{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T03:16:26Z","timestamp":1774926986934,"version":"3.50.1"},"reference-count":27,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,10,1]],"date-time":"2024-10-01T00:00:00Z","timestamp":1727740800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["OTO Open"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess our institution's experience with botulinum toxin A injection management of pharyngoesophageal (PE) segment dysfunction after laryngectomy in tracheoesophageal voice and swallowing restoration<jats:bold>.<\/jats:bold><\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>A retrospective review of 43 patients who had Botox as treatment for PE dysfunction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Tertiary academic center with fellowship\u2010trained otolaryngologists.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Pre\u2010 and post\u2010injection outcomes were evaluated using chart review, and the severity of symptoms was recorded based on the subjective assessment by the patient, speech language pathologists, and the treating surgeon.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Forty\u2010three patients were treated for PE dysfunction with botulinum toxin A injection. Most patients were male (n\u2009=\u200935, 81.4%), underwent primary cricopharnygeal\u00a0myotomy (n\u2009=\u200936, 83.7%), and 37 (86%) had both dysphagia and speech concerns. Our injection methods included percutaneous injection by videofluoroscopy (n\u2009=\u200919, 44.2%), transnasal esophagoscopy (17, 40.5%), electromyography (n\u2009=\u20093, 7%), ultrasound (n\u2009=\u20091, 2.3%), or in the operating room (n\u2009=\u20093,7%). We found that 37 (86%) patients had subjective improvement in their symptoms, with 16 (38.1%) improving in both swallow and voice. There were no significant complications, or subjective difference in speech and swallowing outcomes by method of injection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Botulinum toxin A injection appears to be safe and effective for treating difficulty with speech and swallowing due to PE dysfunction after laryngectomy. Institutions should develop standard protocols for treatment and assessment.<\/jats:p><\/jats:sec>","DOI":"10.1002\/oto2.181","type":"journal-article","created":{"date-parts":[[2024,10,1]],"date-time":"2024-10-01T16:00:33Z","timestamp":1727798433000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Retrospective Exploration of Botulinum Toxin Injection for Pharyngoesophageal Segment Dysfunction Post\u2010laryngectomy"],"prefix":"10.1002","volume":"8","author":[{"given":"Ruby J.","family":"Kazemi","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Michigan Health System  Ann Arbor Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9359-7739","authenticated-orcid":false,"given":"Andrew D.P.","family":"Prince","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Michigan Health System  Ann Arbor Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keith A.","family":"Casper","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Michigan Health System  Ann Arbor Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew E.","family":"Spector","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Michigan Health System  Ann Arbor Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joshua D.","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Michigan Health System  Ann Arbor Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark E.P.","family":"Prince","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Michigan Health System  Ann Arbor Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,10]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.4103\/0973-1482.44289"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348948008900608"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2008.07.008"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1308\/rcsann.2015.0011"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.2880120110"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215100123345"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1996.01890190056013"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0347(199703)19:2<92::AID-HED2>3.0.CO;2-P"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0194-5998(99)70268-8"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1067\/mhn.2000.106400"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.1059"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1258\/002221503322112978"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348940311200312"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1808-8694(15)30776-X"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anl.2009.11.008"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.21961"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.23410"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200309000-00010"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599816642175"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.11152\/mu-2097"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.2880150603"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1044\/1058-0360.0603.66"},{"issue":"7","key":"e_1_2_8_24_1","first-page":"870","article-title":"The development and validation of a dysphagia\u2010specific quality\u2010of\u2010life questionnaire for patients with head and neck cancer: the M. 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