Surgical treatment for adductor spasmodic dysphonia – efficacy of bilateral thyroarytenoid myectomy under microlaryngoscopy

Abstract

Conclusions: Bilateral thyroarytenoid myectomy under microlaryngoscopy by the Muta method (TA myectomy) is a useful surgical treatment for adductor spasmodic dysphonia (ADSD), as a long-term-effect can be expected. Objective: Botulinum toxin (BT) injection is universally accepted as the first choice of treatment for ADSD. However, unfortunately it is not covered by National Health Insurance in Japan and therefore is not a common practice. So, various other therapeutic modalities have been reported. In the current study, we conducted bilateral TA myectomy on patients with ADSD and evaluated the results. Patients and methods: Seven patients with ADSD who visited our department between 1999 and 2005 are described. The details of BT injection and the surgical procedure were described to the patients. As all seven patients wanted to undergo this surgical therapy, they all underwent bilateral TA myectomy. Results: The constriction was eliminated immediately after surgery and the patients became capable of smooth phonation. Hoarseness was recognized, but it began to ease after 1–2 months and was corrected to B grade 1–0 of the GRBAS scale approximately 6 months after the surgery. Improvement in the condition was noted in all seven patients according to evaluations based on the mora method. All patients are currently in the B grade 0.

• Spasmodic dysphonia
• myectomy
• microlaryngoscopy
• mora method
• botulinum toxin