García Ruiz P J, Cenjor Español C, Sanchez Bernardos V, Astarloa R, Sanabria J, García de Yébenes J
Department of Neurology, Fundacion Jimenez Díaz, Madrid, Spain.
Clin Neuropharmacol. 1998 May-Jun;21(3):196-8.
Spasmodic dysphonia (SD) is at present defined as focal dystonia. Botulinum toxin (BT) injection is the treatment of choice for SD. BT is usually injected by a percutaneous route, but a direct, visually guided transoral approach has also been successful. It is not known whether percutaneous injection is as effective as the transoral approach. This article reviews our experience with both techniques of injection on 29 patients with adductor type SD. Since 1992, we have carried out 48 treatment sessions with the transoral technique and 76 treatment sessions with the percutaneous technique. Two patients did not respond to the percutaneous technique despite several attempts, but they did respond to the transoral approach. Globally, transoral technique was superior to percutaneous technique in terms of effectiveness (48 of 48 responses with transoral technique versus 61 of 76 responses with percutaneous approach, p < 0.01). Dosage of BT, duration, and side effects were similar with both techniques. This article also describes a simple, inexpensive device, composed of materials on hand at every hospital, that facilitates the transoral approach.
痉挛性发音障碍（SD）目前被定义为局灶性肌张力障碍。肉毒杆菌毒素（BT）注射是SD的首选治疗方法。BT通常通过经皮途径注射，但直视引导下的经口直接注射方法也已取得成功。尚不清楚经皮注射是否与经口注射方法一样有效。本文回顾了我们对29例内收型SD患者采用两种注射技术的经验。自1992年以来，我们采用经口技术进行了48次治疗，采用经皮技术进行了76次治疗。尽管多次尝试，仍有2例患者对经皮技术无反应，但他们对经口方法有反应。总体而言，就有效性而言，经口技术优于经皮技术（经口技术48次治疗均有反应，而经皮技术76次治疗中有61次有反应，p<0.01）。两种技术的BT剂量、持续时间和副作用相似。本文还介绍了一种简单、廉价的装置，由每家医院现有的材料组成，便于经口方法的实施。
