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KMID : 0361019950380020267
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Korean Journal of Otolaryngology - Head and Neck Surgery
1995 Volume.38 No. 2 p.267 ~ p.274
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Selective Thyro-Arytenoid(TA) Nerve Section and Ansa Cervicalis Reinnervation for the Treatment of Spasmodic Dysphonia
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Abstract
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Spasmodic dysphonia is a kind of focal dystonia and it is divided into two groups: adductor type and abductor type. The patients with adductor spasmodic dysphonia have typical dysphonia due to hyper-adduction of the vocal folds during phonation.
There
have been two kinds of treatment methods: section of the unilateral recurrent laryngeal nerve (RLN) and injection of Botulinum toxin (Botox). Section of the unilateral RLN couldn't get worldwide popularity, because the nature of the treatment
'not
physiologic' and certain amount of recurrences were reported. Although the initial effect of Botox injection is very good, the effect of the drug only lasts couple of months and several complication has been published.
Recently, selective section of the terminal thyroarytenoid (TA) branch of the RLN has been introduced. Through the thyroid cartilage window. TA branch was identified and cut. The proximal and distal part of the TA nerve were ligated with silk
suture.
The author modified this procedures. The proximal TA branch was ligated and the distal TA branch was reanastomosed with ansa cervicalis nerve bilaterally in order to prevent regeneration from the proximal stump as well as muscle atrophy.
The preliminary results and progress of this procedure on three patients with severe adductor spasmodic dysphonia indicated that this procedure may be one of the possible ideal treatment options and it needs large series with long term follow-up
to
be
verified. (Korean J Otolaryngol 38:2, 1995)
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