Authors: Theodores D, Scudamore S, Baldock P, Coman S, Hancock K
Title: The effects of botox and voice therapy in the management of severe muscle tension dysphonia: A case study
Source: Journal of Medical Speech Language Pathology 2007 15(3): 293-304
Year: 2007
Research Design: Single Case Design

This study reports the case of a 61-year-old female participant with severe, intractable muscle tension dysphonia and ventricular phonation treated with botulinum toxin-A (Botox) and subsequent voice therapy. Following bilateral injections of Botox, the participant received 6 months of regular voice therapy aimed at reducing laryngeal constriction. Perceptual ratings of vocal quality, acoustic analyses of voice (fundamental frequency, relative average perturbation, shimmer, noise-to-harmonic ratio, voice turbulence index), and videolaryngoscopic evaluations of laryngeal function were conducted pre- and post-Botox injections at regular intervals over a 7-month period. In addition, the participant completed the Voice Handicap Index during each assessment. Results revealed gradual improvements in perceptual and acoustic parameters of vocal quality over the treatment period. Supraglottic constriction reduced after the initial Botox treatment. This improvement was maintained for the duration of the study. The Voice Handicap Index ratings indicated the participant perceived quality of life improvements following Botox and voice therapy. It was concluded that the combination of Botox and voice therapy was effective.

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