NORMAL PHYSIOLOGY, PATHOPHYSIOLOGY, AND TREATMENT OF VOICE DISORDERS

上级长潜伏期甲杓反应的研究继续进行 喉神经刺激导致清醒时声带内收 人类 在55和70 ms之间的长延迟响应被认为具有 和咳嗽反射一样的神经生理学基础。 这种迟来的反应 在发声过程中减少，而早期同侧反应， 增强，这表明各种喉反射反应可能是 不同的志愿活动。 肉毒杆菌毒素治疗痉挛性发声障碍患者 评估III型甲状腺成形术后症状的恢复， 与先前未经治疗的痉挛性发声障碍患者的反应相比， 注射。 症状改善发生在单侧和 双侧注射在以前未经治疗的患者，而后 甲状腺成形术组在任何一种注射后都没有什么好处。 甲状腺成形术可能使痉挛性发音困难患者无法对 其他治疗方法，当症状复发。 肉毒杆菌毒素注射的长期效果进行了评估， 曾接受过多次治疗痉挛性发声障碍的患者 在一边。 单位有较长的持续时间在注射侧，虽然 旋转次数，单位发射次数的测量，没有改变 在注射侧。 随着最后一次注射后时间的增加， 发现的差异较少，表明生理变化 注射后持续一年。

Studies continued on long latency thyroarytenoid responses to superior laryngeal nerve stimulation resulting in vocal fold adduction in the awake human. The long latency response between 55 and 70 ms is thought to have the same neurophysiological basis as the cough reflex. This late response was decreased during phonation while an earlier ipsilateral response was enhanced, suggesting that the various laryngeal reflex responses may be modified differently by voluntary activity. Treatment with botulinum toxin in spasmodic dysphonic patients who had a return of symptoms following Type III Thyroplasty was evaluated and compared with previously untreated spasmodic dysphonic patients' responses to injection. Symptom improvements occurred following both unilateral and bilateral injections in the previously untreated patients, while the post thyroplasty group had few benefits following either type of injection. Thyroplasty may render spasmodic dysphonic patients unable to respond to other treatment approaches when symptoms return. The long-term effects of botulinum toxin injections were evaluated in patients who had received multiple treatments for their spasmodic dysphonia on one side. Units had longer durations on the injected side, although the number of turns, a measure of the number of unit firings, was not altered on the injected side. As the time following the last injection increased, fewer differences were found suggesting that physiological changes following an injection continue past one year.