{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T19:15:12Z","timestamp":1773774912681,"version":"3.50.1"},"reference-count":20,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,1,22]],"date-time":"2021-01-22T00:00:00Z","timestamp":1611273600000},"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":["Muscle and Nerve"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Despite use of qualitative laryngeal electromyography (LEMG) guided botulinum toxin A (BoNT\u2010A) injection for treatment of adductor spasmodic dysphonia (AdSD), unsatisfactory injections and complete \u201cmisses\u201d remain problematic. We aimed to determine if the quantitative LEMG measure of number of small segments (NSS) correlates with voice outcomes following (BoNT\u2010A injection for AdSD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Automated quantitative LEMG analysis was performed during electromyography (EMG) \u2010guided BoNT\u2010A injection into the thyroarytenoid\u2010lateral cricoarytenoid muscle complex for treatment of AdSD. Pre\u2010injection phonatory NSS values were correlated with clinical voice outcomes and patient reported injection results.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Quantitative LEMG measures were obtained for 45 AdSD patients (28 female, mean age 60.8 \u00b1\u200912.8\u2009years) during EMG\u2010guided BoNT\u2010A injection. Mean sampled NSS during phonation immediately prior to BoNT\u2010A injection was 524\u2009\u00b1\u2009323 (range: 2\u2013904). Mean follow up was 36.5 \u00b1\u20099.4\u2009days; one patient was lost to follow\u2010up. In comparison to their previous BoNT\u2010A injection, the current injection was rated as worse, same, and better by 13 (29.5%), 25 (56.8%), and 6 (13.6%) patients, respectively. All 4 (9.1%) patients with NSS\u2009&lt;\u2009200 rated their BoNT\u2010A injection result as worse than previous, and change in Voice Handicap Index\u201010 (VHI\u201010) scores were worse or without change.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Aiming for an NSS value greater than 200 during phonation prior to BoNT\u2010A toxin injection for AdSD may reduce unfavorable voice outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mus.27161","type":"journal-article","created":{"date-parts":[[2020,12,31]],"date-time":"2020-12-31T16:14:55Z","timestamp":1609431295000},"page":"525-530","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Quantitative laryngeal electromyography parameters may correlate with improved outcomes following botulinum toxin injection for spasmodic dysphonia"],"prefix":"10.1002","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4417-7700","authenticated-orcid":false,"given":"Christopher D.","family":"Dwyer","sequence":"first","affiliation":[{"name":"UCSF Voice and Swallowing Center, Division of Laryngology, Department of Otolaryngology\u2010Head and Neck Surgery University of California San Francisco  San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2398-8018","authenticated-orcid":false,"given":"Andr\u00e9e\u2010Anne","family":"Leclerc","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology\u2010Head and Neck Surgery University of Montreal  Montreal Quebec Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sanjeev D.","family":"Nandedkar","sequence":"additional","affiliation":[{"name":"Natus Neuro, Hopewell Junction  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"VyVy N.","family":"Young","sequence":"additional","affiliation":[{"name":"UCSF Voice and Swallowing Center, Division of Laryngology, Department of Otolaryngology\u2010Head and Neck Surgery University of California San Francisco  San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clark A.","family":"Rosen","sequence":"additional","affiliation":[{"name":"UCSF Voice and Swallowing Center, Division of Laryngology, Department of Otolaryngology\u2010Head and Neck Surgery University of California San Francisco  San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,1,22]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-199810000-00003"},{"key":"e_1_2_11_3_1","first-page":"622","article-title":"Current practices in the management of adductor spasmodic dysphonia","volume":"39","author":"Eskander A","year":"2010","journal-title":"J Otolaryngol Head Neck Surg"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.27696"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.21395"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.25068"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2016.09.022"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2014.08.011"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/0003489420928373"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.21966"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10072-001-8172-9"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.880090603"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.21046"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2009.01.026"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.25910"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.21884"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.20629"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.25090"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.880090508"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200409000-00009"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2018.03.011"}],"container-title":["Muscle &amp; 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