両側甲状披裂筋切除術後にボツリヌストキシン注射を受けた痙攣性発声障害例

抄録

A rare case of adductor spasmodic dysphonia treated with a botulinum toxin injection after a bilateral thyroarytenoid myectomy is reported. We discuss the difficulty of diagnosis and therapy of spasmodic dysphonia. The patient was a 60 year-old male, whose profession depended on his voice. He had felt dysphonia over 20 year period. He had tried voice therapies and folk remedies at otolaryngological and psychopathological hospitals; however, the symptom had not improved. Later he read an article regarding spasmodic disphonia in a newspaper and subsequently visited Osaka University Hospital. He was then diagnosed with adductor spasmodic dysphonia. A bilateral thyroarytenoid myectomy was performed in March of 2001. After the operation, the dysphonia had improved and he was able to spend dairy life with better vocalization. Although it initially appered that there would be no recurrence, he gradually came to sense dysphonia slightly. This dysphonia however was to a degree that couldn't be objectively recognizeed. He hoped this symptom could be remedied because of his occupation as a Buddhist priest and singer of Japanese court music. Boturinum toxin injection therapy was recommended to him. After this treatment, the symptom improved. He presently continues this therapy.