Hostname: page-component-78c5997874-fbnjt Total loading time: 0 Render date: 2024-11-18T17:46:43.505Z Has data issue: false hasContentIssue false
  • English
  • Français

Selective lateral laser thyroarytenoid myotomy for adductor spasmodic dysphonia

Published online by Cambridge University Press:  29 April 2010

A Hussain  and
M Shakeel
A Hussain*
Affiliation:
Department of Otolaryngology Head and Neck surgery, University of Aberdeen Hospitals, Aberdeen Royal Infirmary, Scotland, UK
M Shakeel
Affiliation:
Department of Otolaryngology Head and Neck surgery, University of Aberdeen Hospitals, Aberdeen Royal Infirmary, Scotland, UK
*
Address for correspondence: Mr Akhtar Hussain, Consultant Otolaryngologist Head and Neck Surgeon, Department of Otolaryngology Head and Neck Surgery (Ward 45), University of Aberdeen Hospitals, Aberdeen Royal Infirmary, Foresterhill Road, Aberdeen AB25 2ZN, Scotland, UK. Fax:+44 1224 554569 E-mail: drakhtarhussain93@yahoo.co.uk
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

Selective lateral laser thyroarytenoid myotomy is a conceptually sound, simple, minimally invasive, repeatable and predictable new surgical procedure for treating adductor spasmodic dysphonia. This paper aims to introduce and describe the surgical technique, and to present a clinical case series and its outcomes.

Study design:

A prospective, clinical case series treated with selective lateral laser thyroarytenoid myotomy, with follow up of 2.5 years.

Method:

Pre- and post-operative data were collected prospectively for patients undergoing selective lateral laser thyroarytenoid myotomy. These data included patient demographics, previous interventions for adductor spasmodic dysphonia, technical aspects of surgery and clinical outcome. Outcome data included clinical assessment, voice handicap index, need for further intervention, and patient satisfaction assessed by subjective improvement (detailed subjectively by the patients themselves and objectively using the Glasgow benefit inventory).

Results:

Four patients (two men and two women; mean age 65 years; age range 41–80 years) were included. The mean duration of adductor spasmodic dysphonia was 11 years. All patients had previously been treated with botulinum toxin A. All patients reported improvement in voice quality, fluency, sustainability and elimination of voice breaks over 2.5 years' follow up. Clinical assessment revealed no alteration in mucosal wave, and complete relief of hyperadduction was observed on phonation. No patients required supplementary botulinum toxin treatment during follow up.

Conclusion:

Selective lateral laser thyroarytenoid myotomy seems to represent a curative procedure for adductor spasmodic dysphonia, a chronic, debilitating condition. This procedure is conceptually simple, minimally invasive and repeatable. It also seems to offer a safe and lasting alternative to botulinum toxin therapy.

Keywords

Vocal CordsSpasmodic DysphoniaLaser SurgeryThyroarytenoid
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 124 , Issue 8 , August 2010 , pp. 886 - 891
Copyright
Copyright © JLO (1984) Limited 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Presented at the Winter Meeting of the Scottish Otolaryngological Society, 21 November 2008, Aberdeen, Scotland, UK.

Presented at the 6th European Congress of Oto-Rhino-Laryngology Head and Neck Surgery, 30 June to 4 July 2007, Vienna, Austria.

References

1 Boutsen, F, Cannito, MP, Taylor, M, Bender, B. Botox treatment in adductor spasmodic dysphonia: a meta-analysis. J Speech Lang Hear Res 2002;45:469–81CrossRefGoogle ScholarPubMed
2 Sulica, L, Blitzer, A, Brin, MF, Stewart, CF. Botulinum toxin management of adductor spasmodic dysphonia after failed recurrent laryngeal nerve section. Ann Otol Rhinol Laryngol 2003;112:499–505CrossRefGoogle ScholarPubMed
3 Tsunoda, K, Amagai, N, Kondou, K, Baer, T, Kaga, K, Niimi, S. Autologous replacement of the vocal fold: a new surgical approach for adduction-type spasmodic dysphonia. J Laryngol Otol 2005;119:222–5CrossRefGoogle ScholarPubMed
4 Robinson, K, Gatehouse, S, Browning, GG. Measuring patient benefit from otorhinolaryngological surgery and therapy. Ann Otol Rhinol Laryngol 1996;105:415–22CrossRefGoogle ScholarPubMed
5 Remacle, M, Plouin-Gaudon, I, Lawson, G, Abitbol, J. Bipolar radiofrequency-induced thermotherapy (RFITT) for the treatment of spasmodic dysphonia. A report of three cases. Eur Arch Otorhinolaryngol 2005;262:871–4CrossRefGoogle ScholarPubMed
6 Kim, HS, Choi, HS, Lim, JY, Choi, YL, Lim, SE. Radiofrequency thyroarytenoid myothermy for treatment of adductor spasmodic dysphonia: how we do it. Clin Otolaryngol 2008;33:621–5CrossRefGoogle ScholarPubMed
7 Dedo, HH. Recurrent laryngeal nerve section for spastic dysphonia. Ann Otol Rhinol Laryngol 1976;85:451–9CrossRefGoogle ScholarPubMed
8 Berke, GS, Blackwell, KE, Gerratt, BR, Verneil, A, Jackson, KS, Sercarz, JA. Selective laryngeal adductor denervation-reinnervation: a new surgical treatment for adductor spasmodic dysphonia. Ann Otol Rhinol Laryngol 1999;108:227–31CrossRefGoogle ScholarPubMed
9 Chhetri, DK, Mendelsohn, AH, Blumin, JH, Berke, GS. Long-term follow-up results of selective laryngeal adductor denervation-reinnervation surgery for adductor spasmodic dysphonia. Laryngoscope 2006;116:635–42CrossRefGoogle ScholarPubMed
10 Isshiki, N, Tsuji, DH, Yamamoto, Y, Iizuka, Y. Midline lateralization thyroplasty for adductor spasmodic dysphonia. Ann Otol Rhinol Laryngol 2000;109:187–93CrossRefGoogle ScholarPubMed
11 Sanuki, T, Isshiki, N. Overall evaluation of effectiveness of type II thyroplasty for adductor spasmodic dysphonia. Laryngoscope 2007;117:2255–9CrossRefGoogle ScholarPubMed
12 Netterville, JL, Stone, RE, Rainey, C, Zealear, DL, Ossoff, RH. Recurrent laryngeal nerve avulsion for treatment of spastic dysphonia. Ann Otol Rhinol Laryngol 1991;100:10–14CrossRefGoogle ScholarPubMed
13 Weed, DT, Jewett, BS, Rainey, C, Zealear, DL, Stone, RE, Ossoff, RH et al. Long-term follow-up of recurrent laryngeal nerve avulsion for the treatment of spastic dysphonia. Ann Otol Rhinol Laryngol 1996;105:592–601Google ScholarPubMed

Hussain supplementary material

Movie 1.wmv

Download Hussain supplementary material(Audio)
Audio 7.7 MB

Hussain supplementary material

Movie 2.wmv

Download Hussain supplementary material(Audio)
Audio 5.5 MB

Hussain supplementary material

Movie 3.wmv

Download Hussain supplementary material(Audio)
Audio 2.8 MB

Hussain supplementary material

Movie 4.wmv

Download Hussain supplementary material(Video)
Video 16.2 MB