Presenters at several scientific sessions at the Combined Otolaryngology Spring Meeting (COSM) reported on their recent studies involving the use of botulinum toxin type A (Botox® [BTX]; Allergan, Inc., Irvine, CA) injections to treat adductor spasmodic dysphonia (ADSD) and chronic salivary aspiration.
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December 2007Botulinum toxin is produced by the bacterium Clostridium botulinum and achieves an irreversible neuromuscular blockade at presynaptic terminals, preventing the release of acetylcholine in response to action potentials.1 BTX cleaves to the SNARE protein, SNAP-25 (integral to the docking/release of acetylcholine vesicles at nerve endings), resulting in flaccid paralysis within a day or two that lasts for approximately three to four months.
During the past two decades, BTX therapy has been increasingly used to treat otolaryngological disorders of excessive or inappropriate muscle contraction before pursuing surgical options. These disorders include: