Abstract
Objectives: Spasm of the pharyngoesophageal segment is one of the causes of failed tracheoesophageal voice. Botulinum toxin, a potent neurotoxin, has been successfully used to relieve the spasm and thus improving voice production. This study is aimed at assessing the improvement in voice production after botulinum toxin injection.
Methods: Ten patients with pharyngoesophageal spasm causing aphonia or hypertonic voice who were treated with botulinum toxin injection between 1995 and 2001 were included. Mean age of the patients was 59 years. There were 9 males and 1 female. The spastic or hypertonic segment in the pharyngoesophageal region was identified using video-fluo-roscopy and then infiltrated with 1% lignocaine. If effective in improving voice, botulinum toxin was then injected. The improvement in voice was assessed using the Sunderland voice rating scale.
Results: The seven previously aphonic patients developed voice following injection. Of the three hypertonic patients, two showed improvement in voice and one became hypotonic. This subsequently improved over time.
Conclusions: This study, being one of the first of its kind in the United Kingdom, shows that the botulinum toxin injection into the spastic pharyngoesophageal segment produces significant improvement in voice production in laryngectomies.