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Botulinum toxin injection improved asthma control, narrowing airways

Evidence from a recent study suggested that botulinum toxin injection, or Botox, of one vocal cord improved asthma control and reduced the narrowing of the upper airway.

This novel therapy may be an effective treatment for patients with intractable asthma associated with abnormal vocal cord movement, according to researchers.

“The link between asthma symptoms and coexisting middle airway obstruction has been difficult to establish,” Malcolm Baxter, MBBS, of the Ear, Nose and Throat Surgery at Monash University in Australia, and colleagues wrote. “However, it has long been suspected that middle airway obstruction could contribute to resistant asthma symptoms and seemingly poor asthma control.”

Observational study data indicated the benefits of unilateral vocal cord injection with botulinum toxin among 11 patients (administered 24 injections) with asthma resistant to optimized treatment, and abnormal vocal cord movement.

The patients’ asthma control test scores improved overall (9.1 before and 13.5 after treatment; P<.001). There also was an improvement to airway size on CT larynx (time below lower limit of normal at baseline 39.4% and improved to 17.6% after injection; P=.032).

Dysphonia and dysphagia were the most common adverse events.

“Although a placebo effect cannot be ruled out, local injection of botulinum toxin may be an effective treatment for intractable asthma associated with abnormal vocal cord movement,” the researchers concluded. “Future studies should include additional methods to assess vocal cord function independently from asthma control.”

Disclosure: The researchers report no relevant financial disclosures.