Long-term results of recurrent laryngeal nerve resection for adductor spasmodic dysphonia

1993 ◽  
Vol 7 (2) ◽  
pp. 172-178 ◽  
Author(s):  
Björn Fritzell ◽  
Britta Hammarberg ◽  
Helge Schiratzki ◽  
Stig Haglund ◽  
Evert Knutsson ◽  
...  
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Laryngeal Nerve ◽  
Long Term Results ◽  
Spasmodic Dysphonia ◽  
Adductor Spasmodic Dysphonia

Short- and Long-Term Results of Total vs Subtotal Thyroid- ectomies in the Surgical Treatment of Graves' Disease

Swiss Surgery ◽  
2001 ◽  
Vol 7 (1) ◽  
pp. 20-24 ◽  
Author(s):  
Robert ◽  
Mariéthoz ◽  
Pache ◽  
Bertin ◽  
Caulfield ◽  
...  
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Nerve Palsy ◽  
Recurrent Laryngeal Nerve Palsy ◽  
Laryngeal Nerve ◽  
Long Term Results ◽  
Graves Disease ◽  
Laryngeal Nerve Palsy ◽  
Short And Long Term

Objective: Approximately one out of five patients with Graves' disease (GD) undergoes a thyroidectomy after a mean period of 18 months of medical treatment. This retrospective and non-randomized study from a teaching hospital compares short- and long-term results of total (TT) and subtotal thyroidectomies (ST) for this disease. Methods: From 1987 to 1997, 94 patients were operated for GD. Thirty-three patients underwent a TT (mostly since 1993) and 61 a ST (keeping 4 to 8 grams of thyroid tissue - mean 6 g). All patients had received propylthiouracil and/or neo-mercazole and were in a euthyroid state at the time of surgery; they also took potassium iodide (lugol) for ten days before surgery. Results: There were no deaths. Transient hypocalcemia (< 3 months) occurred in 32 patients (15 TT and 17 ST) and persistent hypocalcemia in 8 having had TT. Two patients developed transient recurrent laryngeal nerve palsy after ST (< 3 months). After a median follow-up period of seven years (1-15) with five patients lost to follow-up, 41 patients having had a ST are in a hypothyroid state (73%), thirteen are euthyroid (23%), and two suffered recurrent hyperthyroidism, requiring completion of thyroidectomy. All 33 patients having had TT - with follow-ups averaging two years (0.5-8) - are receiving thyroxin substitution. Conclusions: There were no instances of persistent recurrent laryngeal nerve palsy in either group, but persistent hypoparathyroidism occurred more frequently after TT. Long after ST, hypothyroidism developed in nearly three of four cases, whereas euthyroidy was maintained in only one-fourth; recurrent hyperthyroidy was rare.

Laryngeal Framework Surgery in the Management of Spasmodic Dysphonia

1989 ◽  
Vol 98 (1) ◽  
pp. 52-54 ◽  
Author(s):  
Harvey M. Tucker
Keyword(s):  
Vocal Fold ◽  
Vocal Folds ◽  
Long Term Results ◽  
Spasmodic Dysphonia ◽  
Management Problem ◽  
Cure Rate ◽  
Adductor Spasmodic Dysphonia ◽  
Laryngeal Framework Surgery ◽  
Selective Lysis

Spasmodic dysphonia continues to be a management problem for otolaryngologists. Selective lysis of the recurrent laryngeal nerve has been useful in the management of this disease. Reported long-term results, however, reveal that spasm recurs in approximately 40% to 50% of initially successful patients in spite of persistence of the unilateral vocal fold paralysis. Although some of these failures can be recaptured with subsequent laser surgery, the overall “cure” rate does not exceed 70%, even in the best hands. The contributions of Isshiki, LeJeune, and Tucker have demonstrated that tension in the vocal folds can be adjusted by laryngeal framework surgery. Experience with 16 patients suffering from adductor spasmodic dysphonia suggests that laryngeal framework surgery is useful in the management of this disorder.

