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Intractable Aspiration Treated With Laryngectomy After SLAD-R Surgery: A Case Report.

Lillian Acree¹, Evan C Compton², J Kenneth Byrd²

¹Department of Otolaryngology-Head and Neck Surgery, Medical College of Georgia at Augusta University, Augusta, Georgia, U.S.A.

The Laryngoscope

|May 13, 2024

Summary

Selective adductor recurrent laryngeal nerve denervation and reinnervation (SLAD-R) surgery for adductor spasmodic dysphonia can lead to bilateral vocal fold paralysis. This rare complication necessitates careful patient follow-up.

Keywords:

dysphagia recurrent laryngeal denervation and reinnervation spasmodic dysphonia

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Area of Science:

Otolaryngology
Neurosurgery
Speech Pathology

Background:

Adductor spasmodic dysphonia (ADSD) is a neurological voice disorder.
Selective adductor recurrent laryngeal nerve denervation and reinnervation (SLAD-R) is a surgical option for ADSD.
Complications of SLAD-R require thorough investigation.

Observation:

A case of bilateral vocal fold paralysis (BVFP) following SLAD-R is presented.
BVFP resulted in the need for a total laryngectomy.
This complication highlights potential risks associated with SLAD-R.

Findings:

Bilateral vocal fold paralysis (BVFP) may be an underreported complication of SLAD-R.
The incidence of BVFP after SLAD-R warrants further study.
Optimal long-term patient follow-up is crucial after this procedure.

Implications:

This case underscores the importance of vigilant post-operative monitoring for SLAD-R patients.
Understanding the risk of BVFP can inform surgical decision-making and patient counseling.
Improved awareness and follow-up protocols may prevent severe outcomes like total laryngectomy.