Thyroplasty for Adductor Spasmodic Dysphonia: Further Experiences

Objectives Two different surgical techniques for midline lateralization thyroplasty (type 2 thyroplasty) for adductor spasmodic dysphonia (SD) have been described, one using a composite graft and the other without. Indications and results for each method among different types of SD were compared, to...

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Bibliographic Details
Published in:The Laryngoscope 2001-04, Vol.111 (4), p.615-621
Main Authors: Isshiki, Nobuhiko, Haji, Tomoyuki, Yamamoto, Yukiko, Mahieu, Hans F.
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Biological and medical sciences
Female
Glottis - physiopathology
Glottis - surgery
Head and neck surgery. Maxillofacial surgery. Dental surgery. Orthodontics
Humans
lateralization
Male
Medical sciences
Middle Aged
Non tumoral diseases
Otorhinolaryngology. Stomatology
phonosurgery
Spasmodic dysphonia
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the upper aerodigestive tract
Thyroid Cartilage - surgery
thyroplasty
Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology
Vocal Cords - surgery
Voice Disorders - diagnosis
Voice Disorders - physiopathology
Voice Disorders - surgery
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Summary:Objectives Two different surgical techniques for midline lateralization thyroplasty (type 2 thyroplasty) for adductor spasmodic dysphonia (SD) have been described, one using a composite graft and the other without. Indications and results for each method among different types of SD were compared, together with the theoretical background for the surgery. Study Design Retrospective. Methods The medical records of six patients with SD together with the fiberscopic video recording of laryngeal findings before, during, and after surgery were reviewed. The intraoperative video recordings of the surgical procedures were compared with the postoperative findings. Results The vocal features of SD, diverse preoperatively, disappeared postoperatively and a normal, or almost normal, voice was attained in 5 of 6 cases. The failure in one patient was attributed to combined focal dystonia of the neck muscles and difficulty in lateralization. Type 2 thyroplasty without a graft, which causes bowing of both vocal folds, is simple to perform and effective enough for most SD cases. No recurrence has been noted so far over postoperative periods ranging from 6 months to more than 3 years. Conclusion The results suggest that thyroplasty is an effective therapeutic approach for SD.
ISSN:0023-852X
1531-4995
DOI:10.1097/00005537-200104000-00011