Voice Response to Injection of Succinylcholine in the Thyroarytenoid Muscle of Normal Subjects Botulinum toxin (Botox) is commonly used in the treatment of spasmodic dysphonia. Succinylcholine is a neuromuscular blocking agent that mimics the biological activity of Botox yet takes effect within minutes. Four subjects with normal voice underwent bilateral vocal fold injection of succinylcholine to determine whether the drug would alter voice ... Clinical Focus
Clinical Focus  |   May 01, 1996
Voice Response to Injection of Succinylcholine in the Thyroarytenoid Muscle of Normal Subjects
 
Author Affiliations & Notes
  • Cheryl L. Rainey
    Vanderbilt University Medical Center, Nashville, TN
  • David L. Zealear
    Vanderbilt University Medical Center, Nashville, TN
  • Mark Courey
    Vanderbilt University Medical Center, Nashville, TN
  • R. E. (Ed) Stone, Jr.
    Vanderbilt University Medical Center, Nashville, TN
  • Contact author: Cheryl L. Rainey, MS, The Vanderbilt Voice Center, 1500 21st Avenue South, Suite 2700, Nashville, TN 37212
    Contact author: Cheryl L. Rainey, MS, The Vanderbilt Voice Center, 1500 21st Avenue South, Suite 2700, Nashville, TN 37212×
Article Information
Speech, Voice & Prosody / Clinical Focus
Clinical Focus   |   May 01, 1996
Voice Response to Injection of Succinylcholine in the Thyroarytenoid Muscle of Normal Subjects
American Journal of Speech-Language Pathology, May 1996, Vol. 5, 43-52. doi:10.1044/1058-0360.0502.43
History: Received April 3, 1995 , Accepted January 2, 1996
 
American Journal of Speech-Language Pathology, May 1996, Vol. 5, 43-52. doi:10.1044/1058-0360.0502.43
History: Received April 3, 1995; Accepted January 2, 1996

Botulinum toxin (Botox) is commonly used in the treatment of spasmodic dysphonia. Succinylcholine is a neuromuscular blocking agent that mimics the biological activity of Botox yet takes effect within minutes. Four subjects with normal voice underwent bilateral vocal fold injection of succinylcholine to determine whether the drug would alter voice in a way comparable to previously reported analyses of voice response with Botox. Acoustic analyses confirmed that succinylcholine induced an increase in fundamental frequency, jitter, and shimmer, and a decrease in harmonic-to-noise ratio. Glottal flow rates were elevated after drug injection. Succinylcholine induced perceptual changes in pitch and quality. These findings suggest that succinylcholine alters vocal parameters that are also influenced by Botox. This drug may prove useful as a screening agent in patients for whom the benefit of Botox is questionable, or as an agent injected coincidentally with Botox to predict an optimal voice result and avoid the side effects associated with treatment.

Acknowledgments
The authors wish to thank James L. Netterville for his assistance with the Botox injections. We also express our appreciation to Jeannie Bragg, Kim Chachere, and Liz Luken for their willingness to serve as expert listeners in the perceptual study. Finally, we want to acknowledge Dan Ashmead for his input on statistical design and analysis.
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