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Vocal outcome after endoscopic thyroarytenoid myoneurectomy in patients with adductor spasmodic dysphonia

  • Laryngology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Spasmodic dysphonia (SD) remains one of the most difficult of laryngeal pathologies to treat. With limited role for speech therapy, various surgical modalities have been tried with various success rates. The objective of the study is to report the results of vocal outcome after thyroarytenoid myoneurectomy in patients of adductor spasmodic dysphonia (ASD). 15 patients of ASD were selected. GRBAS, and voice handicap index (VHI) were used for perceptual evaluation of voice. Thyroarytenoid myoneurectomy was performed by vaporizing the muscular layer of the vocal fold with CO2 laser, at an intensity of 6 W with 1.2 mm diameter in scanner mode. Voice analysis was repeated at 12, 24 and 48 months follow-up. Preoperative GRBAS scores and VHI score of all the patients were poor. At 12 months 12/15 (80 %) patients having strain score of 0. There was marked improvement in VHI scores at 6 months. 10/15 (67 %) patients have been followed up for 24 months. 5/10 (50 %) patients have strain (S) value of 0. VHI scoring of 5/10 (50 %) patients was <30. Two of the four patients completed 48 months follow-up had a strain (S) value of 0, one patient has strain value of 1 and one patient had strain value of 2. 2/4 patients had VHI score of <30; one patient had that of 40. Trans-oral CO2 laser thyroarytenoid myoneurectomy shows significant long-term improvement in voice quality in terms of reduced speech brakes, effort and strain in voice.

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Authors and Affiliations

  1. Department of ORL-Head Neck Surgery, Deenanath Mangeshkar Hospital and Research Centre, Pune, 411004, India

    Sachin Gandhi

  2. Department of ORL-Head and Neck Surgery, University Hospital of Louvain, Mont-Godinne Therasse avenue 1, 5530, Yvoir, Belgium

    Marc Remacle

  3. Bharati Vidyapeeth Medical College, Pune, 411004, India

    Prasun Mishra

  4. Voice Clinic, Department of ORL-Head Neck Surgery, Deenanath Mangeshkar Hospital and Research Centre, Pune, 411004, India

    Vrushali Desai

Authors
  1. Sachin Gandhi
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  2. Marc Remacle
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  3. Prasun Mishra
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  4. Vrushali Desai
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Correspondence to Sachin Gandhi.

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Gandhi, S., Remacle, M., Mishra, P. et al. Vocal outcome after endoscopic thyroarytenoid myoneurectomy in patients with adductor spasmodic dysphonia. Eur Arch Otorhinolaryngol 271, 3249–3254 (2014). https://doi.org/10.1007/s00405-014-3129-9

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  • DOI: https://doi.org/10.1007/s00405-014-3129-9

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