Botulinum toxin A prolongs functional durability of voice prostheses in laryngectomees with pharyngoesophageal spasm

Am J Otolaryngol. 2009 Nov-Dec;30(6):371-5. doi: 10.1016/j.amjoto.2008.07.008. Epub 2009 Mar 9.


Purpose: Laryngectomized patients with pharyngoesophageal spasm frequently have poor voice quality and dysphagia. Local botulinum toxin A (BTA) injection can relieve muscular hypertonicity and improve symptoms. This procedure should also prolong the functional life span of the tracheoesophageal voice prosthesis.

Materials and methods: This study evaluates 33 BTA treatments in 11 laryngectomees. All patients were having poor voice quality; 6 patients had additional dysphagia. In 10 patients, the BTA injection has been carried out during rigid pharyngoscopy under general anesthesia. One patient was treated in local anesthesia.

Results: A subjective improvement of voice quality was reported in 94%. This lasted on average for 20 weeks. The swallowing function improved moderately. For the first time, the functional life span of voice prostheses was examined. After treatment of pharyngoesophageal spasm, their durability was almost tripled. The BTA therapy has a significant effect.

Conclusions: The BTA treatment improves voice quality and prolongs functional durability of voice prostheses in laryngectomees with pharyngoesophageal spasm. The success of treatment is of limited duration but can be repeated in the long-term.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Botulinum Toxins, Type A / administration & dosage
  • Botulinum Toxins, Type A / therapeutic use*
  • Deglutition Disorders / drug therapy
  • Deglutition Disorders / etiology
  • Female
  • Humans
  • Injections, Intramuscular
  • Laryngeal Neoplasms / complications
  • Laryngeal Neoplasms / surgery
  • Laryngectomy / adverse effects*
  • Larynx, Artificial*
  • Male
  • Middle Aged
  • Muscle Hypertonia / drug therapy
  • Muscle Hypertonia / etiology
  • Muscle Spasticity / drug therapy*
  • Muscle Spasticity / etiology
  • Neuromuscular Agents / administration & dosage
  • Neuromuscular Agents / therapeutic use*
  • Pharyngeal Muscles* / drug effects
  • Quality of Life
  • Retrospective Studies
  • Speech, Esophageal
  • Treatment Outcome
  • Voice Disorders / drug therapy
  • Voice Disorders / etiology


  • Neuromuscular Agents
  • Botulinum Toxins, Type A