Inagi K, Ford C N, Bless D M, Heisey D
Department of Surgery, University of Wisconsin Clinical Science Center, Madison 53792, USA.
J Voice. 1996 Sep;10(3):306-13. doi: 10.1016/s0892-1997(96)80012-9.
This study was designed to investigate how variations in patterns of injection could improve the efficacy of botulinum toxin injections in relieving the symptoms of adductor spasmodic dysphonia. A total of 64 adductor spasmodic dysphonia patients who were injected using indirect laryngoscopic localization (for a total of 426 injections) were analyzed retrospectively using their own subjective data on duration of voice improvement, optimal voice improvement, breathiness side effects, and intervals between treatments. Injection to both the thyroarytenoid (TA) and the lateral cricoarytenoid (LCA) simultaneously gave the best voice results; the overall improvement from baseline was the longest lasting, and the period during which the voice was the best was the longest lasting. TA+LCA also gave the shortest duration of undesirable breathiness side effect. On the basis of these data, it seems reasonable to recommend that initial botulinum toxin therapy for adductor spasmodic dysphonia patients should be a single unilateral injection placed strategically at the posterior portion of the TA and directed toward the LCA so that both muscle groups are affected.
本研究旨在探讨注射方式的变化如何提高肉毒杆菌毒素注射缓解内收性痉挛性发声障碍症状的疗效。回顾性分析了64例采用间接喉镜定位注射（共426次注射）的内收性痉挛性发声障碍患者，使用他们自己关于声音改善持续时间、最佳声音改善情况、呼吸音副作用以及治疗间隔的主观数据。同时对甲杓肌（TA）和环杓侧肌（LCA）进行注射可获得最佳的声音效果；与基线相比的总体改善持续时间最长，声音最佳的时期持续时间也最长。TA+LCA联合注射产生不良呼吸音副作用的持续时间也最短。基于这些数据，对于内收性痉挛性发声障碍患者，建议初始肉毒杆菌毒素治疗应采用单次单侧注射，策略性地注射于TA后部并指向LCA，以使两组肌肉都受到影响，这似乎是合理的。
