Botox for Vocal Tremor

This trial explores two methods of using Botox to assist individuals with essential voice tremor, a condition causing uncontrollable voice shaking. Participants will receive Botox injections either into the false vocal folds or through electromyography (EMG) guidance, which uses tiny electrical signals to target specific muscles. The trial aims to determine which method improves quality of life, reduces tremor severity, and increases patient satisfaction. Individuals diagnosed with essential voice tremor who can communicate in English may be suitable candidates. As an unphased trial, this study provides an opportunity to contribute to innovative research that could lead to better treatment options for essential voice tremor.

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.

Studies have shown that botulinum toxin injections are generally well-tolerated for treating voice tremors. Research indicates that injections into the false vocal folds provide similar voice quality and satisfaction as other injection sites. Studies also report that doctors perform over 1,700 of these injections each month, suggesting they are widely accepted and considered safe in the medical community.

Researchers are excited about these treatments for vocal tremor because they offer new ways to deliver botulinum toxin A, a common treatment for muscle-related conditions. The False Vocal Fold (FVF) injection involves an endoscopic-guided method, allowing precise delivery directly to the false vocal folds, which could enhance effectiveness and personalization by tailoring dosing and laterality to each patient's needs. On the other hand, the Electromyography (EMG)-guided injection targets the TA/LCA muscles, using electrical activity to guide the injection, potentially improving accuracy and outcomes compared to traditional methods. These innovative delivery techniques might provide better symptom control and more customized treatment plans for individuals with vocal tremor.

This trial will compare two methods of botulinum toxin injections for managing essential voice tremor. Participants receiving False Vocal Fold (FVF) injections will undergo endoscopic-guided Onabotulinum toxin A injections to the false vocal folds. Studies have indicated that FVF injections improve voice quality and control tremors as effectively as traditional methods, with patients reporting better voice sound and fewer issues like breathiness and choking. Participants receiving Electromyography (EMG)-guided injections will have botulinum toxin A injected into the TA/LCA muscles or equivalent targets. Evidence supports the effectiveness of EMG-guided injections in improving voice quality and reducing tremor severity. Both methods have decreased the effort needed to speak and improved overall satisfaction with the voice. Overall, botulinum toxin treatments have consistently shown promise in managing voice tremor symptoms.¹²⁶⁷⁸