J Korean Soc Laryngol Phoniatr Logoped.  2019 Dec;30(2):82-86. 10.22469/jkslp.2019.30.2.82.

Clinical Application of Botulinum Toxin to Contact Granuloma and Vocal Nodule

• Lee SW

• KMID: 2470489
• DOI: http://doi.org/10.22469/jkslp.2019.30.2.82

Abstract

In the field of otolaryngology-head and neck surgery, botulinum toxins are widely used for the treatment of spasmodic dysphonia and vocal tremors. Recently, the applications of botulinum toxin have gradually expanded with time, to include vocal fold granuloma, mutational falsetto, bilateral vocal cord paralysis, and chemical reduction for arytenoid dislocation as an adjunctive modality. According to a nation-wide multicenter study conducted by the Korean Society of Laryngology, Phoniatrics and Logopedics for treatment modality of contact granuloma, among the various treatment modalities, botulinum toxin injection showed the highest response rate and lowest recurrence rate in both primary and refractory cases. Therefore, botulinum toxin could be reserved as a second-line treatment for contact granuloma in which the first treatment was not effective, but also could be used as a first-line treatment depending on the patient's and institution's situation. For recalcitrant nodules, injection of botulinum toxin into the bilateral thyroarytenoid muscle will reduce glottal contact force and result in a forceful chemical voice rest. In special situations, botulinum toxin injection could be one of the alternative treatment options for recalcitrant vocal nodules.

Keyword

Granuloma; Dysphonia; Botulinum toxin

MeSH Terms

Botulinum Toxins*
Dislocations
Dysphonia
Granuloma*
Laryngeal Muscles
Neck
Otolaryngology
Recurrence
Tremor
Vocal Cord Paralysis
Vocal Cords
Voice
Botulinum Toxins