Improving voice quality in laryngectomy patients with botulinum toxin A

IF 0.9 Q3 OTORHINOLARYNGOLOGY

Acta otorrinolaringologica espanola Pub Date : 2025-05-01 DOI:10.1016/j.otorri.2025.512222

Gonçalo Caetano , Filipa Morgado , Joana Póvoa , Francisco Branquinho

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引用次数: 0

Abstract

Introduction

Tracheoesophageal (TEP) speech is the main voice rehabilitation method following laryngectomy. Pharyngoesophageal hypertonicity is one of the main causes for failure to achieve tracheoesophageal speech after laryngectomy. Botulinum toxin A (BTA) has been used to chemically denervate the pharyngeal musculature, and is an alternative to invasive surgical procedures. The aim of this work is to study the effectiveness and safety of this procedure.

Material & methods

A retrospective cohort study from 2019 to 2023 was performed of 20 patients with failure to achieve a functional tracheoesophageal voice following laryngectomy. These patients undergone local pharyngoesophageal segment BTA injection. A total of 100 units of BTA were injected at 6 different sites, 3 in each side.

Perceptual ratings of voice quality were performed before and 72 h after BTA injection by a speech therapist using a 7-point equal-appearing interval scale.

Results

Speech quality mean rating (μ) improved from 2.05 before to 4.55 after BTA injection (P = .004), 17 (85%) patients had an improvement in postinjection perceptual TEP speech quality ratings, with scores in the good-to-excellent range (5–6 in the 7-point equal-appearing interval scale) in 12 patients (60%).

Three patients (15%) didn’t improve their voice quality, two of them with no discernible TEP speech.

No adverse effects were reported.

Conclusions

The majority of the patients enrolled in this study (85%) showed an improvement in TEP speech following BTA injection. This is a safe and effective method to improve TEP speech following laryngectomy.

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改善A型肉毒杆菌毒素喉切除术患者的语音质量

前言气管食管（TEP）语音是喉切除术后主要的语音康复方法。咽食道高张力是喉切除术后气管食道言语不能实现的主要原因之一。肉毒毒素A （BTA）已被用于化学去神经咽肌肉组织，是一种替代侵入性手术程序。这项工作的目的是研究该程序的有效性和安全性。材料,方法对2019 - 2023年20例喉切除术后气管食管声带功能缺失患者进行回顾性队列研究。患者行咽食管段局部BTA注射。在6个不同部位注射100个单位BTA，每侧3个。在BTA注射前和注射后72 h，由语言治疗师使用7分均等间隔量表对语音质量进行感知评分。结果语音质量平均评分（μ）由注射BTA前的2.05分提高到注射后的4.55分（P = .004），17例（85%）患者注射后感知TEP语音质量评分改善，12例（60%）患者评分在良至优（7分等出现间隔量表5-6分）。3名患者（15%）的语音质量没有改善，其中2名患者没有明显的TEP语音。无不良反应报告。结论本研究中大多数患者（85%）在注射BTA后TEP言语改善。这是一种安全有效的改善TEP术后言语的方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta otorrinolaringologica espanola OTORHINOLARYNGOLOGY-

CiteScore

1.40

自引率

20.00%

发文量

审稿时长

44 days

期刊介绍： Es la revista más importante en español dedicada a la especialidad. Ofrece progresos científicos y técnicos tanto a nivel de originales como de casos clínicos. Además, es la Publicación Oficial de la Sociedad Española de Otorrinolaringología y Patología Cérvico-Facial y está presente en los más prestigiosos índices de referencia.