Mumbai: When speaking of botox, most people are aware of its cosmetic use to eliminate wrinkles, but not many would be aware of its use to smooth out vocal ‘wrinkles’. City doctors recently tapped into this use of botox to restore the voice of a 40-year-old falooda seller in Bhayandar, who had been suffering from vocal issues for the past 15-20 years.
In medical parlance, the patient was suffering from a neurological disorder called ‘adductor spasmodic dysphonia’, also known as laryngeal dystonia, which can affect the voice and speech. The condition is a lifelong condition, causing the muscles that generate a person’s voice to go into spasms. This is the first instance of botox being injected into the larynx (voice box) to treat this condition.
The patient continues to be closely monitored and has been counselled to come back for a second botox injection if his voice gets strained.
The patient had visited several doctors and begun treatment but never got complete relief. When he recently had to go see a doctor because of another episode of vocal strain it was hard for the doctor to understand him. He referred him to the SWAR Voice and Swallowing clinic at Apex Superspeciality Hospital, Borivali.
Experts Provide Details On The Case
Dr Binhi Desai, ENT and voice surgeon – otorhinolaryngologist, Apex Superspeciality Hospital, said that they performed a stroboscopy, which is the gold standard test for voice problems. The patient was diagnosed with spasmodic dysphonia, a very rare condition that afflicts one in 1,00,000 and usually, females between 30 and 50 years of age.
It is of three types - adductor (in which the muscles that close the voice box are affected), abductor (in which the muscles that open the voice box are affected) and a mixed type. It can coexist with other neurological conditions such as tremors and its condition is clinically difficult to diagnose. Botox is the treatment of choice in spasmodic dysphonia, with the affected muscle having to be injected.
Details On The Botox Procedure
“The patient was suffering from adductor spasmodic dysphonia. Under flexible laryngoscopy guidance and a team assisted by an ENT specialist, we carried out botox treatment where botox was administered to the affected voice box muscles. The procedure is painless and the patient’s voice became spasm-free after two weeks. He can now talk comfortably and confidently with everyone. The effect of botox lasts for four to six months,” she said.
She explained that the botox injection is mainly that of the botulinum toxin, a powerful neurotoxin produced by the bacterium Clostridium botulinum. It causes temporary paralysis of the muscle into which it is injected, thereby preventing it from having spasms. In this case, it would allow the person to speak in a normal voice.
“This is the first time Botox has been injected into the voice box for spasmodic dysphonia in the western suburb of Mumbai. The patient is under regular follow up and has been counselled to come again once the voice starts getting strained for a second botox injection,” Dr Desai concluded.