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Korean Journal of Otorhinolaryngology-Head and Neck Surgery 1995;38(2): 267-74. |
Selective Thyro-Arytenoid(TA) Nerve Section and Ansa cervicalis Reinnervation for the Treatment of Spasmodic Dysphonia |
Hong-Shik Choi, MD |
Institute of Logopedics and Phoniatrics, Department of Otorhinolarynology, Yonsei University College of Medicine, Seoul, Korea |
선택적 갑상피열분지의 절단고 경신경고리 신경재지배 방법을 이용한 연축성발성장애의 수술적 치료 |
최홍식 |
음성언어의학연구소, 연세의대 이비인후과 영동세브란스병원 |
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ABSTRACT |
Spasmodic dysphonia is a kind of focal dystonia and it is divided into two groups : adductor type and abductor type. The patients with adductor spasmodic dysphonia have typical dysphonia due to hyper-adduction of the vocal folds during phonation. There have been two kinds of treatment methods : section of the unilateral recurrent laryngeal nerve(RLN) and injection of Botulinum toxin (Botox). Section of the unilateral RLN couldn't get worldwide popularity, because the nature of the treatment looked 'not physiologic' and certain amount of recurrences were reported. Although the initial effect of Botox injection is very good, the effect of the drug only lasts couple of months and several complication has been published. Recently, selective section of the terminal thyroarytenoid(TA) branch of the RLN has been introduced. Through the thyroid cartilage window, TA branch was identified and cut. The proximal and distal part of the TA branch was ligated with silk suture. The author modified this procedures. The proximal TA branch was ligated and the distal TA branch was reanastomosed with ansa cervicalis nerve bilaterally in order to prevent regeneration from the proximal stump as well as muscle atrophy. The preliminary results and progress of this procedure on three patients with severe adductor spasmodic dysphonia indicated that this procedure may be one of the the possible ideal treatment options and it needs large series with long term follow-up to be verified.
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Keywords:
Spamodic dysphoniaㆍSelective section of thyroaryntenoid branchㆍAnsa cervicalis reinnervation. |
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