Premium
Botulinum toxin: Adjunctive treatment for posterior glottic synechiae
Author(s) -
Nathan CherieAnn O.,
Yin Shengguang,
Stucker Fred J.
Publication year - 1999
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1097/00005537-199906000-00002
Subject(s) - medicine , surgery , botulinum toxin , glottis , posterior commissure , vocal folds , anterior commissure , larynx , paresis , adjunctive treatment , nucleus , psychiatry
: Synechiae formation of the posterior glottis can result in tracheostomy dependence secondary to airway obstruction. Stenosis is caused by total or partial fixation of the vocal folds in adduction resulting from scar contracture. The treatment poses a management dilemma because of recurrent scar formation, made worse by mobility of the vocal folds. Although various treatment options from conservative endoscopic repair to open procedures have been proposed, the results are not satisfactory and patients often require multiple procedures. Methods : We present the trial of a conservative approach that includes microscopic CO 2 laser resection of the scar with concomitant botulinum toxin injection of the interarytenoid and thyroarytenoid muscles of the more mobile cord. This results in a temporary paresis of the adductor muscles and hence prevents overadduction in the posterior commissure during the postoperative healing period. Study Design : We present the surgical technique and results in three patients who underwent the procedure. Results : Treatment in all three patients was successful. Conclusions : The appropriate use of botulinum toxin may help improve the treatment outcome of posterior synechiae of the larynx without sacrificing any laryngeal components. Key Words : Larynx, stenosis, botulinum toxin.