Spasmodic Dysphonia Bulletin Board

Botox location
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Posted by: Tony_L ® 04/25/2006, 19:08:18

Hi Can someone please tell me why it can take so long to find the correct location for injecting botox. (I'm thinking now about my bleph. (I tried the Beb BB but I seem to have been logged off there)) Surely the docs know where the correct muscles are, so why would it take up to 12 months to get it right? Is it a nerve they're aiming for or muscle tissue? Thanks Tony

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Re: Botox location Re: Botox location -- Tony_L Top of thread Archive Posted by: mdubovick ® 04/25/2006, 23:38:10 Haking 12 months to get it right? That's highly unusual. Here's some speculation on why results can be different from shot to shot and how the Botox process works: Each muscle in each individual is different; this requires some 'trial and error' guess work in the beginning of the Botox injection process. It's been my experience that the ENT varies the depth of the needle during the injection process. I think this makes the results vary from shot to shot. Specific to your question, in the actual injection, the needle passes under the thyroid cartilage into the muscles of the vocal cord. There are three muscles in this area: the left and right thyroarytenoid muscle, and one of the two posterior cricoarytenoid muscles. For the more AD/SD, the injection is done into the thyroarytenoid muscle. The effect of the Botox is to weaken the involved muscle. When the muscle is weakened, even though it is receiving abnormal signals from the basal ganglia part of the brain, it cannot respond as strongly as before. This weakness temporarily stops the spasm, allowing normal or near normal speech. | Recommend | Alert Where am I? Original message Top of thread Current page Re: Botox location Re: Re: Botox location -- mdubovick Top of thread Archive Posted by: David Barton ® 04/26/2006, 01:25:22 I would add to Mel's very clear response that in most cases an expert doctor will use EMG guidance to precisely locate the muscle being injected - if they are sufficiently skilled in interpreting the feedback from the machine and inserting the needle to the right angle and to the right depth then the patient should expect accurate placement most of the time. In my case I have had about 45 Botox shots over a 14-year period and without exception the injection has 'taken'. Best wishes David Barton (AD/SD, Auckland, New Zealand) | Recommend | Alert Where am I? Original message Top of thread Current page Re: Botox location Re: Botox location -- Tony_L Top of thread Archive Posted by: Barbara S. White ® 04/26/2006, 00:45:11 It sounds like you might need a different doctor. I have never heard of a doctor not being able to find the nerve. Every one I have ever had, including the first one was hit the first try. Maybe there is something different on you but I don't think so. I think I would try a different doctor. Usually they feel and touch it right away. Some of them use a scope down the nose and look for it on a monitor but I think must just feel throught he neck and it is pretty obvious. Some doctors seem to be better at this than others so I would not take a chance with a doctor who dosen't know where the nerve is. Maybe I am wrong but I certainly never had that kind of experience and haven't heard anyone else that has. Blessings, Barbara / god4me@comcast.net | Recommend | Alert Where am I? Original message Top of thread Current page Re: Botox location Re: Botox location -- Tony_L Top of thread Archive Posted by: jerrylee ® 04/26/2006, 08:23:20 I found the ENG method to be a 'hit and miss' situation sometimes. others have found this to work very well. my doctors uses the scope down the throat method so that he can see exactly where the need is and always hits the same spot. Jerry | Recommend | Alert Where am I? Original message Top of thread Current page Re: Botox location Re: Botox location -- Tony_L Top of thread Archive Posted by: Marilee ® 04/26/2006, 12:17:50 Tony, the way I read your question, you are asking about injection locations for blepharospasms, right? One factor is that they do not use an EMG machine on the eyes. As with SD, individuals differ slightly, and doctors have their own techniques and opinions. My first neuro gave me very good eyelid injections, but wasn't effective for my other needed locations for Meige's. I tried a 2nd neuro, who was good at certain ones - but not the eyes! So I found another neuro who does them all quite well, and my ENT works with him in the same hospital, so I get all injections in one appointment. Moral of story: keep looking for a more experienced & knowledgeable doctor, since, as I said at first, they have their own techniques, and can be quite stubborn at changing sometimes. Why don't you try the BEB board again - log in using a slightly different name (i.e. just "Tony"), if necessary,and see if that helps. I remember you posted there just last month, so can't imagine there being any problem. Also, look on the BEBRF website under botulinum toxin, and "injection techniques" for some some good information. Best wishes, Marilee, Indiana, U.S. gcazz@juno.com | Recommend | Alert Where am I? Original message Top of thread Current page