Botulinum toxin management of spasmodic dysphonia (laryngeal dystonia): A 12-year experience in more than 900 patients
Botulinum toxin management of spasmodic dysphonia (laryngeal dystonia): A 12-year experience in more than 900 patients
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DOI：
10.1002/lary.25273
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发表时间：
2015-08-01
期刊：
影响因子：
2.6
通讯作者：
Stewart, Celia F.
中科院分区：
文献类型：
--
作者：
Blitzer, Andrew;Brin, Mitchell F.;Stewart, Celia F.
目的：本文回顾了12年来900多例痉挛性发声障碍患者接受肉毒杆菌毒素治疗的经验。研究设计：这是一项对内收肌痉挛性发声障碍（紧张性窒息音）、外展肌痉挛性发声障碍（耳语音）和内收肌呼吸肌张力障碍（声带反常运动）患者的回顾性分析，所有患者均接受肉毒杆菌毒素注射治疗以缓解症状。研究方法：所有患者均接受了完整的头颈部和神经系统检查;纤维喉镜频闪检查;声学和空气动力学测量;以及包括通用痉挛性发音障碍评定量表在内的语音评估。有些人接受了肌电图检查。所有患者均在肌电图指导下接受肉毒杆菌毒素注射。结果：内收肌患者平均受益90%的正常功能，平均持续15.1周。外展肌患者的正常功能平均受益率为66.7%，平均持续10.5周。副作用包括内收肌患者的轻度呼吸和咳嗽，以及少数外展肌患者的轻度喘鸣。结论：在过去的12年中，发现肉毒毒素A注射喉功能亢进肌肉是控制大多数痉挛性发声障碍患者肌张力障碍症状的治疗选择。
Objectives: This paper reviews a 12-year experience in more than 900 patients with spasmodic dysphonia who have been treated with botulinum toxin. Study Design: This is a retrospective analysis of patients with adductor spasmodic dysphonia (strain-strangled voice), abductor spasmodic dysphonia (whispering voice), and adductor breathing dystonia (paradoxical vocal fold motion), all of whom have been treated with botulinum toxin injections for relief of symptom. Methods: All of the patients were studied with a complete head and neck and neurologic examination; fiberoptic laryngostroboscopy; acoustic and aerodynamic measures; and a speech evaluation including the Universal spasmodic dysphonia rating scale. Some were given electromyography. All patients received botulinum toxin injections into the affected muscles under electromyographic guidance. Results: The adductor patients had an average benefit of 90% of normal function lasting an average of 15.1 weeks. The abductor patients had an average benefit of 66.7% of normal function lasting an average of 10.5 weeks. Adverse effects included mild breathiness and coughing on fluids in the adductor patients, and mild stridor in a few of the abductor patients. Conclusion: Botulinum toxin A injection of the laryngeal hyperfunctional muscles has been found over the past 12 years to be the treatment of choice to control the dystonic symptoms in most patients with spasmodic dysphonia.