Ramachandran K, Arunachalam P S, Hurren Anne, Marsh R L, Samuel P R
Department of Otolaryngology and Head and Neck Surgery, Sunderland Royal Hospital, Sunderland.
J Laryngol Otol. 2003 Jul;117(7):544-8. doi: 10.1258/002221503322112978.
Spasm of the pharyngo-oesophageal segment is one of the important causes of tracheo-oesophageal voice failure. Traditionally it has been managed by either prolonged speech therapy, surgical pharyngeal myotomy or pharyngeal plexus neurectomy with varying degrees of success. Botulinum neurotoxin has been found to be effective in relieving pharyngo-oesophageal segment spasm. Since 1995, we have used botulinum toxin injection on 10 laryngectomees with either aphonia or hypertonicity due to pharyngo-oesophageal segment spasm. Early results were analysed by the Sunderland Surgical Voice Restoration Rating scale. Seven of the 10 patients, who were previously completely aphonic, developed voice following this therapy and are using their valve choice as their only method of communication. Out of the three patients who were treated for hypertonic voice, two did derive some benefit from the procedure. One patient developed a hypotonic voice, which lasted for a few months.
咽食管段痉挛是气管食管发音失败的重要原因之一。传统上，其治疗方法包括长期言语治疗、手术性咽肌切开术或咽丛神经切除术，但疗效各异。现已发现肉毒杆菌神经毒素可有效缓解咽食管段痉挛。自1995年以来，我们对10例因咽食管段痉挛而出现失音或发声亢进的喉切除患者进行了肉毒杆菌毒素注射。采用桑德兰手术语音恢复评分量表对早期结果进行分析。10例先前完全失音的患者中，有7例经此治疗后恢复了发声，并将其选用的瓣膜作为唯一的交流方式。在接受发声亢进治疗的3例患者中，有2例确实从该手术中获益。1例患者出现了发声无力，持续了几个月。