Long-Term Results of Type II Thyroplasty for Adductor Spasmodic Dysphonia

2004 ◽  
Vol 114 (9) ◽  
pp. 1604-1608 ◽  
Author(s):  
Sor Way Chan ◽  
Malcolm Baxter ◽  
Jenni Oates ◽  
Anne Yorston
Keyword(s):  
Long Term Results ◽  
Spasmodic Dysphonia ◽  
Type Ii ◽  
Adductor Spasmodic Dysphonia

Partial Thyroarytenoid Myectomy: An Animal Study Investigating a Proposed New Treatment for Adductor Spasmodic Dysphonia

1993 ◽  
Vol 108 (3) ◽  
pp. 256-264 ◽  
Author(s):  
Sheldon H. Genack ◽  
Peak Woo ◽  
Raymond H. Colton ◽  
Donna Goyette
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Nerve Stimulation ◽  
Vocal Fold ◽  
Compound Muscle Action Potential ◽  
Contralateral Side ◽  
Laryngeal Nerve ◽  
Spasmodic Dysphonia ◽  
True Vocal Cord ◽  
Laryngeal Function ◽  
Adductor Spasmodic Dysphonia

A new surgical procedure with potential application for the treatment of adductor spasmodic dysphonia was performed on ten rabbits to assess surgical effects on laryngeal function. Using an external approach, partial unilateral thyroarytenoid (TA) muscle excision was performed through a thyroplasty cartilage window. The contralateral side was left undisturbed as a control. The animals were studied acutely and at 3 months using videolaryngoscopy. Electrophysiologic measurements were recorded at 3 months. The procedure was well tolerated by all animals, with no postoperative infection or aspiration. At 3 months, spontaneous and evoked (recurrent laryngeal nerve stimulation) TA muscle electromyographic potentials were measurable bilaterally. TA compound muscle action potential amplitudes were reduced on the side of myectomy. The threshold of recurrent laryngeal nerve stimulation needed to produce observable vocal fold adduction was increased on the side operated on. Perioperative and long-term (3 months) videolaryngoscopy demonstrated preservation of laryngeal competence with good true vocal cord adduction. Histologic analysis with whole organ sections showed replacement of excised muscle with loose fibroareolar tissue. No evidence of muscle regeneration was observed. The vocal ligament and vocal fold mucosa were intact and undistorted in all specimens. This procedure is technically simple and appears to effectively result in a functional yet weakened TA muscle. Because myectomy includes motor unit end-plate excision, problems associated with reinnervation may be circumvented. TA myectomy may be applicable in patients with focal laryngeal dystonia to decrease muscle spasm.

Botulinum Toxin Management of Adductor Spasmodic Dysphonia after Failed Recurrent Laryngeal Nerve Section

2003 ◽  
Vol 112 (6) ◽  
pp. 499-505 ◽  
Author(s):  
Lucian Sulica ◽  
Mitchell F. Brin ◽  
Andrew Blitzer ◽  
Celia F. Stewart
Keyword(s):  
Botulinum Toxin ◽  
Recurrent Laryngeal Nerve ◽  
Group Treatment ◽  
Botulinum Toxin Type A ◽  
Laryngeal Nerve ◽  
Spasmodic Dysphonia ◽  
Recurrent Nerve ◽  
Nerve Section ◽  
Adductor Spasmodic Dysphonia ◽  
Botulinum Toxin Therapy

This study examined botulinum toxin type A (BTX-A) treatment of adductor spasmodic dysphonia patients who had previously undergone recurrent laryngeal nerve section that failed to control symptoms. Information was retrieved from records of patients treated by our group between 1984 and 1999. Complete records with standardized outcome measurements were available for 181 BTX-A injection sessions in 16 patients who had had nerve section. These were compared to previously published information regarding 4,621 sessions in 639 adductor spasmodic dysphonia patients also treated by our group. Treatment with BTX-A resulted in significant improvement in voice function in the studied patients (change, 38.2% ± 24.5%; p < .0001). The onset of effect took place approximately 2.3 days after treatment, and the peak effect about 10.0 days after treatment. The therapeutic effect lasted 14.1 weeks on the average. These features were not significantly different from those observed in adductor spasmodic dysphonia patients as a whole. The incidence of complications was also comparable. However, lower baseline and peak posttreatment perceptions of voice function in the nerve section group were statistically significant (baseline, 45.6% ± 23.0% versus 52.4% ± 22.0%; peak, 83.8% ± 16.4% versus 89.7% ± 13.0%; both p < .001). We conclude that BTX-A is effective in the treatment of adductor spasmodic dysphonia in patients who have had recurrent nerve section. However, nerve section may adversely affect perceived voice function and may make botulinum toxin therapy less satisfactory. Because of this finding, and because of the unusual pathological features of the focal dystonias, irreversible means of treating adductor spasmodic dysphonia should be approached with caution.

