Simpson C Blake, Lee Christopher T, Hatcher Jeanne L, Michalek Joel
Department of Otolaryngology-Head and Neck Surgery, University of Texas Health Sciences Center at San Antonio, San Antonio, Texas, U.S.A.
Department of Otolaryngology-Head and Neck Surgery, Emory University, Atlanta, Georgia, U.S.A.
Laryngoscope. 2016 Jan;126(1):118-21. doi: 10.1002/lary.25515. Epub 2015 Oct 15.
OBJECTIVES/HYPOTHESIS: Supraglottic injection of botulinum toxin (Botox) has been described as an effective treatment for adductor spasmodic dysphonia (ADSD). Anecdotal evidence suggests that the patients have little to no breathiness after injection, but no formal longitudinal studies have been carried out to date. The purpose of this study was to examine the voice outcomes in patients with ADSD after supraglottic Botox injection.
Retrospective case series.
Patients with ADSD who were treated with supraglottic Botox injections completed a qualitative self-evaluation of voice function after injection using the percentage of normal function (PNF) scale, a validated, quantitative scale from 0% (no function) to 100% (normal function). Posttreatment voice improvement after injection was determined using a Voice Handicap Index-10 (VHI-10) questionnaire.
A total of 198 supraglottic injections were performed between July 2011 and October 2014. Twenty-five questionnaires were completed. Mean postinjection PNF was 95.0% ± 8.4% and was significantly increased from the preinjection mean PNF (62.5%) ± 22.6% (P < 0.001). The mean best VHI-10 for all injections was 7.23. In 19 of 25 patients (76%), there was no reduction in PNF in the early postinjection period. In the remaining six patients (24%), the decline in mean vocal function was 9.2%.
Supraglottic Botox injection is an effective treatment for ADSD. Postinjection voice is significantly improved, and the majority of patients do not experience breathy voice/decline in vocal function after injection.
目的/假设：声门上注射肉毒杆菌毒素（保妥适）已被描述为治疗内收型痉挛性发声障碍（ADSD）的一种有效方法。轶事证据表明，患者注射后很少或没有呼吸音，但迄今为止尚未进行正式的纵向研究。本研究的目的是检查声门上注射保妥适后ADSD患者的嗓音结果。
回顾性病例系列。
接受声门上保妥适注射治疗的ADSD患者，使用正常功能百分比（PNF）量表完成注射后嗓音功能的定性自我评估，该量表是一种经过验证的定量量表，范围从0%（无功能）到100%（正常功能）。使用嗓音障碍指数-10（VHI-10）问卷确定注射后的嗓音改善情况。
2011年7月至2014年10月期间共进行了198次声门上注射。完成了25份问卷。注射后PNF的平均值为95.0%±8.4%，与注射前PNF的平均值（62.5%）±22.6%相比显著增加（P<0.001）。所有注射的平均最佳VHI-10为7.23。25例患者中有19例（76%）在注射后早期PNF没有降低。其余6例患者（24%）的平均嗓音功能下降了9.2%。
声门上注射保妥适是治疗ADSD的有效方法。注射后嗓音有显著改善，大多数患者注射后没有呼吸音/嗓音功能下降的情况。
