摘要
目的观察腭部肌电图引导下注射A型肉毒毒素治疗腭肌阵挛性耳鸣的临床疗效。方法回顾双侧腭肌阵挛性客观性耳鸣患者资料3例,先将一次性使用肉毒毒素电极针通过鼻内镜辅助分次经鼻腔插入腭帆张肌起始部位、腭帆提肌起始部位、腭帆提肌终止部位,再通过肌电图的引导来确定注射点,注射A型肉毒毒素,每个注射点各注射5U,共30U。复诊至注射后6个月,观察治疗效果及不良反应。结果 1疗效:3例患者分别在注射后26、25、28 h耳鸣完全消失。注射后5个月内每月行鼻内镜、腭肌电图、声导抗检查均未见阳性表现。注射后6个月,仅有1名患者复发单侧耳鸣。2不良反应:随耳鸣逐渐消失出现开放性鼻音、轻度鼻腔反流及轻度耳闷感。治疗后约2周不良反应消失。结论腭肌电图在A型肉毒毒素注射过程中能够精确定位靶肌肉注射点,延长药效作用时间,减少不良反应,取得了良好疗效。
Objective To observe the clinical efficacy of botulinum toxin typeA（BTX-A）in the treatment of palatal myoclonus objective tinnitus（PMOT）under the guidance of palatal electromyography（P-EMG）.Method The clinical data of 3 bilateral PMOT patients were reviewed.With endoscopic assistance,the disposable hypodermic needle elec-trode was inserted at the initiation site of tensor veli palatine（TVP）,levator veli palatine（LVP）,and termination site of LVP through nasal cavity.The direction and depth of the electrodes were adjusted according to the denseness of electric potential outbreak in the EMG diagram d.The superficial site ,with the most dense electric potential outbreak was cho-sen as the point for injection.At each point,5U BTXA was injected every time and the total amount was 30U .The therapeutic effects and adverse reaction were observed for 6 months afterthe injection.Result ①Therapeutic effective-ness：The PMOT was disappeared 26 h,25 h and 28 h after the injection in 3 patients,respectively.None of positive expressions was observed in monthly endoscopic examination,P-EMG,and acoustic immittance examination 5 months after the injection.Recurrence of unilateral tinnitus was noted in only one patient.②Adverse reaction：The side effects, such as open rhinolalia,mild nasal regurgitation and mild ear stuffiness with tinnitus,were identified,but disappeared 2 weeks later afterthe treatment.Conclusion Using P-EMG during BTXA injection can accurately determine the site for injection,extend the action time of BTXA,reduce the adverse reaction,and achieve a good clinical results.
出处
《山东大学耳鼻喉眼学报》
CAS
2015年第1期12-14,共3页
Journal of Otolaryngology and Ophthalmology of Shandong University
关键词
腭肌阵挛性耳鸣
腭肌电图
A型肉毒毒素
腭帆张肌
腭帆提肌
Palatal myoclonus objective tinnitus
Palatal electromyography
Botulinum toxin typeA
Tensor veli pala-tine
Levator veli palatine
