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Neil Bhattacharyya, MD; Daniel Tarsy, MD

Arch Otolaryngol Head Neck Surg. 2001;127:389-392.

Objective  To determine the impact on quality of life of botulinum toxin treatments for common dystonias of the head and neck.

Design  Cross-sectional survey study of a patient cohort treated with botulinum toxin injections for spasmodic dysphonia (SD) or oromandibular dystonia (OMD).

Interventions and Outcome Measures  The Glasgow Benefit Inventory was used to quantify the health benefit of treatment. Data were collected for demographics, time intervals relative to diagnosis, treatment duration, and frequency of injections. The groups were compared to determine whether differences existed in benefit from treatment. Correlation analysis was conducted for inventory scores and time intervals.

Results  A total of 23 patients (5 with OMD and 18 with SD) completed the questionnaire. The mean total benefit score was +38.04 (possible range, -100 to +100) for the whole group (P<.001). The OMD group derived a nonsignificantly smaller benefit (+21.67 vs +42.59) (P = .07). The mean subscores for the combined group were +39.67, +26.81, and +42.75 for the general, social support, and physical health subscores, respectively (P.001). The difference in mean subscores between the 2 groups was not statistically significant, although patients with OMD had a lower social support subscore (+6.67 vs +32.41). No correlation was found between duration of therapy or frequency of injections and the Glasgow Benefit Inventory score.

Conclusions  Patients with OMD or SD derive considerable benefit when treated with botulinum toxin. The magnitude of benefit is largely independent of the time course of therapy. Treatment with botulinum toxin for these conditions is effective on the basis of quality-of-life criteria.

From the Division of Otolaryngology, Brigham and Women's Hospital (Dr Bhattacharyya), and Department of Neurology, Beth Israel Deaconess Medical Center (Dr Tarsy), Harvard Medical School, Boston, Mass.

Corresponding author and reprints: Neil Bhattacharyya, MD, Division of Otolaryngology, 333 Longwood Ave, Boston, MA 02115.

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