{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T04:04:57Z","timestamp":1789790697456,"version":"4.0.1"},"reference-count":37,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:00:00Z","timestamp":1789689600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:00:00Z","timestamp":1789689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"abstract":"ABSTRACT<\/jats:title>\n \n Objective<\/jats:title>\n Central\/peripheral vagal hypersensitivity underpins laryngeal sensory dysfunction (LSD). Botulinum toxin type A (BoNT\u2010A) injection has emerged as a targeted treatment for modulating laryngeal sensory pathways. This study aimed to evaluate short\u2010term outcomes and predictors of response following supraglottic BoNT\u2010A injection in patients with refractory LSD.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Retrospective cohort study of patients undergoing supraglottic BoNT\u2010A injection treatment between 2019 and 2025 for LSD symptoms refractory to medical\/behavioral therapy. Outcome measures included the Newcastle Laryngeal Hypersensitivity Questionnaire (LHQ), Reflux Symptom Index (RSI), Cough Severity Index (CSI), and Voice Handicap Index\u201010 (VHI\u201010). Pre\u2010 and post\u2010treatment scores were compared using paired statistical tests and effect size estimation. Treatment characteristics and follow\u2010up duration were reported, along with attainment of minimal clinically important difference (MCID) and predictors of response.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Eighty consecutive patients (mean age 58.3\u2009years; 48 female) showed significant improvement across hypersensitivity domains: LHQ +3.1 (95% CI: 2.4\u20133.8,\n p<\/jats:italic>\n \u2009<\u20090.001), RSI \u22127.9 points (95% CI: \u22129.7 to \u22125.8,\n p<\/jats:italic>\n \u2009<\u20090.001), CSI \u22125.7 points (\n p<\/jats:italic>\n \u2009<\u20090.001). VHI\u201010 was unchanged (\u22121.3,\n p<\/jats:italic>\n \u2009=\u20090.20). MCID thresholds were achieved in 64% for LHQ and 56% for RSI. Overall, 71% of patients reported phenotypic and clinically relevant improvement. Patients with a positive short\u2010term superior laryngeal nerve (SLN) block were more likely to respond to supraglottic BoNT. No serious complications occurred.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Supraglottic BoNT\u2010A injection is a safe, effective treatment for laryngeal sensory dysfunction targeting the sensory field of the SLN to provide clinically meaningful reductions in throat irritation without compromising voice function.<\/jats:p>\n <\/jats:sec>\n \n Level of Evidence<\/jats:title>\n 4.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/lary.70841","type":"journal-article","created":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T03:45:47Z","timestamp":1789789547000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Supraglottic Botulinum Toxin Injection Improves Symptoms of Laryngeal Sensory Dysfunction"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3839-1353","authenticated-orcid":false,"given":"Daniel","family":"Novakovic","sequence":"first","affiliation":[{"name":"Sydney Voice Lab, Faculty of Medicine and Health University of Sydney Camperdown New South Wales Australia"},{"name":"Sydney Voice and Swallowing St Leonards New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katrina","family":"Sandham","sequence":"additional","affiliation":[{"name":"Sydney Voice Lab, Faculty of Medicine and Health University of Sydney Camperdown New South Wales Australia"},{"name":"Sydney Voice and Swallowing St Leonards New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas Emslie","family":"Stewart","sequence":"additional","affiliation":[{"name":"Sydney Voice and Swallowing St Leonards New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James Jordan","family":"Johnston","sequence":"additional","affiliation":[{"name":"Sydney Voice Lab, Faculty of Medicine and Health University of Sydney Camperdown New South Wales Australia"},{"name":"Department of Surgery University of Auckland Auckland Auckland Region New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,18]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1016\/S0892-1997(99)80049-6","article-title":"The Irritable Larynx Syndrome","volume":"13","author":"Morrison M.","year":"1999","journal-title":"Journal of Voice"},{"key":"e_1_2_10_3_1","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1177\/000348940511400401","article-title":"Chronic Cough as a Sign of Laryngeal Sensory Neuropathy: Diagnosis and Treatment","volume":"114","author":"Lee B.","year":"2005","journal-title":"Annals of Otology, Rhinology, and Laryngology"},{"key":"e_1_2_10_4_1","doi-asserted-by":"crossref","first-page":"596","DOI":"10.1016\/j.jvoice.2010.07.009","article-title":"Chronic Refractory Cough as a Sensory Neuropathy: Evidence From a Reinterpretation of Cough Triggers","volume":"25","author":"Vertigan A. 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D.","year":"2006","journal-title":"European Journal of Neurology"},{"key":"e_1_2_10_36_1","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1155\/2014\/410415","article-title":"Blockade of Glutamate Release by Botulinum Neurotoxin Type A in Humans: A Dermal Microdialysis Study","volume":"19","author":"Bittencourt da Silva L.","year":"2014","journal-title":"Pain Research and Management"},{"key":"e_1_2_10_37_1","doi-asserted-by":"crossref","first-page":"1765","DOI":"10.1002\/lary.31075","article-title":"The Application of Superior Laryngeal Nerve Block for Non\u2010Cough Laryngeal Hypersensitivity","volume":"134","author":"Benninger M. S.","year":"2024","journal-title":"Laryngoscope"},{"key":"e_1_2_10_38_1","doi-asserted-by":"crossref","first-page":"1898","DOI":"10.1002\/lary.27201","article-title":"Treatment of Chronic Neurogenic Cough With In\u2010Office Superior Laryngeal Nerve Block","volume":"128","author":"Simpson C. B.","year":"2018","journal-title":"Laryngoscope"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.70841","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/lary.70841","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.70841","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T03:45:54Z","timestamp":1789789554000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.70841"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,18]]},"references-count":37,"alternative-id":["10.1002\/lary.70841"],"URL":"https:\/\/doi.org\/10.1002\/lary.70841","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"value":"0023-852X","type":"print"},{"value":"1531-4995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,18]]},"assertion":[{"value":"2026-03-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-10","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-18","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"lary.70841"}}