Blitzer A, Brin M F, Fahn S, Lovelace R E
Department of Otolaryngology, College of Physicians and Surgeons, Columbia University, New York, NY 10032.
Laryngoscope. 1988 Feb;98(2):193-7. doi: 10.1288/00005537-198802000-00015.
Spastic dysphonia is a condition producing a strain-strangle phonation. We have previously classified most of these patients as having focal laryngeal dystonia, a disorder of central motor processing. The initial success of recurrent nerve section in many of these patients has been followed by recurrence of symptoms in months to years. Bilateral involvement of the vocal cords with hyperfunction of the nonparalyzed vocal cord could explain these failures. Injection of botulinum toxin (BOTOX) has been effective treatment for many focal dystonias. We have treated more than 100 patients with dystonia including five with laryngeal dystonia. All of the patients laryngeal had dramatic improvement after 48 to 72 hours; benefit lasted 3 to 9 months for each injection period. BOTOX injection can be performed on awake, ambulatory patients. Bilateral treatment and titration of dose can achieve the desired degree of weakness.
痉挛性发音障碍是一种导致紧张性发声的病症。我们之前将大多数此类患者归类为患有局灶性喉肌张力障碍，这是一种中枢运动处理障碍。许多此类患者喉返神经切断术最初取得成功后，数月至数年内症状会复发。双侧声带受累且未麻痹声带功能亢进可以解释这些失败情况。注射肉毒杆菌毒素（保妥适）对许多局灶性肌张力障碍是有效的治疗方法。我们已经治疗了100多名肌张力障碍患者，其中包括5名喉肌张力障碍患者。所有喉部患者在48至72小时后都有显著改善；每次注射期疗效持续3至9个月。保妥适注射可在清醒、能走动的患者身上进行。双侧治疗和剂量滴定可达到所需的无力程度。
