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Updated: Jun 25, 2026
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A Protocol for Comprehensive Assessment of Bulbar Dysfunction in Amyotrophic Lateral Sclerosis (ALS)
Published on: February 22, 2011
Estridor y distonía laríngea focal
1Department of Otorhinolaryngology, Fondation Rothschild, Paris, France.
Lancet (London, England)
|February 22, 1992
Resumen
El síndrome de Gerhardt, caracterizado por estridor laríngeo, no es causado por la parálisis del abductor de las cuerdas vocales. En cambio, es una distonía laríngea focal tratable con inyecciones de toxina botulínica.
Área de la Ciencia:
- La otorrinolaringología otorrinolaringología.
- Neurología Neurología.
- Trastornos del movimiento Trastornos del movimiento.
Sus antecedentes:
- El síndrome de Gerhardt se presenta con estridor laríngeo, históricamente atribuido a la parálisis del músculo abductor de las cuerdas vocales.
- Esta condición afecta el posicionamiento de las cuerdas vocales y la permeabilidad de las vías respiratorias.
Objetivo del estudio:
- Para investigar la fisiopatología subyacente del síndrome de Gerhardt.
- Para determinar la eficacia de la toxina botulínica en el tratamiento del estridor laríngeo asociado con este síndrome.
Principales métodos:
- La laringoscopia de fibra óptica se realizó en 6 pacientes que presentaban estridor laríngeo.
- La electromiografía (EMG) evaluó la actividad muscular de la cuerda vocal.
- Se administraron inyecciones de toxina botulínica a los músculos tiroartenóides hiperactivos en pacientes afectados.
Principales resultados:
- La laringoscopia reveló cuerdas vocales inmóviles en una posición paramediana sin otras causas locales.
- La EMG demostró hiperactividad de los aductores de las cuerdas vocales, sin signos de denervación en los músculos abductores.
- Las inyecciones de toxina botulínica abolieron con éxito el estridor en todos los pacientes tratados.
Conclusiones:
- El síndrome de Gerhardt es una distonía laríngea focal, no causada por la parálisis del abductor de las cuerdas vocales.
- Las inyecciones de toxina botulínica dirigidas a los músculos aductores hiperactivos ofrecen un tratamiento potencial para el síndrome de Gerhardt.
- Este enfoque puede ser una alternativa viable a las intervenciones quirúrgicas como la aritenoidopexia o la traqueotomía.
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