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Recurrent laryngeal nerve section for spastic dysphonia

H H Dedo

    The Annals of Otology, Rhinology, and Laryngology
    |July 1, 1976
    PubMed
    Summary

    Surgical recurrent nerve section can improve spastic dysphonia, a voice disorder. This procedure, combined with speech therapy, offers significant vocal quality improvements for many patients, reducing grimaces.

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    Area of Science:

    • Otolaryngology
    • Neurology
    • Speech Pathology

    Background:

    • Spastic dysphonia is a severe vocal disability characterized by excessively adducted vocal cords, resulting in a tight, strangled voice.
    • Previous treatments, including speech and psychotherapy, yielded disappointing results for spastic dysphonia.
    • Observations of recurrent nerve paralysis retracting the vocal cord suggested a potential surgical solution.

    Purpose of the Study:

    • To investigate the efficacy of recurrent nerve section in improving vocal quality for patients with spastic dysphonia.
    • To evaluate the long-term outcomes of this surgical intervention.

    Main Methods:

    • Recurrent nerve section was performed on 34 patients diagnosed with spastic dysphonia.
    • Temporary vocal cord paralysis was induced using Xylocaine to assess potential improvement prior to surgery.
    • Postoperative speech therapy was administered to patients following nerve section.

    Main Results:

    • Approximately 50% of patients achieved a near-normal, albeit soft, phonatory voice after surgery and speech therapy.
    • The remaining patients experienced varying degrees of improvement in phonation ease and quality.
    • Significant reduction or elimination of associated face and neck grimaces was observed in most patients.

    Conclusions:

    • Recurrent nerve section is a viable surgical option for treating spastic dysphonia, offering substantial vocal improvement.
    • The combination of surgical intervention and postoperative speech therapy enhances functional voice outcomes.
    • The procedure effectively addresses the vocal symptoms and associated physical manifestations of spastic dysphonia.

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