Botox jabs 'help voice disorder'

Botox injections improved patients' confidence levels

Botox - best known for its ability to erase wrinkles - provides long-term benefits to people who have problems speaking, scientists say.

People with the rare voice disorder spasmodic dysphonia have strained, broken or breathy voices.

But researchers from the University of Michigan found a course of botox, which relaxes vocal cord muscles, had significant long-term benefits.

The study is published in Archives of Otolaryngology, Head and Neck Surgery.

This treatment does have a significant and repeatable beneficial effect on the voice-related quality of life Dr Norman Hogikyan, University of Michigan

Spasmodic dysphonia is one of a group of disorders known as dystonias, in which the part of the brain that controls movement causes involuntary muscle motion in specific areas of the body.

It usually affects middle-aged women.

There are two types of spasmodic dysphonia - adductor, which affects the muscles that bring the vocal cords together, and the much less-common abductor form, which affects muscles that move them apart.

The condition can affect patients' confidence and quality of life.

Experts estimate that around 40,000 people in the UK have a type of dystonia, but they say many cases go undiagnosed, or misdiagnosed.

Doctors give botox shots to relax the muscles in the vocal cords, just as they do to the muscles in the furrowed foreheads of those who use botox for cosmetic reasons.

Botox is not licensed for treatment of the condition, but specialists can choose to prescribe it 'off licence' if they feel it will benefit the patient.

But, until now, there has been no long-term data has been available on how the repeated injections affect both patients' voices and their quality of life.

Vocal improvements

Researchers studied 36 patients with an average age of 51.

The patients were given up to six botox injections. Following an initial injection, they returned for re-injection when their voice symptoms had gradually come back, with an average time between injections of 25 weeks.

The patients were assessed using a recognised quality of life questionnaire.

They included questions about whether their vocal condition had stopped them doing something socially in the last couple of weeks, and how they rated their voices.

The biggest improvements were seen after the first treatment. Significant differences were also seen after six injections.

On a scale of 100, with 100 being perfect, the patients went from an average score of 30 before the first injection to an average score of around 80 afterwards.

The findings countered previous suspicions that the effect of botox diminishes after repeated injections.

Overall, 97% of the patients' pre-injection self-assessments rated their voice as poor or fair, but 74% of the post-injection assessments said their voices were good to excellent.

The study also showed patients felt better emotionally, physically and socially when their vocal symptoms were being treated.

Dr Norman Hogikyan, director of the University of Michigan Health System's Vocal Health Center, who led the research, said: "We now have good evidence that this treatment does have a significant and repeatable beneficial effect on the voice-related quality of life."

He added: "The voice means different things to different people, which is why we developed and validated a standardised tool to measure changes."

Eileen Gascoigne, chief executive of the UK Dystonia Society, told BBC News Online: "Treatment of laryngeal dystonia with botulinum toxin injections is increasing in the UK: although it is 'off licence', consultants are permitted to use it in this way.

"It is proving effective in many cases."

She added: "Some patients find that their response to the injections reduces over time.

"For some, changing to a different formulation of the treatment may help."