Selective laryngeal adductor denervation-reinnervation: A new surgical treatment for adductor spasmodic dysphonia
Selective laryngeal adductor denervation-reinnervation: A new surgical treatment for adductor spasmodic dysphonia
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DOI：
10.1177/000348949910800302
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发表时间：
1999-03-01
影响因子：
1.4
通讯作者：
Sercarz, JA
中科院分区：
文献类型：
--
作者：
Berke, GS;Blackwell, KE;Sercarz, JA
在过去的十年中，肉毒杆菌毒素（Botox）已成为公认的治疗内收肌痉挛性语音障碍（ASD）的方法。这种治疗会导致双侧甲状腺样肌无力，无疑会产生对ASD患者有益的生理效应。然而，它也有重要的局限性，包括需要反复注射，剂量和反应之间不可预测的关系，以及短期吞咽和声音问题的可能性。在这项研究中，我们将报告一种新的ASD手术治疗的初步经验。在这个新的手术中，喉返神经的内收支被选择性地双侧去神经，其远端神经残端被颈袢神经的分支再神经支配。每位患者至少随访12个月；中位随访时间为36个月。本文报道了21例患者的手术结果。在21名患者中，有19名患者被判断为语音障碍的总体严重程度，在手术后从“没有到轻微”。只有1例患者术后接受肉毒杆菌素进一步治疗。讨论了这一新程序对ASD的影响。
During the past decade, botulinum toxin (Botox) has emerged as the accepted treatment for adductor spasmodic dysphonia (ASD). This therapy, which produces bilateral weakness of the thyroarytenoid muscle, undoubtedly produces physiologic effects that are beneficial to patients with ASD. However, it also has important limitations, including the need for repeated injections, the unpredictable relationship between dosage and response, and the possibility of short-term swallowing and voice problems. In this study, we will report our preliminary experience with a new surgical treatment for ASD. In this new procedure, the adductor branch of the recurrent laryngeal nerve is selectively denervated bilaterally, and its distal nerve stumps are reinnervated with branches of the ansa cervicalis nerve. Each of the patients was followed for at least 12 months; the median follow-up is 36 months. The outcome of the operation in 21 consecutive patients is reported. Nineteen of the 21 patients were judged to have an overall severity of dysphonia that was "absent to mild" following the procedure. Only 1 patient underwent further treatment with Botox postoperatively. The implications of this new procedure for ASD are discussed.