A very common approach is for the Botox to be given by a team - the ENT with the detailed knowledge of the larynx anatomy so that very precise placement of the needle in the right position can take place, and a neurologist to interpret the signal from the EMG machine, and calibrate the right dose of Botox. This expertise isn't exclusive - some neurologist have considerable experience in doing the injections themselves, and some ENTs are well-versed in the "mixing and monitoring" procedure.In my case I have injections from both types of medical specialist. Dr Paul Darveniza, St Vincent's Hospital, Sydney is a neurologist and Dr Bren Dorman, Auckland Hospital is an ENT specialist. Both knew/know exactly what they were doing. In 40 shots over an 11 year period I have had no misses. Getting the dose right and whether the shots should be unilateral or bilateral is another story.
David Barton (AD/SD, Auckland, NZ
I have always had my BOTOX done by an ENT. I would agree with David that an ENT is more likely to be familiar with the anatomy of the larynx. But I have heard that there are some ENTs out there who are just dabbling in BOTOX treatments and don't get good results. On the other hand, neurologists typically specialize in giving BOTOX for other forms of dystonia such as torticollis, but some do inject for SD as well. Probably the most important thing would be to find a physician who has lots of experience with the specific type of injection you need.
Bill Vanderlinde
AB/SD