Botulinum toxin (Botox) injections are popularly used as a cosmetic procedure to reduce the appearance of fine lines and wrinkles, but the drug has become multi-purposeful in treating a wide range of medical conditions. The wrinkle-smoother has been approved to treat the most severe migraines and has been found to assist asthmatics with their breathing. A study in the journal Respirology found Botox helped patients suffering from voice box problems by partly paralyzing the muscles through vocal cord injections, making it easier to breathe.

"Many of these patients' symptoms are extremely severe, so it has been tremendously satisfying to provide them with some relief,” said Professor Philip Bardin, co-author of the study and director of respiratory and sleep medicine for Monash University's Department of Medicine, in the news release. Those with vocal cord dysfunction experience an abnormal, uncoordinated movement in their vocal cords that causes them to experience episodes of severe shortness of breath and wheezing —  a condition untreatable with traditional asthma medications. Prior to the study, Bardin and Dr. Malcom Baxter, ENT surgeon, speculated whether Botox could effectively stop the muscles from contracting to help manage asthma that is difficult to control with medications and treatment.

The researchers recruited 11 patients with severe asthma for the world's first clinical trial using Botox to treat severe vocal cord dysfunction in asthmatics. The team of Australian researchers trialed other methods of delivery but found a bronchoscope helped guide the injections to a very specific area of the vocal cord tissue where a small dose would be administered to the participants. To evaluate the benefits of the vocal cord injection with Botox, the researchers analyzed the asthma control test (ACT) scores, vocal cord narrowing done by computerized tomography (CT) of the larynx and spirometry. A total of 24 injections were administered to the patients, based on how easily they were able to breathe after treatment.

The findings revealed the effects of Botox lasted between two to three months, with 60 percent of the patients reporting significant reductions in their symptoms. The study aimed to relax the vocal cord muscles and to remove any sensation of breathlessness through the Botox jabs. Although the drug injections were useful and there was no difficulty swallowing afterward, some participants reported side effects like softened voices.

“This treatment may not be suitable for all patients, but the early indicators are that it may be an option for those with severe upper airway distress, which is very exciting,” Bardin said. The researchers didn’t think the Botox jabs would cure these asthmatics, but they did believe it would help them live better with asthma. It could help patients overcome asthma symptoms that may require long hospital stays.

Lyn Dowsey, a patient part of the trial, found the Botox treatment alleviated her symptoms where she often felt like she was being strangled. "I’m not choking up anymore, I can get up on my feet and move around without struggling to breathe," she said, The Age reported. "I asked if I could have it elsewhere, but no," Dowsey said laughing.

The number of people with asthma in the U.S. continues to grow, says the American Academy of Allergy Asthma & Immunology, based on their latest statistics, which report 25 million people were living with asthma in 2009. More than half of people with asthma also were found to have an asthma attack, but recognizing the warning signs could help patients stay away from asthma triggers that provoke these attacks, such as tobacco smoke, dust mites, and pets. Botox may become a new treatment for asthma patients to help prevent an asthma attack, and it may simply allow asthmatics to breathe a little easier.

 

Source: Bardin PG, Baxter M, Hamilton G, et al. Abnormal vocal cord movement treated with botulinum toxin in patients with asthma resistant to optimised management. Respirology. 2014.