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[肉毒杆菌毒素用于治疗痉挛性发音障碍的结果]

[Results of using botulism toxin in the treatment of spasmodic dysphonia].

作者信息

Larrosa F, Idígora A, Aguilar F, Riera L, Martí M J, Valls J

机构信息

Servicio de Otorrinolaringología, Hospital Clínic i Provincial de Barcelona.

出版信息

Acta Otorrinolaringol Esp. 2002 Jan;53(1):27-31. doi: 10.1016/s0001-6519(02)78277-0.

Abstract

Spasmodic Dysphonia (SD) is a dystonia involving laryngeal musculature thus causing a characteristic voice disorder. Two main types of SD have been described. The adductor type is the commonest and it is characterized by a strain-strangle, choked voice. The abductor type can be distinguished from the previous one by episodes of a blown and whispering voice, interrupting speech. Botulism toxin (BTX) has demonstrated to be the most effective treatment for this condition. Thirty patients diagnosed of SD (twenty-nine adductor type/one abductor type) were included. Their degree of dysphonia was evaluated using both functional and visual-analogue scales. They were treated with BTX vocal cord injections using a percutaneous technique under EMG guidance. Improvements up to a 100% of the normal vocal function were obtained, with an average of 82% in the adductor type. The adverse effects were mild and transient. Hypophonia affected 61.3% of patients lasting an average of 11.3 days. Dysphagia was reported in 44.1% of cases lasting an average of 5.8 days.

摘要

痉挛性发声障碍(SD)是一种涉及喉部肌肉组织的肌张力障碍,从而导致特征性的声音障碍。SD主要有两种类型。内收型最为常见,其特征是声音紧张、嘶哑、憋闷。外展型与前者的区别在于会出现气息声和低语声发作,打断言语。肉毒杆菌毒素(BTX)已被证明是治疗这种疾病最有效的方法。纳入了30例诊断为SD的患者(29例内收型/1例外展型)。使用功能量表和视觉模拟量表评估他们的发声障碍程度。在肌电图引导下,采用经皮技术对他们进行BTX声带注射治疗。获得了高达100%的正常发声功能改善,内收型平均改善82%。不良反应轻微且短暂。发声减弱影响了61.3%的患者,平均持续11.3天。44.1%的病例报告有吞咽困难,平均持续5.8天。

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