1 / 23

‘Voice Box’ Asthma – a new treatment with botulinum toxin

‘Voice Box’ Asthma – a new treatment with botulinum toxin. Prof Phil Bardin Lung and Sleep Medicine Monash University & Medical Centre Melbourne. Severe asthma is an ongoing area of medical need. Severe Asthma. Overall approximately 5-25% of asthma

charlton
Télécharger la présentation

‘Voice Box’ Asthma – a new treatment with botulinum toxin

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. ‘Voice Box’ Asthma – a new treatment with botulinum toxin Prof Phil Bardin Lung and Sleep Medicine Monash University & Medical Centre Melbourne

  2. Severe asthma is an ongoing area of medical need

  3. Severe Asthma • Overall approximately 5-25% of asthma • Frequent hospital admissions, use 60% of health-care dollar allocated to asthma care • Usual treatment = steroid tablets with severe side-effects • Poor response to anti-inflammatory treatments – suggesting resistant inflammation – or a problem unrelated to asthma itself

  4. Very little is known about upper airway activities in severe asthma One possibility: upper airway obstruction masquerading as severe asthma

  5. Rhino-Laryngoscope

  6. Endoscopy showing voice box closure Inspiration Expiration

  7. Endoscopy: Uncomfortable Not quantifiable Poorly tolerated in many asthmatics with acute symptoms

  8. Toshiba 320-slice CT • Developed primarily for cardiac study • Scans 16 cm ‘volume’ and obviates the need to ‘stitch together’ images. • Can detect and image movement

  9. 320 x 0.5 mm detectors = 16cm coverage • Detects bigger area • Detects movement

  10. Normal voice box function

  11. Normal RATIO (VC/trachea) Inspiration Expiration Low et al, Am J Resp Crit Care Med 2011

  12. Normal Range Mean 1.5 SD Below Mean = LLN

  13. Healthy person Healthy control

  14. Asthma: voice box closure

  15. Images showing narrowed voice box Inspiration Expiration

  16. Overall: Abnormal laryngeal movement was present in 23 out of 46 asthmatics with severe asthma (50%) (None of 29 healthy persons had abnormality)

  17. Therapy for voice box asthma

  18. Results: speech therapy

  19. Results: speech therapy

  20. Botulinum toxin (Botox®) for voice box asthma • Botox is used to treat muscle cramps and spasms • Voice box asthma may be a form of spasm • Treatment may relieve the spasm and break the ‘bad habit’ • This may improve severe asthma – and possibly turn it into mild disease easy to treat

  21. Botulinum toxin (Botox®) for voice box asthma • Botox will be given by very thin needle directly into one voice box muscle • The procedure is safe and has been used frequently for another condition of voice box spasm in non-asthmatics (vocal cord dystonia)

  22. Botulinum toxin (Botox®) for voice box asthma • The planned trial has been approved by the Southern Health Ethics committee and will start soon • We hope that it will improve severe asthma – and possibly turn it into mild disease easy to treat

  23. Laryngeal dysfunction in severe asthma – it has been happening ……..

More Related