You can get Botox injection in the throat through a procedure called laryngeal Botox.
Onabotulinumtoxin-A or Botox is a substance isolated from bacteria that cause botulism (Clostridium botulinum). Although it is a toxin, Botox is safe when used in a small amount for approved medical or cosmetic purposes by a qualified medical professional. Botox injections block the nerve that supplies the target muscle, causing its paralysis or weakness.
The dose of Botox used for laryngeal procedures is lower (generally one to two units and sometimes up to 15 units) than the amount used to treat skin wrinkles (about 40 to 80 units).
What is laryngeal Botox done for?
Laryngeal Botox can be done for certain conditions that affect the vocal cords or larynx such as:
- Laryngeal dystonia (previously called spasmodic dysphonia): A chronic condition that causes abnormal contraction or spasm of the laryngeal muscles
- Laryngospasms: A reversible condition that causes spasms of the vocal cords, making breathing or speaking difficult
- Laryngeal granulomas: Refers to the formation of an inflammatory mass in the larynx
- Essential voice tremor: A condition that affects the vocal cords, causing a shaky voice
Because the larynx and vocal cord are essential for speaking and breathing, mass or abnormal narrowing can lead to life-threatening consequences. Botox helps relax the tight muscles of the larynx and vocal cords, thereby facilitating speech and breathing.
How is laryngeal Botox done?
Laryngeal Botox is generally done as an outpatient procedure in a doctor’s office.
The procedure may be done in two broad ways:
- Transcutaneously: It involves administering Botox into the larynx or vocal cords by passing a needle through the skin of the neck.
- This procedure is typically done under local anesthesia (by applying for a numbing medicine over the area).
- The person may lie down or stay in a semi-reclined position during the procedure.
- Laryngeal Botox injection may be given under electromyography (EMG) or indirect flexible laryngoscopic guidance.
- EMG is a procedure that measures the electrical activity of muscles (such as vocal cord muscles) in response to stimulation of the nerve that controls them.
- Indirect laryngoscopy is a procedure that uses a long mirror to see the inside of your larynx by inserting a flexible laryngoscope through the nose.
- Trans-oral approach: It involves administering Botox into the larynx or vocal cords through the mouth.
- This procedure requires general anesthesia (you sleep during the procedure).
- A long needle is passed down the throat to inject Botox into the vocal cords.
The procedure generally does not cause any pain or significant discomfort. You may experience momentary noisy breathing during the procedure. If you develop severe pain or coughing, you may tell the operating surgeon.
What are the risks of laryngeal Botox?
Some of the side effects of laryngeal Botox include:
- Difficulty swallowing
- Bruising over the injection site
- Hoarse voice
- Difficulty breathing
- Flu-like symptoms
- General weakness
- Persistent or recurrent symptoms
- High-pitched voice
- Weak cough reflex
Most of the side effects are mild or temporary. Until they subside, one can follow certain tips such as tilting the chin toward the chest during swallowing. Swallowing of liquids may be especially affected. This may be managed by adding THICK-IT powder available at drugstores to thicken liquids.
If the side effects do not subside or worsen, contact your doctor.
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