Morzaria S, Damrose E J
Division of Laryngology, Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, California, USA.
J Laryngol Otol. 2011 Jul;125(7):714-8. doi: 10.1017/S0022215111000739. Epub 2011 Apr 27.
Botulinum toxin injection under electromyographic guidance is the 'gold standard' for adductor spasmodic dysphonia treatment. The point-touch technique, an alternative injection method which relies on anatomical landmarks, is cheaper, quicker and more accessible, but has not yet gained widespread acceptance due to concerns about patient satisfaction.
To assess swallowing and voice-related quality of life following point-touch botulinum toxin injection in adductor spasmodic dysphonia patients.
Stanford University Voice and Swallowing Center.
Prospective case series (evidence level four).
Consecutive adductor spasmodic dysphonia patients with a stable botulinum toxin dose-response relationship were recruited prospectively. The Eating Assessment Tool and Voice-Related Quality of Life questionnaires were completed pre-treatment and at 10 and 30 per cent completion of the injection cycle, respectively.
Thirty-seven patients completed follow up. The mean total botulinum toxin dose was 0.88 units. Pre-treatment Voice-Related Quality of Life questionnaire results reflected the burden of disease. Post-treatment Eating Assessment Tool and Voice-Related Quality of Life questionnaire results were collected at 2.53 and 7.84 weeks, respectively; the former showed an increase in dysphagia, albeit statistically insignificant, while the latter showed significantly improved scores (both domain and total).
The point-touch technique is a viable alternative for botulinum toxin injection in the treatment of adductor spasmodic dysphonia.
肌电图引导下肉毒杆菌毒素注射是内收型痉挛性发声障碍治疗的“金标准”。点触技术是一种依赖解剖标志的替代注射方法，成本更低、速度更快且更容易实施，但由于对患者满意度的担忧，尚未得到广泛认可。
评估内收型痉挛性发声障碍患者采用点触法注射肉毒杆菌毒素后的吞咽及与嗓音相关的生活质量。
斯坦福大学嗓音与吞咽中心。
前瞻性病例系列研究（证据水平为四级）。
前瞻性招募肉毒杆菌毒素剂量 - 反应关系稳定的连续性内收型痉挛性发声障碍患者。分别在治疗前、注射周期完成10%和30%时完成饮食评估工具和嗓音相关生活质量问卷调查。
37例患者完成随访。肉毒杆菌毒素平均总剂量为0.88单位。治疗前嗓音相关生活质量问卷结果反映了疾病负担。治疗后饮食评估工具和嗓音相关生活质量问卷结果分别在2.53周和7.84周收集；前者显示吞咽困难有所增加，尽管无统计学意义，而后者显示得分显著改善（包括领域得分和总分）。
点触技术是内收型痉挛性发声障碍治疗中肉毒杆菌毒素注射的一种可行替代方法。
