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 botu linum toxin (BTX). Although the treatment is well tolerated and generally p roduces clinical voice improvement, it has never been statistically shown t o alter the patient's perception of voice quality or general health. Declin ing resources for medical carl mandate that treatment outcomes be documente d. 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 tre atment and 1 month after. Pretreatment and posttreatment scores were analyz ed with a Student's t-test. On the VHI, improvements in the patients' perce ption of their functional, physical. and emotional voice handicap reached s tatistical significance (p less than or equal to .0005). On the SF-36, pati ents had statistically significant improvements in mental health (p less th an or equal to .03) and social functioning (p less than or equal to .04). T reatment of SD with BTX significantly lessened the patients' perception of dysphonia. In addition, it improved their social functioning and their perc eption of their mental health These outcomes measure justify the continued treatment of SD with BTX. ued treatment of SD with BTX.