{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T18:36:03Z","timestamp":1760985363217},"reference-count":20,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2015,8,26]],"date-time":"2015-08-26T00:00:00Z","timestamp":1440547200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2016,3]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>Although onabotulinum neurotoxin A (BoNTA) has been used for over three decades for the treatment of adductor spasmodic dysphonia, no study has been performed to look at the trend of BoNTA dosages across time. The goal of this study is to evaluate the dosage trends to determine if the dosage necessary for voice improvement in patients increases over time.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Charts were reviewed for patients with 15 years or more of experience.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Linear regression analysis was performed to determine correlation coefficients and trends.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifty\u2010five patients receiving BoNTA injections by the senior author (<jats:sc>a.b<\/jats:sc>.) for over 15 years were evaluated. Thirty\u2010nine patients (82% female) met inclusion criteria. Patients received injections over an average of 18.6 years\u2009\u00b1\u20091.36 years, with the longest follow\u2010up of 21.5 years. Of 39 patients, 16 (41%) had a negative correlation coefficient (Pearson's r) suggesting a decrease over time, whereas 23 (59%) had a positive correlation coefficient suggesting an increase over time. The mean correlation coefficient was 0.139\u2009\u00b1\u20090.534 and <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05 in 19 patients and <jats:italic>P<\/jats:italic>\u2009&gt;\u20090.05 in 20 patients. R<jats:sup>2<\/jats:sup> for all patients were less than 0.75.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Onabotulinum neurotoxin A injection dosage trends vary depending on the individual over time. Overall, the dose range appears to be stable in the majority of patients, suggesting that tolerance does not play a significant part in dose variation over time.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4. <jats:italic>Laryngoscope<\/jats:italic>, 126:678\u2013681, 2016<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.25551","type":"journal-article","created":{"date-parts":[[2015,8,26]],"date-time":"2015-08-26T17:13:48Z","timestamp":1440609228000},"page":"678-681","source":"Crossref","is-referenced-by-count":16,"title":["Onabotulinum toxin <scp>A<\/scp> dosage trends over time for adductor spasmodic dysphonia: A 15\u2010year experience"],"prefix":"10.1002","volume":"126","author":[{"given":"Christopher G.","family":"Tang","sequence":"first","affiliation":[{"name":"New York Center for Voice and Swallowing Disorders New York New York U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Novakovic","sequence":"additional","affiliation":[{"name":"Sydney Medical School University of Sydney Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Niv","family":"Mor","sequence":"additional","affiliation":[{"name":"New York Center for Voice and Swallowing Disorders New York New York U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Blitzer","sequence":"additional","affiliation":[{"name":"New York Center for Voice and Swallowing Disorders New York New York U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,8,26]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/62.1.96"},{"key":"e_1_2_7_3_1","first-page":"237","article-title":"Laryngeal dystonia (spasmodic dysphonia): observations of 901 patients and treatment with botulinum toxin","volume":"78","author":"Brin MF","year":"1998","journal-title":"Adv Neurol"},{"key":"e_1_2_7_4_1","first-page":"1300","article-title":"Botulinum toxin (Botox) for the treatment of \"spastic dysphonia\" as part of a trial of toxin injections for the treatment of other cranial dystonias","volume":"96","author":"Blitzer A","year":"1986","journal-title":"Laryngoscope"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-199810000-00003"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.21395"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2007.01.035"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1615\/CritRevImmunol.v30.i2.50"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348941112000708"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.126.4.533"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1044\/1092-4388(2002\/037)"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0892-1997(03)00072-9"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.2307\/1412159"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0300-9084(00)00216-9"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1038\/365160a0"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/359832a0"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.toxicon.2009.02.034"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.imbio.2010.12.009"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.20020"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348940711601204"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2014.08.011"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Flary.25551","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.25551","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,26]],"date-time":"2023-09-26T10:16:49Z","timestamp":1695723409000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.25551"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,8,26]]},"references-count":20,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2016,3]]}},"alternative-id":["10.1002\/lary.25551"],"URL":"https:\/\/doi.org\/10.1002\/lary.25551","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"value":"0023-852X","type":"print"},{"value":"1531-4995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,8,26]]}}}