Klap P, Marion M H, Perrin A, Fresnel-Elbaz E, Cohen M
Fondation A. de Rothschild, Service O.R.L., Paris, France.
Rev Laryngol Otol Rhinol (Bord). 1993;114(4):281-7.
The botulinum toxin is a highly potent neurotoxin, used since several years in the treatment of the focal musculary dystonias. We define the laryngeal dystonia as a clinical entity, which is represented by a spasmodic dysphonia or an inspiratory dyspnea without dysphonia, related to a specific dystonia of the thyroarytenoid muscles. The laryngeal functional exploration (i.e. fibroscopy, videostroboscopy, acoustic analysis, computerized voice analysis), the neurological and electrophysiological assessment allow to make diagnosis and evaluation of the therapeutical results of this rare laryngeal neurologic disease which was relatively misunderstood until now. There are several clinical types of spasmodic dysphonia: adductor form (with a jerky voice, pitch beaks, vocal arrests and pneumophonatory incoordination); abductor form (with a breathy voice of very low intensity) and mixed types which can be difficult to identify. Since 1989, we have treated 55 laryngeal dystonias with local intra-muscular botulinum toxin injection: 48 spasmodic dysphonia and 7 inspiratory dyspnea without dysphonia, with hyperactivity of the thyroaryténoïd muscles. We present our therapeutical protocol and results which are good in 87% of cases.
肉毒杆菌毒素是一种高效的神经毒素，数年来一直用于治疗局灶性肌张力障碍。我们将喉肌张力障碍定义为一种临床病症，其表现为痉挛性发声困难或无发声困难的吸气性呼吸困难，与甲杓肌的特定肌张力障碍有关。喉部功能检查（即纤维喉镜检查、频闪喉镜检查、声学分析、计算机语音分析）、神经学和电生理评估有助于对这种迄今为止相对被误解的罕见喉部神经疾病进行诊断和评估治疗效果。痉挛性发声困难有几种临床类型：内收型（声音急促、音高突变、发声中断和呼吸性发声不协调）；外展型（声音微弱且带呼吸声）以及难以鉴别的混合型。自1989年以来，我们用局部肌肉注射肉毒杆菌毒素治疗了55例喉肌张力障碍患者：48例痉挛性发声困难和7例无发声困难的吸气性呼吸困难，均伴有甲杓肌功能亢进。我们展示了我们的治疗方案及结果，87%的病例效果良好。
