Table 1. Literature summary.
| Authors | Year | No. of Pts | Botox Dose (Units) | Dysport Dose (Units) | Improvement | Method of Delivery | Causes | Complications |
|---|---|---|---|---|---|---|---|---|
| Schneider et al5 | 1994 | 7 | 80-120 | 5/7 (71%) | General anesthesia, direct esophagoscopy | Stroke, CN palsies, supraglottic or oropharyngeal cancer, reflux disease | None | |
| Atkinson and Rees10 | 1997 | 5 | 5-20 | 4/5 (80%) | CT-guided injection | Stroke, CN palsies, bulbar palsy | Left vocal fold paresis, aspiration pneumonia when injection wore off | |
| Blitzer and Brin7 | 1997 | 6 | 10 | 6/6 (100%) | Percutaneous injection | CVA, partial pharyngectomy, small Zenker's diverticulum | None | |
| Brant et al11 | 1999 | 1 | 100 | 1/1 (100%) | Flexible endoscopy | CVA | None | |
| Alberty et al12 | 2000 | 10 | 30 | 10/10 (100%) | Endoscopy under general anesthesia | CVA, idiopathic polymyositis | None | |
| Shaw and Searl13 | 2001 | 12 | 25-50 | 10/12 (83%) | Endoscopy under general anesthesia (9), flexible endoscopy (2), open technique (2) | Progressive neuropathy, oculopharyngeal dysphagia, skull base tumor resection, total laryngectomy, CVA, partial pharyngectomy, CN X neuropathy | Pharyngeal tear, worsening dysphagia | |
| Haapaniemi et al14 | 2001 | 4 | 14-50 | 3/4 (75%) | Endoscopy under general anesthesia | Brain stem stroke, inclusion body myositis, peripheral motor neuropathy, CVA | None | |
| Moerman et al15 | 2002 | 4 | 100 | 4/4 (100%) | General anesthesia | Head and neck cancer resection including total laryngectomy, radiation | None | |
| Parameswaran and Soliman16 | 2002 | 12 | 10-30 | 11/12 (92%) | Endoscopic injection with mask ventilation and apneic technique | Idiopathic, radiation, CVA, total laryngectomy, ALS, Parkinson's disease | Neck cellulitis (concurrent thyroglossal duct excision) | |
| Zaninotto et al17 | 2004 | 21 | 4-10 | 9/21 (43%) | Percutaneous with EMG | CNS disease, peripheral neuropathies, idiopathic | Death of aspiration (attributed to underlying disease) | |
| Liu et al18 | 2004 | 2 | 100 | 2/2 (100%) | Flexible EGD under conscious sedation | Inclusion body myositis | None | |
| Chiu et al19 | 2004 | 1 | 120 | 1/1 (100%) | General anesthesia and direct laryngoscopy | Brain stem stroke | None | |
| Murry et al6 | 2005 | 13 | 100 | 11/13 (85%), other 2 had improvement after second injection | EMG-guided transcutaneous approach | Stroke, extirpative head and neck surgery, cranial neuropathies, MVC, chemical inhalation, radiation therapy or lymphoma | None | |
| Kim et al20 | 2006 | 8 | 100 | 5/8 (62.5%) | Flexible endoscopy | CVA | None | |
| Masiero et al21 | 2006 | 2 | 25, 30 | 2/2 (100%) | Percutaneous injection | CVA | None | |
| Restivo et al22 | 2006 | 12 | 60 | 12/12 (100%) | EMG-guided transcutaneous approach | Diabetic neuropathy | None | |
| Suzukia et al23 | 2007 | 1 | 5 | 1/1 (100%) | Percutaneous injection | Spinal muscular atrophy type 2 | Transient worsening of dysphagia | |
| Krause et al24 | 2008 | 1 | 180, 150 | 1/1 (100%), 0/1 (0%) | Endoscopic injection with propofol sedation | Spasticity secondary to SAH | None | |
| Alfonsi et al25 | 2010 | 34 | 15 | 17/34 (50%) | EMG-guided transcutaneous approach | MS, multiple system atrophy (cerebellar variant and Parkinson variant), Parkinson's disease, progressive supranuclear palsy, ataxia-telangiectasia | None | |
| Restivo et al26 | 2011 | 14 | 20 | 14/14 (100%) | Percutaneous injection with EMG guidance | MS | None |
CN — cranial nerve; CT — computed tomography; CVA — cerebrovascular accident or stroke; ALS — amyotrophic lateral sclerosis; EMG — electromyography; CNS — central nervous system; EGD — esophagogastroduodenoscopy; MVC — motor vehicle collision; SAH — subarach-noid hemorrhage; MS — multiple sclerosis.