中国内镜杂志2026，Vol.32Issue(1)：76-79,4.DOI:10.12235/E20250188
纤维鼻咽镜下经环甲膜声带肉毒毒素注射治疗喉痉挛性构音障碍的应用效果
Fiberoptic nasopharyngoscopy-guided cricothyroid membrane puncture and botulinum toxin injection into the vocal cords in the treatment of spasmodic dysphonia
徐定远 1马昕 1王斌 1王智杰 2叶惠平 2朱悦彤 2熊羿仁2
作者信息
- 1. 河南省人民医院 耳鼻咽喉-头颈外科,河南 郑州 450003
- 2. 贵州省人民医院 耳鼻咽喉科,贵州 贵阳 550000
- 折叠
摘要
Abstract
Objective To explore the clinical efficacy of botulinum toxin injection through the cricothyroid membrane and vocal cords under fiberoptic nasopharyngoscopy in the treatment of spasmodic dysarthria(SD).Methods A retrospective analysis was conducted on the clinical data of 17 patients with SD from December 2022 to December 2024.Observe the type A botulinum toxin injection situation and the occurrence of complications in patients.Results When the fiberoptic nasopharyngoscopy was inserted into the nasal cavity,2 cases(11.8%)found that one nasal cavity was severely narrowed.After switching to the opposite nasal cavity,the insertion was successful.Under the guidance of fiberoptic nasopharyngoscopy,the injection needle was punctured through the cricothyroid membrane into the laryngeal cavity,and 2 u of type A botulinum toxin was injected into both vocal cords respectively.During the injection process,3 cases(17.6%)of patients experienced severe choking cough,which was relieved after repeated surface anesthesia with tetracaine.In 2 cases(11.8%),due to coughing and vocal cord activity,the injection needle fell off and part of the liquid medicine leaked.After adjusting the needle angle,the remaining liquid medicine was injected into the vocal cords.The overall operation time ranged from 0.43～0.68 h,with an average of 0.58 h.1～12 d after injection,with an average of 3.5 d,the patients'pronunciation returned to normal.Three patients had choking cough when drinking water and three patients had hoarseness,which were relieved after 3 to 4 d.Conclusion Injection of botulinum toxin through cricothyroid membrane guided by fiberoptic nasopharyngoscopy is convenient and has a good clinical efficacy in the treatment of SD.It is worthy of clinical promotion and application.关键词
纤维鼻咽镜/肉毒毒素/穿刺/环甲膜/注射/痉挛性构音障碍(SD)Key words
fiberoptic nasopharyngoscopy/botulinum toxin/puncture/cricothyroid membrane/injection/spasmodic dysphonia(SD)分类
医药卫生引用本文复制引用
徐定远,马昕,王斌,王智杰,叶惠平,朱悦彤,熊羿仁..纤维鼻咽镜下经环甲膜声带肉毒毒素注射治疗喉痉挛性构音障碍的应用效果[J].中国内镜杂志,2026,32(1):76-79,4.
