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Mystery writer recovers voice box with botox
January 14, 2007
For three decades, Grimes struggled with vocal spasms, involuntary movements of the muscles of her larynx, or voice box, that strained and strangled her speech like severe laryngitis.
Our Review Summary
This story reports on the use of botox injections to treat spasmodic dysphonia, a rare but disturbing condition in which an individual could lose their voice. Botox is being increasingly used to treat a variety of neurological conditions that involve involuntary muscle movements, or spasms. This story vividly describes what it must be like to have this difficult condition, but does little to provide consumers with important information, such as the evidence to support the use of Botox, how much the injections cost and any potential harms of the treatment.
The story does indicate that Botox is widely used for wrinkles but that it is a relatively new idea for spasmodic dysphonia.
While stating that Botox is now "the standard of care" for this condition, the story does not give any sense of how many practitioners are available who are skilled at the specialized injections nor does it state how much they cost, which could be substantial given that the injections are needed every 4 or 5 months. Furthermore, the story does not adequately describe the strength of the available evidence to support the use of Botox for spasmodic dysphonia.
The story says that "The injections help about 90% of patients with the most common type of spasmodic dysphonia." But 90% of how many? In what trials? It does not mention any harms, such as difficulty swallowing. The story does indicate that over time Botox wears off and that the individual may become resistant to it, but this is not adequate information on harms. Finally, the story does not provide enough information on alternative treatments. The story mentions vocal therapy briefly, but does not discuss the advantages and disadvantages of vocal therapy compared to Botox. Nor does the story mention other treatments such as surgery or counseling.
Click on Criteria for definitions.
The story said Botox injections have become "the standard of care," implying widespread availability. It could have been more explicit, especially about how many physicians are trained in this type of specialized Botox injections.
The story does not mention cost of treatment, which could be substantial given that the injections are given every 4 or 5 months.
The story does not appear to exaggerate the seriousness or prevalence of spasmodic dysphonia.
The story does not adequately describe the strength of the available evidence to support the use of Botox for spasmodic dysphonia. The story indicates that Botox is now the standard of care for the condition, and says that "The injections help about 90% of patients with the most common type of spasmodic dysphonia." But 90% of how many? In what trials?
The story does not mention any harms, such as difficulty swallowing. The story does indicate that over time Botox wears off and that the individual may become resistant to it, but this is not adequate information on harms.
The story does indicate that Botox is widely used for wrinkles but that it is a relatively new idea for spasmodic dysphonia.
The story says that "The injections help about 90% of patients with the most common type of spasmodic dysphonia." But 90% of how many? Was it 90% of 10 patients or 90% of 100 patients? The absolute data is important for readers to know.
There is no way to know if the story relied soley or largely on a press release. It did only cite one expert source.
The story only quotes one expert and several patients. The story should have quoted other clinicians or experts who could give some more perspective on the potential benefits and harms of Botox.
The story mentions vocal therapy briefly, but does not discuss the advantages and disadvantages of vocal therapy compared to Botox. Nor does the study mention other treatments such as surgery or counseling.
Total Score: 3 of 9 Satisfactory
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