성대결절에서 보툴리늄독소주입술의 효과
The Effects of Botulinium Toxin in Vocal Nodules
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Background and Objectives Vocal nodules are the most common voice disorder due to vocal misuses. Vocal nodules are primarily treated with voice therapy and are rarely removed through laryngomicrosurgery. Although the rate of recovery for individual patients may vary, 60-70% of them are fully treated. Because vocal nodules have many possible causes, 30-40% of patients remain untreated. Also, vocal nodules recurrence after the surgical treatment is sometimes observed. The author claims that incomplete contact between vocal cords during phonation is a major cause of the vocal nodules. Most vocal nodules do occur from incomplete contact between vocal cords during phonation, and various voice therapies are designed to improve habitual misuses of the vocal cords. However, vocal nodules tend to remain unhealed unless patients change their habitual misuses of the vocal cords. The cricothyroid muscle tension is known to hinder the contact between vocal cords. The author injected a restricted amount of botulinium toxin to the cricothyroid muscle to reduce the muscle tension and observed changes in vocal cords’ movement. Subjects and Method In this study, the author injected botulinium toxin to the cricothyroid muscle of 21 patients. For 2-4 weeks, we observed patients’ responses to the treatment, by measuring changes in subglottal pressure, mean air flow rate, maximum phonation time, jitter, shimmer, noise-to-harmonic ration of patients and subjective evaluation of voice changes. In addition, the author conducted stroboscopy to evaluate the usefulness of the treatment. Results The improvement was in the subjective evaluation of voice changes and stroboscopic findings. Conclusion The observation demonstrated a great improvement in vocal nodules after the injection of botulinium toxin into the cricothyroid muscle. Korean J Otorhinolaryngol-Head Neck Surg 2014;57(9):610-5
Abstract
Background and Objectives Vocal nodules are the most common voice disorder due to vocal misuses. Vocal nodules are primarily treated with voice therapy and are rarely removed through laryngomicrosurgery. Although the rate of recovery for individual patients may vary, 60-70% of them are fully treated. Because vocal nodules have many possible causes, 30-40% of patients remain untreated. Also, vocal nodules recurrence after the surgical treatment is sometimes observed. The author claims that incomplete contact between vocal cords during phonation is a major cause of the vocal nodules. Most vocal nodules do occur from incomplete contact between vocal cords during phonation, and various voice therapies are designed to improve habitual misuses of the vocal cords. However, vocal nodules tend to remain unhealed unless patients change their habitual misuses of the vocal cords. The cricothyroid muscle tension is known to hinder the contact between vocal cords. The author injected a restricted amount of botulinium toxin to the cricothyroid muscle to reduce the muscle tension and observed changes in vocal cords’ movement. Subjects and Method In this study, the author injected botulinium toxin to the cricothyroid muscle of 21 patients. For 2-4 weeks, we observed patients’ responses to the treatment, by measuring changes in subglottal pressure, mean air flow rate, maximum phonation time, jitter, shimmer, noise-to-harmonic ration of patients and subjective evaluation of voice changes. In addition, the author conducted stroboscopy to evaluate the usefulness of the treatment. Results The improvement was in the subjective evaluation of voice changes and stroboscopic findings. Conclusion The observation demonstrated a great improvement in vocal nodules after the injection of botulinium toxin into the cricothyroid muscle. Korean J Otorhinolaryngol-Head Neck Surg 2014;57(9):610-5
참고문헌 (19)
- Ahn CM, "Functional Dysphonia and Voice Therapy", pp.123~130 (2004), Dae Han Eui Hak Seo Jeok
- Czerwonka L, "Vocal nodules and edema may be due to vibration-induced rises in capillary pressure", Laryngoscope, 118(4), pp.748~752 (2008)
- 이정엽, "전문 음성사용인들의 성대결절에 있어 성대 내 스테로이드 주입술 이후 음성치료의 유용성", 대한이비인후과학회지 두경부외과학, 57(1), pp.32~37 (2014), 대한이비인후과학회[DOI]
- Ahn CM, "Therapeutic effects of voice therapy on functional voice disorders", Korean J Otolaryngol, 39(2), pp.288~294 (1996)
- Holmberg EB, "Efficacy of a behaviorally based voice therapy protocol for vocal nodules", J Voice, 15(3), pp.395~412 (2001)
- McCrory E, "Voice therapy outcomes in vocal fold nodules: a retrospective audit", Int J Lang Commun Disord, 36(Suppl), pp.19~24 (2001)
- Pyo HY, "The efficiency of voice therapy for the patients with vocal nodules", J Korean Logo Phon, 8(2), pp.178~184 (1997)
- Van Houtte E, "The prevalence of laryngeal pathology in a treatment-seeking population with dysphonia", Laryngoscope, 120(2), pp.306~312 (2010)
- Shah RK, "Pediatric vocal nodules:correlation with perceptual voice analysis", Int J Pediatr Otorhinolaryngol, 69(7), pp.903~909 (2005)
- Martins RH, "Vocal fold nodules: morphological and immunohistochemical investigations", J Voice, 24(5), pp.531~539 (2010)
- Johns MM, "Update on the etiology, diagnosis, and treatment of vocal fold nodules, polyps, and cysts", Curr Opin Otolaryngol Head Neck Surg, 11(6), pp.456~461 (2003)
- Chernobelsky SI, "The treatment and results of voice therapy amongst professional classical singers with vocal fold nodules", Logoped Phoniatr Vocol, 32(4), pp.178~184 (2007)
- Ragab SM, "Radiophonosurgery of benign superficial vocal fold lesions", J Laryngol Otol, 119(12), pp.961~966 (2005)
- Benninger MS, "Microdissection or microspot CO2 laser for limited vocal fold benign lesions: a prospective randomized trial", Laryngoscope, 110(2 pt 2 Suppl 92), pp.1~17 (2000)
- Allen JE, "Botulinum toxin in the treatment of vocal fold nodules", Curr Opin Otolaryngol Head Neck Surg, 17(6), pp.427~430 (2009)
- Cheng CM, "Unlabeled uses of botulinum toxins:a review, part 1", Am J Health Syst Pharm, 63(2), pp.145~152 (2006)
- Sataloff RT, "Professional voice: the science and art of clinical care", pp.111~130 (1997), Singular Publishing Group
- Valadez V, "Voice parameters and videonasolaryngoscopy in children with vocal nodules: a longitudinal study, before and after voice therapy", Int J Pediatr Otorhinolaryngol, 76(9), pp.131~1365 (2012)
- Brockmann M, "Reliable jitter and shimmer measurements in voice clinics: the relevance of vowel, gender, vocal intensity, and fundamental frequency effects in a typical clinical task", J Voice, 25(1), pp.44~53 (2011)
