Yin S, Stucker F J, Nathan C A
Department of Otolaryngology-Head & Neck Surgery, Louisiana State University School of Medicine, Shreveport, Louisiana, USA.
J La State Med Soc. 2001 Feb;153(2):92-7.
Botulinum toxin (Botox) is useful in controlling the symptoms of patients with movement disorders. Application of Botox serves to (1) inhibit hypertonicity, (2) enhance the action of the antagonistic muscles, and (3) avoid an impingement in order to reestablish "the balance of forces". In accordance with the principles mentioned above, Botox can be used to treat dystonias of the larynx (adductor laryngeal spasmodic dysphonia, abductor laryngeal spasmodic dysphonia), laryngeal granulomas, laryngeal joint dislocation, cricopharyngeal spasm, and posterior glottic synechiae. In addition, extra-laryngeal disorders such as blepharospasm, hemifacial spasm, oromandibular dystonia, and spasmodic torticollis respond well to Botox. The effects of Botox are reversible and have specific localized activity. Hence, Botox has served as a powerful diagnostic method in exploring the underlying mechanism of various types of dystonias and provides some therapeutic benefits before pursuing surgical options. Here we review the literature and describe our experiences with Botox, including such topics as preparing and storing Botox, identifying the target muscles under EMG-guidance, choosing an appropriate dose, and outlining the applications of Botox in Otolaryngology, Head and Neck Surgery practice.
肉毒杆菌毒素（保妥适）有助于控制运动障碍患者的症状。使用保妥适的作用在于：（1）抑制张力亢进；（2）增强拮抗肌的作用；（3）避免撞击，以重建“力量平衡”。根据上述原则，保妥适可用于治疗喉部肌张力障碍（内收性喉痉挛性发声困难、外展性喉痉挛性发声困难）、喉部肉芽肿、喉关节脱位、环咽肌痉挛和后声门粘连。此外，诸如眼睑痉挛、半面痉挛、口下颌肌张力障碍和痉挛性斜颈等喉外疾病对保妥适反应良好。保妥适的作用是可逆的，且具有特定的局部活性。因此，保妥适已成为探索各类肌张力障碍潜在机制的有力诊断方法，并在考虑手术治疗之前提供了一些治疗益处。在此，我们回顾相关文献并描述我们使用保妥适的经验，包括保妥适的制备与储存、在肌电图引导下识别靶肌肉、选择合适剂量以及概述保妥适在耳鼻咽喉头颈外科实践中的应用等主题。
