Sanuki Tetsuji, Takemoto Naoki
Department of Otolaryngology-Head & Neck Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
Laryngoscope. 2023 Dec;133(12):3443-3448. doi: 10.1002/lary.30806. Epub 2023 Jun 6.
Injection of botulinum toxin type A (BTX) into intrinsic laryngeal muscles is the current gold standard therapy for adductor spasmodic dysphonia (AdSD). However, a surgical procedure could potentially offer more stable and long-lasting voice quality to AdSD patients. Here, we report the long-term results of type 2 thyroplasty (TP2) with TITANBRIDGE® (Nobelpharma, Tokyo, Japan) compared with those of BTX injections.
In total, 73 AdSD patients visited our hospital between August 2018 and February 2022. Patients were provided the option of BTX injections or TP2. They were assessed via the Voice Handicap Index (VHI)-10 before treatments and at scheduled clinical follow-ups at 2, 4, 8, and 12 weeks for BTX and at 4, 12, 26, and 52 weeks for TP2.
Overall, 52 patients selected the BTX injection and had a pre-injection mean VHI-10 score of 27.3 ± 8.8. Following injections, the scores significantly improved to 21.0 ± 11.1, 18.6 ± 11.5, and 19.4 ± 11.7 at 2, 4, and 8 weeks, respectively. There were no significant differences between the pre-injection scores and the 12-week scores (21.5 ± 10.7). Alternately, 32 patients opted to be treated with TP2 and had a pre-treatment mean VHI-10 score of 27.7. All patients reported an improvement in their symptoms. Additionally, the mean VHI-10 score significantly improved to 9.9 ± 7.4 at 52 weeks following treatment. There was a significant difference between the two treatment groups at 12 weeks. Some patients received both treatments.
These preliminary results provide important insights into the value of TP2 as a potential permanent treatment for AdSD patients.
3 Laryngoscope, 133:3443-3448, 2023.
向喉内肌注射A型肉毒杆菌毒素（BTX）是目前治疗内收型痉挛性发声障碍（AdSD）的金标准疗法。然而，一种外科手术可能会为AdSD患者提供更稳定、持久的嗓音质量。在此，我们报告使用TITANBRIDGE®（日本东京诺贝尔制药公司）进行2型甲状成形术（TP2）与BTX注射相比的长期结果。
2018年8月至2022年2月期间，共有73例AdSD患者到我院就诊。患者可选择BTX注射或TP2治疗。在治疗前以及BTX治疗后2、4、8和12周以及TP2治疗后4、12、26和52周的定期临床随访中，通过嗓音障碍指数（VHI）-10对患者进行评估。
总体而言，52例患者选择了BTX注射，注射前VHI-10平均评分为27.3±8.8。注射后，2周、4周和8周时评分分别显著改善至21.0±11.1、18.6±11.5和19.4±11.7。注射前评分与12周评分（21.5±10.7）之间无显著差异。另外，32例患者选择接受TP2治疗，治疗前VHI-10平均评分为27.7。所有患者均报告症状有所改善。此外，治疗后52周时VHI-10平均评分显著改善至9.9±7.4。两个治疗组在12周时存在显著差异。部分患者接受了两种治疗。
这些初步结果为TP2作为AdSD患者潜在的永久性治疗方法的价值提供了重要见解。
3 《喉镜》，133:3443 - 3448，2023年。
