Assessing Multifactorial Quality of Life Benefit of Botulinum Injection in Treatment of Spasmodic Dysphonia with the Modified 5-Factor Glasgow Benefit Inventory

Michael Cirelli, BA | Mayo Clinic Alix School of Medicine

Researcher Michael Cirelli is a recipient of the 2023 Dysphonia International Research Travel Award in partnership with The Voice Foundation. Michael participated in the 2023 Voice Foundation Conference and presented research entitled, “Assessing Multifactorial Quality of Life Benefit of Botulinum Injection in Treatment of Spasmodic Dysphonia with the Modified 5-Factor Glasgow Benefit Inventory.”

Michael stated about his work, “our study provides specific statistical guidance for otolaryngologists as they advise patients about the particular expected benefits of botulinum injection to quality of life, self-confidence, and social involvement for people living with adductor spasmodic dysphonia. We also hope that our use of the 5-Factor Glasgow Benefit Inventory survey will lead to its use in future quality of life investigations of otolaryngological procedures and treatments.”

Below is an abstract of Michael’s poster presentation.


Additional Authors: Michael J. Marino, MD, David G. Lott, MD, Charles H. Adler, MD/PhD, Stephen F. Bansberg, MD

Introduction: Botulinum toxin injection into the true vocal cords is an effective treatment for adductor spasmodic dysphonia (AdSD), primarily due to improvement in vocal quality and effort. The 18-item Glasgow Benefit Inventory (GBI) was developed to measure quality of life improvement following any otorhinolaryngologic intervention. The GBI has been updated to a 15 question, 5 factor domain instrument (GBI-5F) to improve its utility and our understanding of the benefit reported by patients. The GBI-5F has not applied to AdSD patients undergoing botulinum toxin therapy and the original GBI has been applied to a limited number of AdSD patients.   

Objective: To utilize the GBI-5F to measure patient-reported quality of life change in AdSD patients following botulinum toxin injection.   

Methods: The GBI-5F was consecutively collected from AdSD patients following a botulinum toxin injection. All patients had received multiple prior injections. Data on patient demographics were determined. The GBI-5F subdomains were analyzed to identify specific areas for patient reported improvement.   

Results: A total of 57 patients completed the GB1-5F after botulinum injection for SD, including 44 (77.2%) females and 13 (22.8%) males with a mean age of 69.1 (standard deviation, 11.1 years). The median total benefit score was +40.0 (interquartile range [IQR], 16.7). Median subdomain scores were +83.3 (IQR, 50.0) for quality of life, +50.0 (IQR, 50.0) for self-confidence, +33.3 (IQR, 33.3) for social involvement, +16.7 (IQR, 50.0) for support, and 0.0 (IQR, 16.7) for general health. The differences in the individual subdomain scores were statistically significant (p<0.0001). The median total and subdomain scores were not statistically different between men and women (all p>0.05).   

Conclusion: Botulinum toxin therapy for AdSD provides overall benefit to patients as measured by the GBI-5F, with particular improvement observed for perceived quality of life, self-confidence, and social involvement. There were no differences detected, either in total score or any subdomain score, between men and women having this treatment.

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Sponsoring Organizations

The Fall Voice Conference is designed to encourage and educate professionals on a multi-disciplinary approach to the management of vocal disorders. The focus of this conference is the clinical care of patients with voice-related difficulties and how clinical and basic science research guide clinical care. For more information:

Dysphonia International is dedicated to improving the lives of people with spasmodic dysphonia and related voice conditions through research, education, awareness, and research.