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- ItemSomente MetadadadosComparação do uso da toxina botulínica e propranolol em pacientes com tremor vocal essencial e distônico(Universidade Federal de São Paulo (UNIFESP), 2013-10-21) Cruz, Grazzia Guglielmino da [UNIFESP]; Biase, Noemi Grigoletto de Biase [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Background: The vocal tremor produces a lot of discomfort and commitment in sociability in these patients. The vocal tremors are classified, in any body part, in resting tremor and action tremor. Among the action tremor thatcommits the voice, the essential is the most common and it is related with the attitude. The rarer seems to be the dystonic vocal tremor that is related with especific tasks. Botulinum toxin and oral medications have been used to vocal tremor, but with no comparative clinical trials. Purpose: The aim of this study was to verify and to compare the treatment responses of intramuscular application of botulinum toxin and the oral use of propranolol in essential vocal tremor and dystonic vocal tremor. Method: Clinical trial. This research was performed with fifteen patients with vocal tremor selected in two groups: essential vocal tremor and dystonic vocal tremor. After both groups had been treated with botulinum toxin and propranolol in distinct periods and randomly, they underwent by self assessment, flexible nasolaryngoscopy evaluation and perceptual, hearing and acoustic voice evaluation. Statistical analysis was performed with 0,05 (5%) rate of significance. Results: There were statistically significant improvement in the perceptual and hearing measures of vocal instability of dystonic vocal tremor after botulinum toxin application comparing with propranolol and the pretreatment. The acoustic measure variability in fundamental frequency proved to be reliable with significant decrease in dystonic vocal tremor with botulinum toxin comparing with propranolol and the pretreatment also. The flexible nasolaryngoscopy evaluation proved to be applicable parameter post treatment with botulinum toxin in dystonic vocal tremor patients. Conclusions: Essential vocal tremor and dystonic vocal tremor differ in responses to treatments. Dystonic vocal tremor responds significantly to botulinum toxin application, but not to propranolol oral use. The essential tremor does not respond significantly to any treatment described before.