Journal article
Dyspnea Severity Index and Voice Handicap Index Following Botulinum Toxin Injection in Patients with Bilateral Vocal Fold Paralysis: A Case Series and Review of the Literature
Indian journal of otolaryngology, and head, and neck surgery, Vol.77(9), pp.3452-3459
09/2025
DOI: 10.1007/s12070-025-05662-7
Abstract
To report a case series of patients with bilateral vocal fold paralysis (BVFP) who underwent vocal fold botulinum toxin (Botox) injection and to review the literature on this rare treatment modality. Retrospective chart review. The medical records and video-recordings of patients who presented to the Voice and Swallowing Unit between April 2022 and September 2024 and were diagnosed with BVFP were reviewed. Only those who underwent office-based vocal fold Botox injection were included in this study. Outcome measures included dyspnea severity index (DSI), voice handicap index-10 (VHI-10), and glottal gap changes on laryngeal endoscopy. The mean follow-up period was 7.75 ± 6.7 weeks. A total of 10 patients with BVFP were included in this study. The male-to-female ratio was 3:7. The dose injected into each vocal fold varied between 1.25 IU to 2.5 IU. The mean DSI score decreased significantly from 26.2 ± 7.5 before the injection to 9.6 ± 4.4 after the injection (p = 0.001). A total of 9 patients had an improvement in voice quality, and one patient had no change in voice quality. The mean VHI-10 score decreased significantly from 24.8 ± 8.8 before the injection to 13.9 ± 9.5 after the injection (p = 0.004). The most common side effects were breathiness and aspiration. Vocal fold Botox injection in patients with bilateral vocal fold paralysis is an effective treatment. Patients with BVFP who experience worsening of their respiratory symptoms should be advised about this unfrequently used treatment alternative to glottal widening procedures.
Details
- Title: Subtitle
- Dyspnea Severity Index and Voice Handicap Index Following Botulinum Toxin Injection in Patients with Bilateral Vocal Fold Paralysis: A Case Series and Review of the Literature
- Creators
- Abdul-Latif HamdanZeina Maria SemaanLana GhzayelChristophe Abi Zeid DaouPatrick Abou Raji FeghaliMarwan Rizk - American University of Beirut Medical CenterRami SaadeMarc Mourad
- Resource Type
- Journal article
- Publication Details
- Indian journal of otolaryngology, and head, and neck surgery, Vol.77(9), pp.3452-3459
- DOI
- 10.1007/s12070-025-05662-7
- ISSN
- 2231-3796
- eISSN
- 0973-7707
- Publisher
- Springer
- Language
- English
- Electronic publication date
- 06/26/2025
- Date published
- 09/2025
- Academic Unit
- Anesthesia
- Record Identifier
- 9984843244202771
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