{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:49:18Z","timestamp":1787014158572,"version":"build-2736575974"},"reference-count":34,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2021,1,23]],"date-time":"2021-01-23T00:00:00Z","timestamp":1611360000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and purpose<\/jats:title>\n                    <jats:p>Botulinum toxin (BT) injection into the laryngeal muscles has been a standard treatment for spasmodic dysphonia (SD). However, few high\u2010quality clinical studies have appeared, and BT is used off\u2010label in most countries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a multicenter, placebo\u2010controlled, randomized, double\u2010blinded, parallel\u2010group comparison\/open\u2010label clinical trial to obtain approval for BT (Botox) therapy in Japan. Twenty\u2010four patients (22 with adductor SD and two with abductor SD) were enrolled. The primary end point was the change in the number of aberrant morae (phonemes) at 4\u00a0weeks after drug injection. The secondary end points included the change in the number of aberrant morae, GRBAS scale, Voice Handicap Index (VHI), and visual analog scale (VAS) over the entire study period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In the adductor SD group, the number of aberrant morae at 4\u00a0weeks after injection was reduced by 7.0\u00a0\u00b1\u00a02.30 (mean\u00a0\u00b1\u00a0SE) in the BT group and 0.2\u00a0\u00b1\u00a00.46 in the placebo group (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.0148). The improvement persisted for 12\u00a0weeks following BT injections. The strain element in GRBAS scale significantly reduced at 2\u00a0weeks after BT treatment. The VHI and VAS scores as subjective parameters also improved. In the abductor SD group, one patient responded to treatment. Adverse events included breathy hoarseness (77.3%) and aspiration when drinking (40.9%) but were mild and resolved in 4\u00a0weeks.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Botulinum toxin injection was safe and efficacious for the treatment of SD. Based on these results, BT injection therapy was approved as an SD treatment in Japan.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ene.14714","type":"journal-article","created":{"date-parts":[[2021,1,4]],"date-time":"2021-01-04T04:39:29Z","timestamp":1609735169000},"page":"1548-1556","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Botulinum toxin injection into the intrinsic laryngeal muscles to treat spasmodic dysphonia: A multicenter, placebo\u2010controlled, randomized, double\u2010blinded, parallel\u2010group comparison\/open\u2010label clinical trial"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9144-3242","authenticated-orcid":false,"given":"Masamitsu","family":"Hyodo","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Kochi University Nankoku 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