For the first time in Clinical Hospital Center Rijeka Botulinum toxin (Botox) was successfully applied in the treatment of spasmodic dysphonia in two patients (from Slavonski Brod and Rijeka) thanks to the cooperation of the Institute of Audiology and Phoniatrics and the Clinic of Neurology of the Clinical Hospital Center Rijeka. Until now, patients have been referred to the University Center in Ljubljana, where Rijeka’s experts have been trained.
The process of applying botox to vocal cords was performed under the control of EMNG. The team who did the procedure are: the Head of the Department of Audiology and Phoniatrics, Prim. M.Sc. Tatjana Šepić, Phonocurgeon Dr. Dijana Maržić and Head Nurse Astrid Rodin, as well as the Head of the Clinic for Neurology Prim. Ass. prof. Vladimira Vuletić, MD Ph.D., Dr. Barbara Zadković, and Head Nurse Sanja Milinković.
Spasmodic dysphonia, also known as laryngeal dystonia, is a disorder in which the muscles that generate a person’s voice go into periods of spasm. This results in breaks or interruptions in the voice, often every few sentences, which can make a person difficult to understand. The exact cause of spasmodic dysphonia is unknown. Most cases result from problems in the parts of the brain (basal ganglia) that control movement, and involuntary muscle movements (spasms) that can affect the voice. The vocal muscles in the spasm cause the vocal cords to get too close or too far while the person uses his or her voice. Mostly women between the ages of 30 and 50 are affected by this disease.
Diagnosis and treatment are multidisciplinary. Treatment can only reduce the symptoms. This is why the botulinum toxin is used in small doses to help ease muscle spasms. Unfortunately, this is a procedure that must be repeatedly done because the effect of botox is temporary.
Botulinum toxin is mainly incorporated to enhance the mass of the vocal cords so that healthy vocal cords touch the diseased and thus restore the patient's voice. Patients are extremely pleased with the results as their voice returns to function.
"We cooperate with neurologists because extrapyramidal disorders also incorporate botox to help relax the vocal cords and facilitate speech for patients. The procedure is performed under local anesthesia, as well as the control of the ultrasound”, said Dr. Tatjana Šepić.