Abstract
Various treatment modalities for addctor spasmodic dysphonia (ASD) including psychotherapy, relaxation, chewing, audio-visual feedback, tranquillizers, recurrent laryngeal nerve sectioning or botulinum toxin injections into the thyroarytenoid muscle have been reported in the literature. However, these modalities appear to have provided little success toward curing the voice pathology. ASD had long been thought to be largely of psychogenic origin, but recently a few voice scientists have come to believe that the problem reflects an organic disorder of the brain system. Since 1978, we have treated a total of 30 ASD patients by intra-laryngeal sectioning of the thyroarytenoid branch of the recurrent laryngeal nerve. Out of the 30 cases, twenty-seven involved unilateral sectioning while three involved bilateral sectioning. The age of the ASD patients ranged from 18 through 73 years; the average was 47 years. Twelve of the cases were men and 18 were women. Postoperatively, voice rehabilitation programs were administered in all cases weekly, monthly and then yearly until the voice became normal or as nearly normal as possible. Postoperative follow-up periods ran 2 to 15 years. No case showed any complication, including none at all of vocal-cord paralysis, alteration of patient's own voice quality, air-way problem or misdeglutition.
Long-term results indicated normal or nearly normal voice in 26 out of the 30 ASD cases (86.7%). Three other cases yielded moderate improvement. Only one case showed little improvement.
