{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T06:52:23Z","timestamp":1777877543088,"version":"3.51.4"},"reference-count":59,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Otolaryngology - Head &amp; Neck Surgery"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec>\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>Onabotulinumtoxin A (BTX) is the first-line treatment for laryngeal dystonia (LD). The US FDA designated BTX as a pregnancy category C drug because there are no well-controlled studies in pregnant women.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To describe pregnancy and neonatal outcomes in pregnant LD patients treated with BTX injections and to assess the current practice and comfort level of Canadian laryngologists in treating these patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Case Series and Survey.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Academic, tertiary care, laryngology center.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Pregnant women who received BTX for LD from 2010 to 2020.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Intervention<\/jats:title>\n                    <jats:p>A retrospective chart review was conducted for eligible patients. An anonymous, online, cross-sectional survey was distributed to Canadian laryngologists, according to Dillman\u2019s Total Design method.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>Pregnancy and neonatal outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Four adductor LD patients received BTX during each of their 2 pregnancies; 8 pregnancies were examined. Patients received a median of 4.5 treatments (IQR 3) with a median cumulative dose of 5.12\u2009U (IQR 2.93\u2009U) over the whole pregnancy. One pregnancy was pre-term and the median APGAR score was 9 (IQR 0.5). All mothers breastfed their infants. There were no adverse events (AE) and all children were healthy, with a median age of 7 (IQR 2). Twenty-three Canadian laryngologists responded to the survey, for an 85.2% response rate. Three laryngologists (13.0%) have previously injected BTX in a total of 5 pregnant women. All 5 pregnancies went to term with no AE. The majority (68.4%) of respondents indicated that they would offer BTX injections to pregnant LD patients after obtaining informed consent.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case series was the largest in the literature of pregnant LD patients undergoing BTX treatment. The majority of Canadian laryngologists would offer the procedure to pregnant women with informed consent.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Relevance<\/jats:title>\n                    <jats:p>This study added to the growing literature on the safety of BTX injections in LD patients during pregnancy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/19160216251392559","type":"journal-article","created":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T13:37:01Z","timestamp":1763127421000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Botulinum Toxin Treatment in Pregnant Laryngeal Dystonia Patients: Case Series and Survey of Current Practice of Canadian Laryngologists"],"prefix":"10.1177","volume":"54","author":[{"given":"Kaishan","family":"Aravinthan","sequence":"first","affiliation":[{"name":"Division of Otolaryngology, Head and Neck Surgery, Department of Surgery, University of British Columbia, Vancouver, BC, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M\u00e9lissa","family":"Patry","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology, Head and Neck Surgery, Department of Surgery, University of British Columbia, Vancouver, BC, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1292-1582","authenticated-orcid":false,"given":"Amanda","family":"Hu","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology, Head and Neck Surgery, Department of Surgery, University of British Columbia, Vancouver, BC, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,11,14]]},"reference":[{"key":"e_1_3_3_2_2","unstructured":"Allergan Inc. 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