Blitzer A, Sulica L
New York Center for Voice and Swallowing Disorders, St. Luke's-Roosevelt Hospital Center, NY, USA.
Laryngoscope. 2001 Feb;111(2):218-26. doi: 10.1097/00005537-200102000-00006.
The role of botulinum toxin as a therapeutic agent is expanding rapidly in otolaryngology. Botulinum toxin is a protease that blocks the release of acetylcholine from nerve terminals. Its effects are transient and nondestructive, and largely limited to the area in which it is administered. These effects are also graded according to dose, allowing for individualized treatment of patients and disorders. Botulinum toxin has been used primarily to treat disorders of excessive or inappropriate muscle contraction. In the field of otolaryngology, these include spasmodic dysphonia, oromandibular dystonia, and blepharospasm; vocal tics and stuttering; cricopharyngeal achalasia; various tremors and tics; hemifacial spasm; temporomandibular joint disorders; and a number of cosmetic applications. Botulinum toxin treatment has recently begun to show some benefit in the control of pain from migraine and tension headache. It may also prove useful in the control of autonomic dysfunction, as in Frey syndrome, sialorrhea, and rhinorrhea. In over 20 years of use in humans, botulinum toxin has accumulated a considerable safety record, and in many cases represents relief for thousands of patients unaided by other therapy.
肉毒杆菌毒素作为一种治疗药物，在耳鼻喉科的应用正在迅速扩展。肉毒杆菌毒素是一种蛋白酶，可阻断神经末梢乙酰胆碱的释放。其作用是短暂且非破坏性的，并且很大程度上局限于给药部位。这些作用也会根据剂量分级，从而实现对患者和病症的个体化治疗。肉毒杆菌毒素主要用于治疗过度或不适当的肌肉收缩紊乱。在耳鼻喉科领域，这些病症包括痉挛性发声障碍、口下颌肌张力障碍和眼睑痉挛；发声性抽搐和口吃；环咽失弛缓症；各种震颤和抽搐；面肌痉挛；颞下颌关节紊乱；以及一些美容应用。肉毒杆菌毒素治疗最近已开始在控制偏头痛和紧张性头痛引起的疼痛方面显示出一定益处。它在控制自主神经功能障碍方面也可能被证明是有用的，如在 Frey 综合征、流涎和鼻漏中。在人类使用超过 20 年的时间里，肉毒杆菌毒素积累了相当可观的安全记录，并且在许多情况下为数以千计无法通过其他治疗缓解的患者带来了缓解。
