Outcomes assessment following treatment of spasmodic dysphonia with botulinum toxin

Spasmodic dysphonia (SD); disabling focal dystonia involving the laryngeal musculature is most commonly treated by the intramuscular injection of botulinum toxin (BTX). Although the treatment is well tolerated and generally produces clinical voice improvement, it has never been statistically shown to alter the patient's perception of voice quality or general health. Declining resources for medical carl mandate that treatment outcomes be documented. A prospective analysis of the effects of BTX on the patient's perception of voice and general health was undertaken. The Voice Handicap Index (VHI) and Short Form 36 (SF-36) surveys were administered to patients before treatment and 1 month after. Pretreatment and posttreatment scores were analyzed with a Student's t-test. On the VHI, improvements in the patients' perception of their functional, physical. and emotional voice handicap reached statistical significance (p less than or equal to .0005). On the SF-36, patients had statistically significant improvements in mental health (p less than or equal to .03) and social functioning (p less than or equal to .04). Treatment of SD with BTX significantly lessened the patients' perception of dysphonia. In addition, it improved their social functioning and their perception of their mental health These outcomes measure justify the continued treatment of SD with BTX. ued treatment of SD with BTX.