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Botulinum Toxin Therapy: A Series of Clinical Studies on Patients with Spasmodic Dysphonia in Japan

1
Department of Otolaryngology-Head and Neck Surgery, Kochi Medical School, Nankoku 783-8505, Japan
2
Integrated Center for Advanced Medical Technologies, Kochi Medical School Hospital, Nankoku 783-8505, Japan
3
Department of Medical Innovation, Osaka University Hospital, Suita 565-0871, Japan
4
Rehabilitation Department, Kochi Medical School Hospital, Nankoku 783-8505, Japan
5
Department of Communication Disorders, School of Rehabilitation, Health Sciences University of Hokkaido, Tobetsu 061-0293, Japan
*
Author to whom correspondence should be addressed.
Toxins 2021, 13(12), 840; https://doi.org/10.3390/toxins13120840
Received: 31 October 2021 / Revised: 14 November 2021 / Accepted: 19 November 2021 / Published: 25 November 2021
(This article belongs to the Special Issue Botulinum Toxins in Clinical Practice)
Spasmodic dysphonia (SD) is a rare voice disorder caused by involuntary and intermittent spasms of the laryngeal muscles. Both diagnosis and treatment have been controversial. Therefore, a series of clinical studies has recently been conducted in Japan. A nationwide epidemiological survey revealed that adductor SD predominated (90–95% of all cases; 3.5–7.0/100,000), principally among young women in their 20s and 30s. To facilitate early diagnosis, we created diagnostic criteria for SD and a severity grading system. The diagnostic criteria include the principal and accompanying symptoms, clinical findings during phonation, the treatment response, and the differential diagnoses. The severity grade is determined using a combination of subjective and objective assessments. Botulinum toxin (BT) injection is the treatment of choice; however, there have been few high-quality clinical studies and BT has been used off-label. We conducted a placebo-controlled, randomized, double-blinded clinical trial of BT therapy; this was effective and safe. BT treatment is now funded by the Japanese medical insurance scheme. Studies thus far have facilitated early diagnosis and appropriate therapy; they have fostered patient awareness of SD. View Full-Text
Keywords: spasmodic dysphonia; nationwide survey; diagnostic criteria; severity grading; placebo-controlled double-blind clinical trial spasmodic dysphonia; nationwide survey; diagnostic criteria; severity grading; placebo-controlled double-blind clinical trial
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MDPI and ACS Style

Hyodo, M.; Asano, K.; Nagao, A.; Hirose, K.; Nakahira, M.; Yanagida, S.; Nishizawa, N. Botulinum Toxin Therapy: A Series of Clinical Studies on Patients with Spasmodic Dysphonia in Japan. Toxins 2021, 13, 840. https://doi.org/10.3390/toxins13120840

AMA Style

Hyodo M, Asano K, Nagao A, Hirose K, Nakahira M, Yanagida S, Nishizawa N. Botulinum Toxin Therapy: A Series of Clinical Studies on Patients with Spasmodic Dysphonia in Japan. Toxins. 2021; 13(12):840. https://doi.org/10.3390/toxins13120840

Chicago/Turabian Style

Hyodo, Masamitsu, Kento Asano, Asuka Nagao, Kahori Hirose, Maya Nakahira, Saori Yanagida, and Noriko Nishizawa. 2021. "Botulinum Toxin Therapy: A Series of Clinical Studies on Patients with Spasmodic Dysphonia in Japan" Toxins 13, no. 12: 840. https://doi.org/10.3390/toxins13120840

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