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Clinical Note |

Airway Augmentation and Maintenance Through Laryngeal Chemodenervation in Children With Impaired Vocal Fold Mobility

Marshall E. Smith, MD; Albert H. Park, MD; Harlan R. Muntz, MD; Steven D. Gray, MD
Arch Otolaryngol Head Neck Surg. 2007;133(6):610-612. doi:10.1001/archotol.133.6.610.
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Botulinum toxin has a variety of therapeutic uses. In the larynx, it has mainly been used to treat the voice disorder known as spasmodic dysphonia. It has also been used to treat some patients with laryngeal disorders affecting breathing.13 These patients were generally found to have excessive laryngeal adduction during respiration.

Children frequently develop airway problems due to impaired vocal fold mobility. They are usually labeled as having bilateral vocal fold paresis or paralysis. It is difficult to document the cause of these disorders with laryngeal electromyography.4 We hypothesized that some of these children may have inappropriate synchrony of abductor and adductor laryngeal motor control due to either central dysfunction or peripheral nerve injury. This has also been termed laryngeal synkinesis.5 We tested this hypothesis by selectively injecting the thyroarytenoid muscles to weaken laryngeal adduction in an attempt to augment airway dimensions.

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