{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T01:05:27Z","timestamp":1771463127966,"version":"3.50.1"},"reference-count":48,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,7,6]],"date-time":"2023-07-06T00:00:00Z","timestamp":1688601600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100012161","name":"Faculty of Medicine, University of British Columbia","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012161","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To evaluate spasmodic dysphonia patients' perception of pain associated with laryngeal botulinum toxin (BTX) injections and to determine factors associated with higher pain scores relative to other included patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Prospective cohort study. Adult patients with adductor spasmodic dysphonia that presented to a tertiary laryngology practice for BTX injections were recruited from March to July 2022. Patients completed the visual analog scale (VAS) pre\u2010procedure to quantify predicted pain. Ten minutes post\u2010procedure they completed VAS and the short form McGill Pain Questionnaire (SF\u2010MPQ). Factors that may affect pain were extracted from charts. Descriptive statistics, univariate, and multivariate analyses were conducted (alpha\u2009=\u20090.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One hundred and nineteen patients were included (63\u2009\u00b1\u200914 yo, 26% Male). SF\u2010MPQ reported mild pain (4.12\u2009\u00b1\u20094.05 out of 45) with a pain intensity of none to mild (0.70\u2009\u00b1\u20090.89 out of 5). Bilateral injections yielded significantly higher SF\u2010MPQ scores (5.19\u2009\u00b1\u20094.66) than unilateral injections (3.30\u2009\u00b1\u20093.30) (<jats:italic>p<\/jats:italic>\u2009=\u20090.012). There was a significant VAS reduction from pre 28.9\u2009\u00b1\u200924.6\u2009mm (out of 10\u2009mm) to post 24.5\u2009\u00b1\u200922.3 (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). On multiple regression analyses, receiving a bilateral injection significantly (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05) contributed to a model that predicted higher pre\u2010VAS (<jats:italic>p<\/jats:italic>\u2009=\u20090.013). Bilateral injections (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05) and higher VHI\u201010 (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05) contributed to a model that predicted higher total SF\u2010MPQ (<jats:italic>p<\/jats:italic>\u2009=\u20090.001) and affective SF\u2010MPQ (<jats:italic>p<\/jats:italic>\u2009=\u20090.001) scores. Not being a professional voice user (PVU) significantly (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05) contributed to a model that predicted higher post\u2010VAS (<jats:italic>p<\/jats:italic>\u2009=\u20090.008) scores.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>BTX injections were well tolerated with low pain scores. Factors associated with higher relative predicted or experienced pain included bilateral versus unilateral injection, PVU status, and higher VHI\u201010.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4 <jats:italic>Laryngoscope<\/jats:italic>, 134:240\u2013246, 2024<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.30864","type":"journal-article","created":{"date-parts":[[2023,7,6]],"date-time":"2023-07-06T12:41:35Z","timestamp":1688647295000},"page":"240-246","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Spasmodic Dysphonia Patients' Perception of Pain with Botulinum Toxin Injections"],"prefix":"10.1002","volume":"134","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5086-9220","authenticated-orcid":false,"given":"Austin","family":"Heffernan","sequence":"first","affiliation":[{"name":"Division of Otolaryngology\u2010Head and Neck Surgery, Department of Surgery University of 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