Tremor Laryngeal Dystonia: Treatment of the Lateral Cricoarytenoid Muscle

Tremor laryngeal dystonia is a clinical entity distinct from adductor laryngeal dystonia, according to perceptual, stroboscopic, and fine-wire electromyographic findings. Treatment with botulinum toxin has proven more difficult for tremor laryngeal dystonia than for adductor laryngeal dystonia, yet no treatment variations have been considered that might produce improved clinical results. We present 81 patients with a clinical presentation of tremor laryngeal dystonia who were treated with a variety of approaches with botulinum toxin. On the basis of both fine-wire electromyographic findings and clinical response, currently 44 of those patients are being followed up after at least 3 injections. Twenty-one patients (48%) are maintained on lateral cricoarytenoid injections, and 23 (52%) are maintained on thyroarytenoid muscle injections. The electromyographic findings of this group are presented along with their clinical outcome. According to our findings, the majority of patients with tremor laryngeal dystonia can be successfully treated with botulinum toxin if the practitioner includes injections to the lateral cricoarytenoid muscle as a treatment option.