应用肉毒毒素A治疗腭肌阵挛性耳鸣临床分析

目的探讨肉毒毒素A对腭肌阵挛源性耳鸣的治疗作用。方法在鼻内窥镜下,将20U肉毒毒素A注射到4例腭肌阵挛性耳鸣患者患侧腭部肌肉内(腭帆张肌、腭帆提肌等),观察患者耳鸣的变化以及是否有并发症出现。同时回顾相关文献,对该病的病因、诊断及治疗加以分析。结果用药后第三天,患者腭部肌肉阵挛和耳鸣均消失,疗效持续约3个月。耳鸣消失的同时出现轻度鼻咽部返流或发声困难,约一周后逐渐消失。结论阵挛的腭部肌肉内注射肉毒毒素A是治疗腭肌阵挛性耳鸣的有效方法。

The Use of Botulinum Toxin A in the Treatment of Palatal Myoclonus Tinnitus

Objective To investigate the use of botulinum toxin (BTX) A in the treatment of palatal myoclonus objective tinnitus (PMOT).Methods We report four patients of involuntary palatal myoclonus presenting with objective tinnitus treated with botulinum toxin injection. Twenty units of botulinum toxin A were injected into the soft palate at the palatal muscles (levator veli palatini,tensor veli palatini muscle,et al). The change of tinnitus and possible complication were observed after injection.Related English research publi cations were reviewed and the pathogenesis, diagnosis, differential diagnosis, treatment and prognosis of PMOT patients were investigated.Results Relief of tinnitus with cessation of palatal myoclonus was found within three days of injection,and the effect of the treatment faded within 3 months period. Mild nasal regurgitation or difficulty with speech, which existed postoperatively, resolved completely after about 7 days.Conclusion The palatal muscles botulinium toxin A injection is an effective treatment for palatal myoclonus tinnitus.