Die Behandlung laryngealer Bewegungsstörungen mit Botulinumtoxinen

Abstract

Laryngeal dystonia (spasmodic dysphonia) is a movement disorder characterised by involuntary contractions of the laryngeal muscles involved in vocalisation. The introduction of botulinum toxin (BTX) in the treatment of laryngeal dystonia had a major clinical impact due to the striking improvement of symptoms. In general, BTX can be delivered by percutaneous injection or by the transoral route. The subcutaneous method is simple, but the effects of the transoral injection, applied through a curved device or by use of a flexible nasolaryngoscope with a working channel and visual control, might be more effective. However, for various reasons the transoral route does not work in every patient. We report our experiences using these different techniques for the monitoring of patients and their treatment with botulinum toxin in laryngeal movement disorders.

Medikamentöse Stimmbehandlung und stimmliche Medikamentennebenwirkungen: Update

“…lupenlaryngoskopischer Kontrolle in Oberflächenanästhesie) oder transkutan (bzw. durch die Membrana cricothyroidea hindurch) unter elektromyografischer Kontrolle [20]. Die Injektion kann uni-oder bilateral durchgeführt werden.…”

Position paper of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery and the German Society of Phoniatrics and Pediatric Audiology – Current state of clinical and endoscopic diagnostics, evaluation, and therapy of swallowing disorders in children

“…Drugs or substances that have an effect based on their form as injections or local applications are, for example, botulinum toxins, injection of which in cases of spasmodic dysphonia or cervical dystonia may cause swallowing difficulties [ 72 ]. Furthermore, superficial anesthetics (contained in some pastilles) reduce sore throat and pains of aphthosis.…”

Medikamentöse Therapie bei Sprach-, Stimm- und Schluckstörungen (Übersicht)

“…lupenlaryngoskopischer Kontrolle in Oberfl ä chenan ä sthesie erfolgen oder transkutan (bzw. die Membrana cricothyreoidea) ü ber eine elektromyographische Kontrolle [16] . F ü r die Behandlung der Spasmodischen Dysphonie wird der etwas aufwendigere transorale Zugang als vorteilhaft angesehen [16] , da ,,Zielgenauigkeit'' als h ö her und daher die notwendige Dosis als geringer eingesch ä tzt werden.…”