2018 Volume 59 Issue 2 Pages 141-149
Objectives: The study had two objectives: 1) to consider surgical effectiveness on adductive type spasmodic dysphonia (AdSD) performed by thyroplasty type II (TP2), 2) to assess how phonation changes according to the size of the titanium bridge (Tb) and treatment of the anterior commissure.
Subjects and Method: Twenty-eight women with AdSD who underwent TP2 at Tokyo Medical University Hospital were examined for Voice Handicap Index (VHI-10), maximum phonation time (MPT), pitch range, and perceptive judgment: strained (S), interruption (I), or tremor (T), before and after surgery.
Results: VHI-10 was significantly improved from a preoperative mean of 28.3 points to 13.9 postoperatively. S, I and T total scores (Total-SIT) significantly improved from a preoperative mean of 3.2 to 1.1, and pre- and postoperative VHI-10 and Total-SIT significantly correlated.
MPT decreased in dispersion and converged to physiological MPT. The size of Tb significantly correlated with postoperative S and T but not with preoperative factors. The change in pitch range showed no tendency, and voice deterioration seen in one case was suspected to be attributable to difficulty in treatment of the anterior commissure.
Summary: TP2 is useful for AdSD, but in cases of severe tremor, improvement of Total-SIT is insufficient even when using larger Tb.
