Document Detail


Endoscopic laser thyroarytenoid myoneurectomy in patients with adductor spasmodic dysphonia: a pilot study on long-term outcome on voice quality.
MedLine Citation:
PMID:  21940146     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Adductor spasmodic dysphonia (ADSD) is a focal laryngeal dystonia, which compromises greatly the quality of life of the patients involved. It is a severe vocal disorder characterized by spasms of laryngeal muscles during speech, producing phonatory breaks, forced, strained and strangled voice. Its symptoms result from involuntary and intermittent contractions of thyroarytenoid muscle during speech, which causes vocal fold to strain, pressing each vocal fold against the other and increasing glottic resistance. Botulinum toxin injection remains the gold-standard treatment. However, as injections should be repeated periodically leading to voice quality instability, a more definitive procedure would be desirable. In this pilot study we report the long-term vocal quality results of endoscopic laser thyroarytenoid myoneurectomy.
STUDY DESIGN: Prospective study.
METHODS: Surgery was performed in 15 patients (11 females and four males), aged between 29 and 73 years, diagnosed with ADSD. Voice Handicap Index (VHI) was obtained before and after surgery (median 31 months postoperatively).
RESULTS: A significant improvement in VHI was observed after surgery, as compared with baseline values (P=0.001). The median and interquartile range for preoperative VHI was 99 and 13, respectively and 24 and 42, for postoperative VHI. Subjective improvement of voice as assessed by the patients showed median improvement of 80%.
CONCLUSIONS: Because long-term follow-up showed significant improvement of voice quality, this innovative surgical technique seems a satisfactory alternative treatment of ADSD patients who seek a definite improvement of their condition.
Authors:
Domingos Hiroshi Tsuji; Marystella Tomoe Takahashi; Rui Imamura; Adriana Hachiya; Luiz Ubirajara Sennes
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Publication Detail:
Type:  Journal Article     Date:  2011-09-22
Journal Detail:
Title:  Journal of voice : official journal of the Voice Foundation     Volume:  26     ISSN:  1873-4588     ISO Abbreviation:  J Voice     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-09-07     Completed Date:  2013-02-14     Revised Date:  2013-05-02    
Medline Journal Info:
Nlm Unique ID:  8712262     Medline TA:  J Voice     Country:  United States    
Other Details:
Languages:  eng     Pagination:  666.e7-12     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 The Voice Foundation. Published by Mosby, Inc. All rights reserved.
Affiliation:
Department of Otorhinolaryngology, University of São Paulo, School of Medicine, São Paulo, SP, Brazil. domingostsuji@terra.com.br
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Disability Evaluation
Dysphonia / diagnosis,  physiopathology,  surgery*
Female
Humans
Laryngeal Muscles / innervation,  physiopathology,  surgery*
Laryngoscopy* / instrumentation
Laser Therapy* / instrumentation
Lasers, Gas
Male
Middle Aged
Muscle Denervation* / instrumentation
Phonation
Pilot Projects
Prospective Studies
Recovery of Function
Recurrent Laryngeal Nerve / physiopathology,  surgery*
Speech
Speech Production Measurement
Time Factors
Treatment Outcome
Voice Quality*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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