Kühnel T S, Schulte-Mattler W, Bigalke H, Wohlfarth K
Department of Otorhinolaryngology, University of Regensburg, Germany.
Sleep Breath. 2008 Mar;12(1):63-8. doi: 10.1007/s11325-007-0136-8.
The objective of this study was to investigate whether injections of botulinum toxin into the soft palate reduce snoring in a subgroup of patients that present an active process causing habitual snoring. The study was conducted in eight patients with habitual snoring but without evidence of obstructive sleep apnea. Polysomnography was performed for diagnostic purposes and to monitor sleep quality before and after treatment. The patients and their partners completed a questionnaire before and after treatment. Recordings of snoring noise before and after treatment were evaluated on a visual analog scale by a blinded assessor. Doses of 20 U of botulinum toxin type A (Dysport) were injected unilaterally into the muscles of the soft palate. Snoring was reduced in eight cases. The patients reported no major adverse effects. These results justify further studies of botulinum toxin therapy in patients with habitual snoring. The scheme presented for injections of botulinum toxin into the levator veli palatini muscle provides a rational basis for the design of such studies. Therapy with botulinum toxin for habitual snoring is safe, non-invasive, easy to perform, fully reversible, and thus warrants investigation under placebo-controlled, double-blind conditions. This treatment is appropriate for a disorder that is of paramount social importance but does not pose a medical threat to the individuals affected.
本研究的目的是调查向软腭注射肉毒杆菌毒素是否能减轻一组因活跃过程导致习惯性打鼾患者的打鼾症状。该研究针对8名习惯性打鼾但无阻塞性睡眠呼吸暂停证据的患者进行。进行多导睡眠图检查以用于诊断目的,并监测治疗前后的睡眠质量。患者及其伴侣在治疗前后完成了一份问卷。由一名不知情的评估者在视觉模拟量表上评估治疗前后的打鼾噪音记录。将20单位A型肉毒杆菌毒素(Dysport)单侧注射到软腭肌肉中。8例患者的打鼾症状减轻。患者报告无重大不良反应。这些结果证明有必要对习惯性打鼾患者的肉毒杆菌毒素疗法进行进一步研究。向腭帆提肌注射肉毒杆菌毒素的方案为这类研究的设计提供了合理依据。肉毒杆菌毒素治疗习惯性打鼾安全、无创、易于实施、完全可逆,因此有必要在安慰剂对照、双盲条件下进行研究。这种治疗适用于一种具有极其重要社会意义但对受影响个体不构成医学威胁的疾病。