Botulinum toxin injection of the vocal fold for spasmodic dysphonia. A preliminary report.

A number of different therapies have been used in the management of spasmodic dysphonia. None are curative, and the results of the most widely used surgical procedure (resection of the recurrent laryngeal nerve) are not universally good, with a high recurrence rate in some series. Furthermore, the procedure is not reversible. Using a special electromyographic hypodermic needle, we injected botulinum A toxin into one of the vocal folds of two patients with severe spasmodic dysphonia. Both had significant improvement without any complications. Although the resultant paresis is not permanent, the injection can be repeated as needed as an outpatient procedure.