García Ruiz P J, Cenjor Español C, Sánchez Pernaute R, Astarloa R, Sánchez Bernardos V, García de Yébenes Prous J
Servicio de Neurología, Fundación Jiménez Diaz, Madrid.
Neurologia. 1996 Jun-Jul;11(6):216-9.
Spasmodic dysphonia is a focal dystonia that effects the proximal muscles (adduction dystonia) or dilatory (abduction dystonia) of the larynx. Botulinum toxin (BTX), generally delivered by percutaneous injection, is the treatment of choice. Recently, use has been made of a transoral route of delivery, with BTX injected through a curved device with visual control. It remains to be determined which route is better. Percutaneous injection is simple and well-tolerated, but the transoral route is theoretically more effective. We assessed the efficacy of both techniques in 19 patients with adduction dystonia, conducting 55 treatment sessions by percutaneous injection and 20 by transoral injection. All the transoral treatments were effective (20/20, 100%), but only 81% (45-155) of the percutaneous treatments were (p < 0.05). Two patients who had doubtful responses after percutaneous delivery improved considerably when the transoral approach was used. In spite of its greater complexity, the transoral approach is probably more effective than the percutaneous route. We describe a curved device for transoral injection that is composed of simple elements available at any health center.
痉挛性发音障碍是一种局灶性肌张力障碍，影响喉部近端肌肉（内收性肌张力障碍）或扩张肌（外展性肌张力障碍）。肉毒杆菌毒素（BTX）通常通过经皮注射给药，是首选治疗方法。最近，已采用经口给药途径，通过带有视觉控制的弯曲装置注射BTX。哪种途径更好仍有待确定。经皮注射简单且耐受性良好，但经口途径理论上更有效。我们评估了这两种技术对19例内收性肌张力障碍患者的疗效，经皮注射进行了55次治疗，经口注射进行了20次治疗。所有经口治疗均有效（20/20，100%），但经皮治疗只有81%（45/55）有效（p<0.05）。两名经皮给药后反应可疑的患者采用经口方法后有明显改善。尽管经口方法更为复杂，但可能比经皮途径更有效。我们描述了一种用于经口注射的弯曲装置，它由任何健康中心都能获得的简单部件组成。
