喉部肌张力障碍和肌张力障碍性发声震颤临床特征的全面描述

文献信息

中文摘要

目的： 本研究旨在利用联合分类标准描述喉部肌张力障碍（LD）的表型，并评估A型肉毒神经毒素（BoNT-A）的治疗结果。
方法： 本研究回顾性审查了我院5年内的患者病历以识别LD病例。我们根据更新后的标准对LD亚型（内收型、外展型、混合型）和肌张力障碍性发声震颤（DVT）进行了分类。
结果： 我们分析了75例病例，主要为内收型LD（60%）和DVT（28%）。总体而言，84%的患者为女性，诊断年龄约为68岁。DVT组表现为迟发性发声困难，随时间推移而恶化，并且近半数病例与特发性震颤相关。混合型LD受试者的嗓音障碍指数（VHI）随时间增加最大，并且在所有与DVT相关的病例中病程最长。外展型LD病例的发声困难最严重（VHI：73.3）。三分之二的病例接受了BoNT-A治疗；大多数为内收型LD，接受治疗时间更长，并且治疗拒绝率最低。
结论： 正确的LD分类有助于诊断、预后和治疗；它应该是动态的，并随着患者病史而演变。然而，文献中缺乏关于LD某些方面的数据，强调需要进一步研究以改善临床实践。

英文摘要

OBJECTIVE: This study aimed to characterise laryngeal dystonia (LD) phenotypes using combined classification criteria and to evaluate treatment outcomes with botulinum neurotoxin type A (BoNT-A).
METHODS: The study retrospectively reviewed patient medical records from our clinic over 5 years to identify cases of LD. We classified LD subtypes (adductor, abductor, mixed) and dystonic vocal tremor (DVT) based on updated criteria.
RESULTS: We analysed 75 cases, predominantly adductor LD (60%) and DVT (28%). In all, 84% of patients were females, diagnosed around 68 years of age. The DVT group had late-onset dysphonia that worsened over time and was associated with essential tremor in almost half of cases. Subjects with mixed LD had the greatest increase in Voice Handicap Index (VHI) over time and the longest duration of disease in all cases associated with DVT. Abductor LD cases had the most severe dysphonia (VHI: 73.3). Two-thirds of cases received BoNT-A therapy; most had adductor LD and had received treatment for longer times and had the lowest rate of treatment refusal.
CONCLUSIONS: Correct LD classification aids in diagnosis, prognosis and treatment; it should be dynamic and evolve with the patient's history. However, there is a lack of data in the literature on certain aspects of LD, emphasising the need for further research to improve clinical practice.