Kim Deog Young, Park Chang-il, Ohn Suk Hoon, Moon Ja Young, Chang Won Hyuk, Park Seung-woo
Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, South Korea.
Arch Phys Med Rehabil. 2006 Oct;87(10):1346-51. doi: 10.1016/j.apmr.2006.06.018.
To evaluate the therapeutic effectiveness of botulinum toxin type A (BTX-A) in poststroke patients with cricopharyngeal muscle dysfunction.
Before-after trial.
University hospital.
Eight poststroke patients.
BTX-A injection into the cricopharyngeal muscle under endoscope guidance for poststroke cricopharyngeal muscle dysfunction.
Clinical symptom score, disability rating scale for swallowing impairment, videofluoroscopic swallowing study, and upper esophageal sphincter (UES) manometry.
Clinical symptom score, disability rating scale for swallowing impairment, residue in piriform sinus, and UES pressure were all significantly improved at 2 weeks after BTX-A injection compared with evaluations before injection (P<.05). The effects on the clinical symptom score and disability rating scale for swallowing impairment continued to be significantly improved to 12 weeks after injection (P<.05). However, the residue in piriform sinus and the UES pressure at 12 weeks postinjection were reduced compared with before-injection evaluations; these results were not significant. The pharyngeal transit time was not changed after injection. There were no side effects observed in the patients studied.
The results of the present study suggest that BTX-A injection may be an effective and safe treatment in patients with poststroke cricopharyngeal muscle dysfunction.
评估A型肉毒毒素（BTX-A）对脑卒中后环咽肌功能障碍患者的治疗效果。
前后对照试验。
大学医院。
8例脑卒中患者。
在内镜引导下向环咽肌注射BTX-A，用于治疗脑卒中后环咽肌功能障碍。
临床症状评分、吞咽障碍残疾评定量表、电视荧光吞咽造影检查以及食管上括约肌（UES）测压。
与注射前评估相比，注射BTX-A后2周时，临床症状评分、吞咽障碍残疾评定量表、梨状窝残留以及UES压力均显著改善（P<0.05）。对临床症状评分和吞咽障碍残疾评定量表的影响在注射后持续显著改善至12周（P<0.05）。然而，注射后12周时梨状窝残留和UES压力较注射前评估有所降低，但这些结果无统计学意义。注射后咽传输时间未改变。在所研究的患者中未观察到副作用。
本研究结果表明，注射BTX-A可能是治疗脑卒中后环咽肌功能障碍患者的一种有效且安全的方法。
