Assessment of Patients Receiving Short-Interval Botulinum Toxin Chemodenervation Treatment for Laryngeal Dystonia and Essential Tremor of the Vocal Tract

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dc.catalogadordfo
dc.contributor.authorLagos Villaseca, Antonia Elisa
dc.contributor.authorBhatt, Neel K.
dc.contributor.authorAbdolhosseini, Parirash
dc.contributor.authorQuinonez, Leonel
dc.contributor.authorPaoletti, Marcus F.
dc.contributor.authorGochman, Grant
dc.contributor.authorJohns, Michael M.
dc.contributor.authorRosen, Clark A.
dc.contributor.authorKao,Tzu-Cheg
dc.contributor.authorMeyer, Tanya K.
dc.date.accessioned2024-06-05T19:55:09Z
dc.date.available2024-06-05T19:55:09Z
dc.date.issued2023
dc.description.abstractImportanceThe gold-standard treatment for laryngeal dystonia (LD) and essential tremor of the vocal tract (ETVT) is botulinum toxin (BoNT) chemodenervation. Although safe and effective, it is not curative, and periodic injections are required. Some medical insurance companies only cover injections at a 3-month interval, though some patients benefit from injections more frequently.ObjectiveTo determine the proportion and characteristics of patients who receive BoNT chemodenervation treatment in intervals shorter than 90 days.Design, Setting, and ParticipantsThis retrospective cohort study across 3 quaternary care neurolaryngology specialty practices in Washington and California recruited patients who underwent at least 4 consecutive laryngeal BoNT injections for LD and/or ETVT in the past 5 years. Data were collected from March through June 2022 and analyzed from June through December 2022.ExposureLaryngeal BoNT treatment.Main Outcomes and MeasuresBiodemographic and clinical variables, injection characteristics, evolution during the 3 interinjection intervals, and lifetime laryngeal BoNT treatment data were collected from patient medical records. Logistic regression was used to assess association to the short-interval outcome, defined as an average injection interval shorter than 90 days.ResultsOf 255 patients included from the 3 institutions, 189 (74.1%) were female, and the mean (SD) age was 62.7 (14.3) years. The predominant diagnosis was adductor LD (n = 199 [78.0%]), followed by adductor dystonic voice tremor (n = 26 [10.2%]) and ETVT (n = 13 [5.1%]). Seventy patients (27.5%) received short-interval injections (<90 days). The short-interval group was younger than the long-interval group (≥90 days), with a mean (SD) age of 58.6 (15.5) years and 64.2 (13.5) years, respectively, and a mean difference of −5.7 years (95% CI, −9.6 to −1.8 years). There were no patient-related differences between the short- and long-interval groups in terms of sex, employment status, or diagnosis.Conclusions and RelevanceThis cohort study demonstrated that while insurance companies often mandate a 3-month or greater interval for BoNT chemodenervation financial coverage, there is a considerable subset of patients with LD and ETVT who receive short-interval treatment to optimize their vocal function. Short-interval chemodenervation injections demonstrate a similar adverse effect profile and do not appear to predispose to resistance through antibody formation.
dc.fuente.origenORCID
dc.identifier.doi10.1001/jamaoto.2023.0162
dc.identifier.urihttp://dx.doi.org/10.1001/jamaoto.2023.0162
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/86469
dc.information.autorucEscuela de Medicina; Lagos Villaseca, Antonia Elisa; 0000-0002-2579-5474; 185024
dc.issue.numero7
dc.language.isoen
dc.nota.accesoContenido parcial
dc.pagina.final620
dc.pagina.inicio615
dc.revistaJAMA Otolaryngology–Head & Neck Surgery
dc.rightsacceso restringido
dc.subject.ddc610
dc.subject.deweyMedicina y saludes_ES
dc.titleAssessment of Patients Receiving Short-Interval Botulinum Toxin Chemodenervation Treatment for Laryngeal Dystonia and Essential Tremor of the Vocal Tract
dc.typeartículo
dc.volumen149
sipa.codpersvinculados185024
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