Otorhinolaryngology

Patient reported voice outcomes following multi-disciplinary approach to botulism toxin for spasmodic dysphonia (2025)

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Type of publication:

Journal article

Author(s):

Kakar, Sahil; Gupta, Keshav Kumar; *Richards, Emma; Shirley, Colin; Bradley, Paige; Sonsale, Anita.

Citation:

Acta Otorrinolaringologica Espanola. 512261, 2025 Jun 19. [epub ahead of print]

Abstract:

PURPOSE: Spasmodic dysphonia (SD) is a debilitating disorder primarily affecting voice production. Current treatment includes repeat botulinum toxin (botox) injections for symptomatic management. The aim of this study is to review the impact of botox injections on patient reported outcome measures (PROM), using a novel and unique quality of life, proforma, and side effects in patients treated at our centre.

METHODS: This retrospective case series evaluated all patients who were treated in our specialised voice clinic, at a single tertiary referral centre between May 2019 and April 2024 with botox for SD. The primary outcome measure was PROM of voice quality weekly post-injection as per a unique proforma. Variables extracted included patient demographics, treatment specifics and complications.

RESULTS: Fifty-two patients were included representing 21 (40.4%) males. Forty-two (80.8%) suffered from adductor spasmodic dysphonia with 8 (15.4%) having abductor dysphonia and 1 (1.92%) with mixed dysphonia. Patients with abductor dysphonia had a statistical improvement in voice following dose 2, (1.8-3.0, p=0.03) and dose 3 (1.4-3.2, p = <0.001). Patients with adductor dysphonia had significant improvements in voice following all doses (2.1-2.9, p=0.01), (1.9-3.0, p = <0.01) and (2.1-3.0, p = <0.01). The most common complication was a 'breathy voice', ranging from 31.4% to 51.0% but all patients reported this as transient.

CONCLUSION: Patient reported quality of voice is improved following botox injections for spasmodic dysphonia, and most patients do not suffer from long-term complications.

DOI: 10.1016/j.otoeng.2025.512261

Orbital Onset: The Intricate Journey From Ear Abscess to Cavernous Sinus Thrombosis in a Diabetic Male (2023)

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Type of publication:Journal article

Author(s):*Ekomwereren, Osatohanmwen; Sunkara, Vyshnavidevi; Grezenko, Han; Hamid, Yusra H; Faran, Nuzhat; Abubakar, Muhammad.

Citation:Cureus. 15(11):e48922, 2023 Nov.

Abstract:Cavernous sinus thrombosis (CST) is a rare, yet severe condition often linked to infections in the nasal and facial areas. We present a case of a 43-year-old male farmer with diabetes who initially showed ear abscess symptoms that progressed to vision loss and CST-like symptoms. Self-treatment and an unidentified medication regimen may have worsened his condition. Advanced diagnostic evaluations, particularly magnetic resonance imaging with magnetic resonance venography, confirmed CST, likely originating from the ear infection spreading to the eyes, causing bilateral orbital cellulitis. Treatment with antibiotics, anticoagulants, and supportive therapy stabilized the patient's condition. This case emphasizes the importance of early detection and intervention in CST, especially in atypical presentations, and the need for comprehensive diagnostic and therapeutic approaches.

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Cerebrospinal fluid leak following a COVID-19 nasopharyngeal swab (2021)

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Type of publication:Journal article

Author(s):*Hill, Thomas ; *Sivapatham, Stefan; *Metcalfe, Christopher; *Tzortzis, Sevina

Citation:British Journal of Hospital Medicine (17508460); Nov 2022; vol. 82 (no. 11); p. 398-400

Abstract:The article describes the case of an adult who developed cerebrospinal fluid leak after taking a COVID-19 nasopharyngeal swab.

Description of a novel technique for creation of a custom-made prosthesis to aid vocalisation following laryngectomy (2021)

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Type of publication:
Journal article

Author(s):
*Halliday, E; *Beswick, H; *Bunn, S; *Ahsan, S F

Citation:
European Annals of Otorhinolaryngology, Head and Neck Diseases; Dec 2021; vol. 138 (no. 6); p. 475-477

Abstract:
There are various options to restore phonation after laryngectomy; one option involves using tracheo-oesophageal voice by placing a speaking valve through the tracheo-oesophageal wall. Some patients struggle to obtain good fixation of an adhesive base plate to the skin; this can result in air leakage and poor voice. We describe a technique using a custom-made prosthesis to provide a better base plate for fixation of the heat and moisture exchange cassette. This technique involves making an impression of the anterior neck around the laryngectomy stoma to create an anatomically fitted prosthesis, which accurately fills the void around the stoma. The custom-made prosthesis provides a more individualised fit compared to a standard base plate, helping improve vocalisation and communication.