Spasmodic dysphonia: An overview of clinical features and treatment options
Spasmodic dysphonia: An overview of clinical features and treatment options
复制标题
痉挛性发声困难：临床特征和治疗选择概述
DOI：
10.1016/j.anl.2022.05.012
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发表时间：
2023
影响因子：
1.7
通讯作者：
Sanuki Tetsuji
中科院分区：
文献类型：
--
作者：
Murofushi T;Tsubota M;Suzuki D;Suizu R;Sanuki Tetsuji
痉挛性发声困难（SD）被认为是一种罕见的局灶性喉肌张力障碍，其特征是选择性喉内肌肉组织功能亢进导致的任务特定声音不流畅。症状可以通过感觉技巧来减轻。虽然SD有时可以在全身性肌张力障碍综合征中看到，但它通常是一种偶发现象，并且喉内收肌的受累比外展肌更常见。本研究回顾了文献的发病机制，临床特点，治疗方案，和目前的管理方法的SD。技术进步使临床医生能够更好地了解喉功能和功能障碍之间的联系。影像学和遗传学研究技术的改进有助于更好地了解这种神经喉部疾病的潜在机制。目前，SD的标准治疗是肉毒杆菌毒素（BT）化学去神经的对症治疗。这得到了大量文献的支持，这些文献在许多不同的研究中证明了其疗效，特别是在简单的内收肌形式的疾病中。手术治疗的努力早于BT治疗的发展十年，但长期疗效尚未得到证实，预计将进行进一步的研究。手术和BT治疗后外展肌SD和肌张力障碍伴震颤患者的症状缓解以及患者的症状缓解仍不理想。
Spasmodic dysphonia (SD) is considered a rare focal laryngeal dystonia characterized by task-specific voice dysfluency resulting from selective intrinsic laryngeal musculature hyperfunction. Symptoms may be attenuated by a sensory trick. Although SD can be seen at times in generalized dystonia syndrome, it is typically a sporadic phenomenon, and the involvement of the laryngeal adductor muscles is more common than that of the abductor muscles. This research reviews the literature for the pathogenesis, clinical characteristics, treatment options, and current management methods of SD. Technological advances have enabled clinicians to better understand the connection between laryngeal function and dysfunction. Refinements in imaging and genetic investigation techniques have helped better understand the underlying mechanisms of this neurolaryngology disorder. Currently, the standard of care for SD is the symptomatic management of botulinum toxin (BT) chemodenervation. This is supported by a large body of literature attesting to its efficacy in many different research studies, particularly in the uncomplicated adductor form of the disorder. Efforts towards surgical treatment predate the development of BT treatment by a decade, but the long-term efficacy has not been proven and, further research is expected. Symptom relief in patients with abductor SD and dystonia with tremors after surgical and BT treatments and those in patients remains suboptimal.