with improved outcomes following botulinum toxin injection for spasmodic dysphonia</title><author>Dwyer, Christopher D. ; Leclerc, Andrée‐Anne ; Nandedkar, Sanjeev D. ; Young, VyVy N. ; Rosen, Clark A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3531-b6013e7aeb0954749963714702a82c34a206c2ed368043ec6358f836a67d3d0e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>adductor spasmodic dysphonia</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Botulinum toxin</topic><topic>Botulinum toxin type A</topic><topic>Botulinum Toxins, Type A - pharmacology</topic><topic>Current injection</topic><topic>Dysphonia - diagnosis</topic><topic>Dysphonia - drug therapy</topic><topic>Dysphonia - physiopathology</topic><topic>Electromyography</topic><topic>Electromyography - methods</topic><topic>Female</topic><topic>Humans</topic><topic>Injection</topic><topic>Injections, Intramuscular - methods</topic><topic>laryngeal dystonia</topic><topic>laryngeal electromyography</topic><topic>Laryngeal Muscles - drug effects</topic><topic>Laryngeal Muscles - physiopathology</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Muscles</topic><topic>number of small segments</topic><topic>Patients</topic><topic>Phonation</topic><topic>Retrospective Studies</topic><topic>Toxins</topic><topic>Treatment Outcome</topic><topic>Voice</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dwyer, Christopher D.</creatorcontrib><creatorcontrib>Leclerc, Andrée‐Anne</creatorcontrib><creatorcontrib>Nandedkar, Sanjeev D.</creatorcontrib><creatorcontrib>Young, VyVy N.</creatorcontrib><creatorcontrib>Rosen, Clark A.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Physical Education Index</collection><collection>Toxicology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><jtitle>Muscle & nerve</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dwyer, Christopher D.</au><au>Leclerc, Andrée‐Anne</au><au>Nandedkar, Sanjeev D.</au><au>Young, VyVy N.</au><au>Rosen, Clark A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Quantitative laryngeal electromyography parameters may correlate with improved outcomes following botulinum toxin injection for spasmodic dysphonia</atitle><jtitle>Muscle & nerve</jtitle><addtitle>Muscle Nerve</addtitle><date>2021-04</date><risdate>2021</risdate><volume>63</volume><issue>4</issue><spage>525</spage><epage>530</epage><pages>525-530</pages><issn>0148-639X</issn><eissn>1097-4598</eissn><abstract>Background
Despite use of qualitative laryngeal electromyography (LEMG) guided botulinum toxin A (BoNT‐A) injection for treatment of adductor spasmodic dysphonia (AdSD), unsatisfactory injections and complete “misses” remain problematic. We aimed to determine if the quantitative LEMG measure of number of small segments (NSS) correlates with voice outcomes following (BoNT‐A injection for AdSD.
Methods
Automated quantitative LEMG analysis was performed during electromyography (EMG) ‐guided BoNT‐A injection into the thyroarytenoid‐lateral cricoarytenoid muscle complex for treatment of AdSD. Pre‐injection phonatory NSS values were correlated with clinical voice outcomes and patient reported injection results.
Results
Quantitative LEMG measures were obtained for 45 AdSD patients (28 female, mean age 60.8 ± 12.8 years) during EMG‐guided BoNT‐A injection. Mean sampled NSS during phonation immediately prior to BoNT‐A injection was 524 ± 323 (range: 2–904). Mean follow up was 36.5 ± 9.4 days; one patient was lost to follow‐up. In comparison to their previous BoNT‐A injection, the current injection was rated as worse, same, and better by 13 (29.5%), 25 (56.8%), and 6 (13.6%) patients, respectively. All 4 (9.1%) patients with NSS < 200 rated their BoNT‐A injection result as worse than previous, and change in Voice Handicap Index‐10 (VHI‐10) scores were worse or without change.
Conclusions
Aiming for an NSS value greater than 200 during phonation prior to BoNT‐A toxin injection for AdSD may reduce unfavorable voice outcomes.</abstract><cop>Hoboken, USA</cop><pub>John Wiley & Sons, Inc</pub><pmid>33382480</pmid><doi>10.1002/mus.27161</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0002-4417-7700</orcidid><orcidid>https://orcid.org/0000-0003-2398-8018</orcidid></addata></record> |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | adductor spasmodic dysphonia Aged Aged, 80 and over Botulinum toxin Botulinum toxin type A Botulinum Toxins, Type A - pharmacology Current injection Dysphonia - diagnosis Dysphonia - drug therapy Dysphonia - physiopathology Electromyography Electromyography - methods Female Humans Injection Injections, Intramuscular - methods laryngeal dystonia laryngeal electromyography Laryngeal Muscles - drug effects Laryngeal Muscles - physiopathology Male Middle Aged Muscles number of small segments Patients Phonation Retrospective Studies Toxins Treatment Outcome Voice |
| title | Quantitative laryngeal electromyography parameters may correlate with improved outcomes following botulinum toxin injection for spasmodic dysphonia |
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