McGuirt W F, Blalock D
Laryngoscope. 1980 Sep;90(9):1496-501.
In the early insidious phase of Amyotrophic Lateral Sclerosis (ALS), the patient will often present initially to the otolaryngologist for a presumed speech problem or dysphagia. Adult onset hypernasality, breathiness, articulation defects and voice harshness should all be seen as possible early signs of ALS and may allow the otolaryngologist to be the primary diagnostician for that disease; three such cases are reported here. Once the diagnosis of ALS is made, the otolaryngologist may be involved at different stages in the disease, offering treatment such as Teflon¿ injections, pharyngeal flap, obturator fitting, cricopharyngeal myotomy, tracheostomy, and cervical esophagostomy for speech, swallowing and aspiration problems. Although they do not halt the progression of this fatal disease, these procedures provide an improved quality of life for the patient whose intellectual function is preseved while his motor functions progressively deteriorate. This is more important for the minority of patients having prolonged survival.
在肌萎缩侧索硬化症（ALS）的早期隐匿阶段，患者通常最初会因疑似言语问题或吞咽困难而就诊于耳鼻喉科医生。成人起病的鼻音过重、呼吸音、发音缺陷和声音嘶哑都应被视为ALS可能的早期迹象，这可能使耳鼻喉科医生成为该疾病的主要诊断医生；本文报告了三例此类病例。一旦确诊为ALS，耳鼻喉科医生可能会在疾病的不同阶段参与其中，针对言语、吞咽和误吸问题提供诸如注射聚四氟乙烯、咽瓣手术、佩戴阻塞器、环咽肌切开术、气管切开术和颈部食管造口术等治疗。尽管这些手术无法阻止这种致命疾病的进展，但对于智力功能得以保留而运动功能逐渐恶化的患者而言，这些手术可改善其生活质量。这对于少数生存期延长的患者更为重要。
