{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T09:18:22Z","timestamp":1793092702754,"version":"4.5.0"},"reference-count":19,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,12,29]],"date-time":"2023-12-29T00:00:00Z","timestamp":1703808000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2024,5]]},"abstract":"Objectives<\/jats:title>There is an absence of data in the literature regarding methods to improve the patient experience during the performance of awake in\u2010office laryngeal injections. This study sought to evaluate whether the use of local anesthetic or a vibrating instrument decreased overall pain experienced by patients with laryngeal dystonia, frequently referred to as spasmodic dysphonia (SD), undergoing transcervical botulinum toxin injections.<\/jats:p><\/jats:sec>Methods<\/jats:title>This was an unblinded, prospective randomized control trial with a crossover design where each patient received transcutaneous transcricothyroid injection of botulinum toxin with alternating use of no anesthesia, local anesthesia (2% lidocaine in 1:100,000 epinephrine), and vibrating instrument in three consecutive laryngeal injections to treat adductor SD. Patients were randomized to the order they received these treatments. Patients measured pain on a 0\u201310 visual analogue scale (VAS) and selected their preferred technique after receiving all three analgesic modalities.<\/jats:p><\/jats:sec>Results<\/jats:title>Thirty\u2010two patients completed the study. There was no statistically significant difference in pain between the three analgesic techniques (p<\/jats:italic>\u2009=\u20090.38). The most preferred analgesic technique was the vibrating wand (44% (14\/32)). Lidocaine was the second most preferred (37% (12\/32)) and 19% (6\/32) of patients preferred nothing. When combining the wand and nothing groups, 63% of patients preferred one of these two methods (95% exact CI: 44%\u201379%).<\/jats:p><\/jats:sec>Conclusion<\/jats:title>There was no statistically significant difference in median pain experienced by patients during laryngeal botulinum toxin injection between these different analgesic modalities. More than half of the patients selected a preference for a technique that did not include lidocaine. This data supports individualization of analgesia during transcutaneous laryngeal injections.<\/jats:p><\/jats:sec>Level of Evidence<\/jats:title>2 Laryngoscope<\/jats:italic>, 134:2277\u20132281, 2024<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.31208","type":"journal-article","created":{"date-parts":[[2023,12,29]],"date-time":"2023-12-29T15:54:36Z","timestamp":1703865276000},"page":"2277-2281","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Analgesia in Transcutaneous Laryngeal Botulinum Toxin Injections: A Randomized Crossover Trial"],"prefix":"10.1002","volume":"134","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6923-3131","authenticated-orcid":false,"given":"Richard","family":"Heyes","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology\u2014Head and Neck Surgery Mayo Clinic Arizona Phoenix Arizona U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles H.","family":"Adler","sequence":"additional","affiliation":[{"name":"Department of Neurology Mayo Clinic Arizona Phoenix Arizona U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"Yee","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Bioinformatics Mayo Clinic Arizona Phoenix Arizona U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6541-9687","authenticated-orcid":false,"given":"David G.","family":"Lott","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2014Head and Neck Surgery Mayo Clinic Arizona Phoenix Arizona U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8512-232X","authenticated-orcid":false,"given":"William E.","family":"Karle","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Northwell New Hyde Park NY U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,12,29]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2011.08.011"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1159\/000059525"},{"issue":"4","key":"e_1_2_6_4_1","first-page":"551","article-title":"Spasmodic dysphonia: a review. Part 1: pathogenic factors","volume":"157","author":"Hintze JM","year":"2017","journal-title":"Surgery"},{"issue":"1","key":"e_1_2_6_5_1","first-page":"S1","article-title":"Clinical practice guideline: hoarseness (dysphonia) (update)","volume":"158","author":"Stachler RJ","year":"2018","journal-title":"Surgery"},{"key":"e_1_2_6_6_1","article-title":"Position statement: botulinum toxin treatment","author":"AAO\u2010HNS","journal-title":"Am Acad Otolaryngol\u2010Head Neck Surg"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2021.104131"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/1090820X11422809"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599819835503"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.22185"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.29238"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24010"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.27061"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.27696"},{"issue":"4","key":"e_1_2_6_15_1","first-page":"825","article-title":"Effectiveness of vibratory stimulation on needle\u2010related procedural pain in children: a systematic review protocol","volume":"16","author":"Ueki S","year":"2018","journal-title":"JBI Evid Synth"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.150.3699.971"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00266-013-0264-4"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/asj\/sjx073"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1177\/0145561319839839"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2020.04.037"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.31208","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,24]],"date-time":"2024-07-24T10:54:03Z","timestamp":1721818443000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.31208"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,29]]},"references-count":19,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2024,5]]}},"alternative-id":["10.1002\/lary.31208"],"URL":"https:\/\/doi.org\/10.1002\/lary.31208","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"value":"0023-852X","type":"print"},{"value":"1531-4995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,12,29]]},"assertion":[{"value":"2023-04-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-11-16","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-12-29","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}