Artikel
Effects of a therapy with botulinum toxin A for functional indications in otorhinolaryngology on the health-related quality of life
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Veröffentlicht: | 6. Juli 2010 |
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Background: Botulinum toxin A (BTA) is used for many indications in otorhinolaryngology. For the most functional indications, no studies with validated tools exist to analyze the effects of this therapy on the health-related quality of life, a parameter nowadays considered an essential evaluation criterium of a therapy. Since an off-label use of BTA is common, this question also is of medicolegal and economic importance.
Methods: 40 patients who were treated with BTA for functional disorders in our department received the Glasgow Benefit Inventory. This well-validated retrospective questionnaire measures the effects of otorhinolaryngological interventions on the health-related quality of life. Scores from –100 (maximal negative effect) to 100 (maximal positive effect) can be achieved.
Results: 29 patients (return rate 72.5%) achieved the following mean total scores: 1.2 (sialorrhea, n=7), 22.6 (gustatory sweating, n=8), 20.6 (ear clicking due to palatal tremor, n=5), 15.0 (voice prothesis disorders after laryngectomy due to pharyngoesophageal spasm, n=5), 38.9 (adductor type spasmodic dysphonia, n=2), and 27.8 (oromandibular dystonia, n=2). The percentage of patients with an elevated health-related quality of life, i. e. positive total scores, differed considerably for the various indications: sialorrhea 29%, gustatory sweating 88%, palatal tremor 60%, voice prothesis disorders after laryngectomy 60%, spasmodic dysphonia 100%, oromandibular dystonia 100%.
Conclusions: A therapy with BTA can elevate the health-related quality of life in all the indications investigated, but not in all patients. Follow-up studies with larger numbers of patients have to show which patients take the most benefit from a therapy with BTA.