Mumbai Voice Surgeon » Voice Problems http://drnupurkapoor.mumbaivoicesurgeon.com Just another WordPress weblog Sat, 15 May 2010 13:57:26 +0000 http://wordpress.org/?v=2.9.2 en hourly 1 Botox and Voice http://drnupurkapoor.mumbaivoicesurgeon.com/botox-and-voice http://drnupurkapoor.mumbaivoicesurgeon.com/botox-and-voice#comments Tue, 28 Jul 2009 11:26:38 +0000 Dr. Nupur Kapoor Nerurkar http://drnupurkapoor.mumbaivoicesurgeon.com/?p=27 Botulinum toxin is produced by the bacteria “clostridium botulinum”. It’s the same toxin that causes a life-threatening type of food poisoning called botulism. Doctors use it in small doses to treat health problems.
One unit of this poison is lethal for mice and generally 3,500 units are lethal for humans. However in the correct dose this poison has many benefits. This toxin creates a weakness in the muscle into which it is injected and this effect lasts for a variable period of 2 to 9 months.

The question that comes to mind – Why would we want to create muscle weakness?
Well, many reasons really. Lets start with one of the most popular – prevention of wrinkles! Facial muscles where wrinkles are developing are injected with botulinum so as to cause a localized weakness of that area which then cannot wrinkle and appears smooth (and at times expressionless!)

When I was doing my Laryngology training in America I was amazed to see hoards of very pretty and wrinkle free 20 something girls line up for a shot of left-over botulinum. On my very naïve inquiry I was told that the injection was being taken to prevent the future possibility of a wrinkle!So anyway, the toxin was “left-over” from being used for a debilitating voice disorder called as “spasmodic dysphonia”. In this uncommon voice disorder the patients vocal muscles contract too much giving rise to a strained voice. The toxin is injected into the straining vocal muscle under EMG control so as to weaken and relax it. Interestingly the voice in this disorder tends to get better while singing, whispering or after a few drinks! One of my patients came to me 2 months after his first injection of botulinum saying he had a problem. Since his voice was sounding good I wondered what it was.Well, as it turns out his friends were aware of the fact that his voice improved with alcohol and now they were ribbing him about being constantly under the influence of alcohol!

Botulinum has helped in the rehabilitation of children and adults suffering from dystonia’s in which large muscle groups become rigid such as cerebral palsy and cervical dystonia. Hemi facial spasms, blepharospasm , migraine, severe underarm sweating and strabismus are other indications for its use.

Side effects can include pain at the injection site, flu-like symptoms, headache,upset stomach,allergic reactions. You should not use Botox if you are pregnant or breast feeding.

Botulinum is expensive, not currently made indigenously, not covered by insurance companies, and so for many the treatment can prove to be prohibitively expensive. Matters do not improve on telling the patient that every 6 months or so a repeat shot is needed.

One way out to reduce costs is pooling of resources by doctors and clubbing together patients who need the toxin. Basically working as a TEAM –Together Everyone Achieves More!

]]> http://drnupurkapoor.mumbaivoicesurgeon.com/botox-and-voice/feed 0