Evaluation of transnasal videoendoscopic-guided botulinum toxin injection in patients with adductor spasmodic dysphonia

<ns3:p>&lt;b&gt;Introduction:&lt;/b&gt; Adductor spasmodic dysphonia (ASD) is a focal laryngeal dystonia characterized by involuntary vocal fold spasms, resulting in a strained and effortful voice. Botulinum toxin injection is the standard treatment, typically performed using electromyography-guided techniques. &lt;br&gt;&lt;br&gt;&lt;b&gt;Aim: &lt;/b&gt;This study evaluates the efficacy of office-based transnasal videoendoscopic-guided botulinum toxin injection as an alternative to electromyography-guided percutaneous injection in patients with adductor spasmodic dysphonia (ASD). &lt;br&gt;&lt;br&gt;&lt;b&gt;Methods:&lt;/b&gt; A cohort of patients with ASD underwent transnasal laryngeal injections of botulinum toxin using a flexible video endoscope. Local anesthesia was administered, and a flexible needle was used to inject botulinum toxin into the vocal and/or vestibular folds. Phonation was assessed before and after the procedure. &lt;br&gt;&lt;br&gt;&lt;b&gt;Results:&lt;/b&gt; Twenty-seven patients with ASD showed significant improvements in VHI-10 (Voice Handicap Index-10) and VRQOL (Voice Related Quality of Life) scores post-injection. Additionally, the GRBAS scale scores improved after the procedure. &lt;br&gt;&lt;br&gt;&lt;b&gt;Conclusions:&lt;/b&gt; Office-based transnasal videoendoscopic-guided botulinum toxin injection is a reliable and straightforward technique for treating ASD. It can be performed without electromyography, making it accessible for all laryngologists.</ns3:p>