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United Airways: Botulinum toxin for the nose and voice box

United Airways: Botulinum toxin for the nose and voice box. Vocal cord dysfunction (VCD). Condition that accompanies asthma in ~50% of patients. May severely worsen asthma symptoms. Diagnosis is made by possible using the Monash Toshiba 320-slice CT. VCD is like ‘breathing through a straw’.

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United Airways: Botulinum toxin for the nose and voice box

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  1. United Airways: Botulinum toxin for the nose and voice box

  2. Vocal cord dysfunction (VCD) • Condition that accompanies asthma in ~50% of patients. • May severely worsen asthma symptoms. • Diagnosis is made by possible using the Monash Toshiba 320-slice CT.

  3. VCD is like ‘breathing through a straw’ Inspiration Expiration

  4. Treatment of VCD Botulinum toxin (trade name: Botox®) may be an effective treatment that lasts for 3 months. Q: Why could this work? A: The voice box is a muscular organ. Vocal cord injection with botulinum toxin will cause temporaryand partial paralysis and may improve symptoms.

  5. Results • First phase treatment studies with botulinum toxin completed at Monash Medical Centre. • A total of 19 injections given in patients with VCD. • 9 patients had one or more injections. • Two methods used: • ‘Blind’ injection using anatomical landmarks (8 cases). • Injection under direct vision (11 cases).

  6. Results 8 ‘blind’ injections – 3 successful (37%). 11 injections under direct vision – 9 successful (82%). Asthma symptoms were improved and reduced VCD was demonstrated by 320-slice CT.

  7. Therapeutic response to botulinum toxin injection seen on 320-slice CT After injection Before injection Normal curves Patient curve: Moved to normal range Normal curves Patient curve: abnormal

  8. The Next Step? Randomised (blinded) controlled trial using injection under direct vision

  9. Allergic rhinitis (AR) – common name hay fever

  10. Botulinum toxin to treat AR AR is a common problem in Australia. More than 25% of all persons may suffer from AR. Botulinum toxin blocks nerve endings in the nose and may be an effective treatment. Studies using injection of the nose have indicated benefits – but these studies were not blinded.

  11. This study New gel formulation that penetrates into the nasal tissue – simply placed in the nose with a cotton bud

  12. Study summary Nasal gel safety tested: First-ever randomised placebo controlled trial in AR. If it works: gel into the nose once every 3 months and…………. no more sneezing!

  13. Questions?

  14. Contacts Clinical Trials Unit Prof. Phil Bardin / Ms Joanne McKenzie Monash Medical Centre Tel: 9594 2620

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