Faham Maryam, Ahmadi Akram, Silverman Erin, Harouni Gholamreza Ghaedamini, Dabirmoghaddam Payman
Department of Speech and Language Pathology, Shiraz University of Medical Sciences, Shiraz, Iran; Rehabilitation Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Department of Speech Therapy, School of Rehabilitation, Babol University of Medical Sciences, Babol, IR Iran.
J Voice. 2021 Mar;35(2):271-283. doi: 10.1016/j.jvoice.2019.07.025. Epub 2019 Aug 30.
Adductor spasmodic dysphonia is an extremely disabling voice disorder that negatively impacts a patient's quality of life (QOL). We performed a systematic review to determine if Botulinum Toxin (BT) injections improved voice related QOL in patients with this disorder.
PubMed, EMBASE, Web of Science, Cochrane Library, ProQuest, and Scopus from 2000, to and including November 1st, 2018, were searched. We identified randomized controlled trials, controlled trials, and observational studies of the effects of BT injections on the QOL in patients with adductor spasmodic dysphonia. The two authors, separately and individually chose the studies based on inclusion criteria, assessed study quality, and relevant extracted data.
Nine studies used the Voice Handicap Index (VHI). The results showed significant changes pre- to post-BT injection (SMD = -0.357; 95% CI: -0.579, -0.136; z = 3.16; P = 0.002; I-squared = 0.000%). Five studies used the Voice-Related QOL; their results also showed a significant improvement pre- to postinjection (SMD = -2.99; 95% CI: -3.27, -1.32; z = 4.61; P < 0.001; I-squared = 87%). Three other studies used other, shortened versions of the VHI, VHI-10. They also showed significant results (SMD = -0.145; 95% CI: -0.349, 0.06; z = 1.38; P = 0.17; I-squared = 0.000).
BT injections positively affect patients' QOL. However, patients' QOL scores may never be normalized, in line with perceptual voice quality and acoustic parameters.
内收肌痉挛性发音障碍是一种极其致残的语音障碍，会对患者的生活质量（QOL）产生负面影响。我们进行了一项系统评价，以确定肉毒杆菌毒素（BT）注射是否能改善这种疾病患者与语音相关的生活质量。
检索了2000年至2018年11月1日（含该日）期间的PubMed、EMBASE、科学网、考克兰图书馆、ProQuest和Scopus数据库。我们确定了关于BT注射对内收肌痉挛性发音障碍患者生活质量影响的随机对照试验、对照试验和观察性研究。两位作者分别根据纳入标准选择研究，评估研究质量，并提取相关数据。
九项研究使用了嗓音障碍指数（VHI）。结果显示，BT注射前后有显著变化（标准化均数差[SMD]=-0.357；95%置信区间：-0.579，-0.136；z=3.16；P=0.002；I²=0.000%）。五项研究使用了与语音相关的生活质量量表；其结果也显示注射前后有显著改善（SMD=-2.99；95%置信区间：-3.27，-1.32；z=4.61；P<0.001；I²=87%）。另外三项研究使用了VHI的其他缩短版本，即VHI-10。它们也显示出显著结果（SMD=-0.145；95%置信区间：-0.349，0.06；z=1.38；P=0.17；I²=0.000）。
BT注射对患者的生活质量有积极影响。然而，根据感知语音质量和声学参数，患者的生活质量评分可能永远无法恢复正常。
