2006 Volume 57 Issue 1 Pages 20-27
Spasmodic dysphonia is one of the diseases that present a formidable problem for the attending otorhinolaryngologist. To treat adductor-type spasmodic dysphonia, an injection of botulinum toxin (BT) into the thyroarytenoid muscle is universally accepted as the first choice of treatment, but unfortunately it is not covered by National Health Insurance in this country and there is not a common practice. In its place, various other therapeutic modalities have been reported. Furthermore the efficacy of BT therapy is not permanent, which is another reason calling for the design of a surgical procedure with more lasting effect as an alternate choice to correct this affliction.
In the current study, we conducted a thyroarytenoid myectomy on patients with adductor-type spasmodic dysphonia, the results of which are presented below.
This cases of three patients with adductor-type spasmodic dysphonia who visited our department between 2001 and 2005 are described. The details of BT therapy and the surgical procedure were informed to the patients and their families. Because all three desired to undergo the surgical therapy, a bilateral thyroarytenoid myectomy via laryngomicrosurgery was conducted.
The constriction was eliminated immediately after surgery and the patients became capable of smooth phonation. However, hoarseness B grade 3 related to breathing was recognized; but this began to ease after a month or two and was corrected to B grade 1-0 after about 6 months after the surgery. Improvement in the condition was noted in all three patients according to evaluations based on the Mora method before and after surgery. All patients are currently in the B grade 0 state, free of recurrence but are still under observation.
Bilateral thyroarytenoid myectomy is a therapeutic option for cases of spasmodic dysphonia if they expect an effect of long term.
