Laryngeal botox injection improves work productivity in patients of spasmodic dysphonia: Study

The study is published in the JAMA Otolaryngology- Head & Neck Surgery.

Tanya K. Meyer and associates assessed whether employed patients with spasmodic dysphonia experience voice-related work productivity impairment before botulinum neurotoxin injection, and had a 10% or greater improvement in productivity 1 month after treatment with botulinum neurotoxin injection.

The authors enrolled a total of 101 patients, out of which only 75 completed the study. The eligible participants completed the following validated outcomes instruments immediately before and 1 month after outpatient laryngeal botulinum neurotoxin injection: the Work Productivity and Activity Impairment instrument (WPAI), Voice Handicap Index (VHI), and WorkHoarse. Demographic, comorbidity, and occupational voice use data were also collected at baseline.

The changes in outcome measures were tested using a paired 2-tailed t test. Exploratory subgroup analyses were analyzed with multivariable linear regression, adjusting for demographic, comorbidity, and voice use variables.

The following key findings were observed-

a. The mean (SD) age of the 75 completing participants was 55.7 (11.8) years and 53 (71%) were women.

b. The participants who completed the study had mean (SD) voice-related work productivity impairment of 43% (27%) at baseline and 22% (23%) at 1 month after botulinum neurotoxin injection (difference, 20% [27%] improvement; 95% CI, 14%-27%; effect size, 0.74).

Hence, the authors concluded that the association of spasmodic dysphonia with voice-related work productivity appeared greater in women than men with comparable outcomes with botulinum neurotoxin treatment, but this exploratory sex-associated difference requires independent validation.

doi:10.1001/jamaoto.2021.1745