山东大学耳鼻喉眼学报 ›› 2015, Vol. 29 ›› Issue (1): 12-14.doi: 10.6040/j.issn.1673-3770.0.2014.242

• 论著 • 上一篇    下一篇

腭肌电图引导下治疗腭肌阵挛性耳鸣

王坛, 安丰伟, 陈剑秋, 林家峰, 侯晓智, 解翠丽, 王英, 林娟   

  1. 济南军区总医院耳鼻咽喉头颈外科, 山东 济南 250033
  • 收稿日期:2014-07-23 出版日期:2015-02-16 发布日期:2015-02-16
  • 通讯作者: 安丰伟。E-mail:90ent@163.com E-mail:90ent@163.com
  • 作者简介:王坛。E-mail:41269304@qq.com

Treatment of palatal myoclonus objective tinnitus guided by palatal electromyogram

WANG Tan, AN Feng-wei, CHEN Jian-qiu, LIN Jia-feng, HOU Xiao-zhi, XIE Cui-li, WANG Ying, LIN Juan   

  1. Department of Otolaryngology & Head and Neck Surgery, General Hospital of Jinan Military Region, Jinan 250031, Shandong, China
  • Received:2014-07-23 Online:2015-02-16 Published:2015-02-16

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。

关键词: A型肉毒毒素, 腭帆张肌, 腭肌阵挛性耳鸣, 腭肌电图, 腭帆提肌

Abstract: 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 electrode 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 chosen 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 ① Therapeutic effectiveness: 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.② Adverse 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.

Key words: Tensor veli palatine, Palatal electromyography, Levator veli palatine, Botulinum toxin typeA, Palatal myoclonus objective tinnitus

中图分类号: 

  • R764.45
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