Cross-Innervation of the Thyroarytenoid Muscle by a Branch from the External Division of the Superior Laryngeal Nerve

1997 ◽  
Vol 106 (7) ◽  
pp. 594-598 ◽  
Author(s):  
Sina Nasri ◽  
Joel A. Sercarz ◽  
Pouneh Beizai ◽  
Young-Mo Kim ◽  
Ming Ye ◽  
...  
Keyword(s):  
Vocal Fold ◽  
Superior Laryngeal Nerve ◽  
Laryngeal Nerve ◽  
Spasmodic Dysphonia ◽  
Clinical Implications ◽  
Motor Innervation ◽  
Vocal Fold Vibration ◽  
Adductor Spasmodic Dysphonia ◽  
Thyroarytenoid Muscle ◽  
Stimulation Of

The neuroanatomy of the larynx was explored in seven dogs to assess whether there is motor innervation to the thyroarytenoid (TA) muscle from the external division of the superior laryngeal nerve (ExSLN). In 3 animals, such innervation was identified. Electrical stimulation of microelectrodes applied to the ExSLN resulted in contraction of the TA muscle, indicating that this nerve is motor in function. This was confirmed by electromyographic recordings from the TA muscle. Videolaryngostroboscopy revealed improvement in vocal fold vibration following stimulation of the ExSLN compared to without it. Previously, the TA muscle was thought to be innervated solely by the recurrent laryngeal nerve. This additional pathway from the ExSLN to the TA muscle may have important clinical implications in the treatment of neurologic laryngeal disorders such as adductor spasmodic dysphonia.

scholarly journals The impact of the recurrent laryngeal nerve injury on prognosis after McKeown esophagectomy for ESCC

2020 ◽  
Author(s):  
Rirong Qu ◽  
Dehao Tu ◽  
Wei Ping ◽  
Qi Wang ◽  
Ni Zhang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Recurrent Laryngeal Nerve ◽  
Recurrent Laryngeal Nerve Injury ◽  
Laryngeal Nerve ◽  
Term Survival ◽  
Laryngeal Nerve Injury ◽  
Independent Risk Factors ◽  
Mckeown Esophagectomy ◽  
The Impact

Abstract Background: The objective of this study was to assess the impact of the recurrent laryngeal nerve injury (RLNI) after esophagectomy on prognosis.Methods: Retrospectively collected data from 297 patients with esophageal squamous cell carcinoma who underwent McKeown esophagectomy at our department from April 2014 to May 2018, were analyzed.Results: RLNI occurred in 31.9% of the patients. Left-side RLNI occurred 2.8 times more often than right-side RLNI. Among the cases in which assessment of the vocal cords was continued, 8.4% involved permanent injury. There were no significant differences among clinicopathological data between patients with RLNI and without. Compared with patients without RLNI,patients with RNLI have longer operation time,more number of bronchoscopy suctions, longer postoperation hospital stay, and higher incidence of postoperative complications. T stage, N stage, RLN LN metastasis were independent risk factors for the prognosis, but RLNI is not independent risk factors for long-term survival. Conclusion: RLNI is a serious complication that will affect the short-term prognosis of patients and reduce the quality of life of patients. It should be avoided as much as possible during surgery, but it may not have negative impact on the long-term survival.

Sign in / Sign up

Export Citation Format

Share Document