What are the common complications?
Most complications of treatment are the result of either inaccuracy of injection or inappropriate dosing of botulinum toxin.If an injection is not well placed, the toxin may have no effect, or it may be reduced. This can be corrected by repeating the injection. Difficulty swallowing is probably the most common side effect. Since the larynx lies next to the entrance of the esophagus, and since laryngeal muscles are small and located fairly deep within the neck, toxin may inadvertently reach the esophageal or pharyngeal muscles. Weakening of these muscles, when added to the weakening of the vocal folds that results from treatment, can result in altered or impaired swallowing. Some temporary change in swallowing is reported by up to 17% of patients treated. In the vast majority of cases, this is more of an inconvenience than a danger. However, it is possible to impair swallowing more severely, and even theoretically to cause a lung infection from food entering the trachea (windpipe). Beca
