Retrospective Analysis of Phonatory Outcomes after CO2 Laser Thyroarytenoid Myoneurectomy in Patients with Adductor Spasmodic Dysphonia

Abstract

Introduction: Adductor spasmodic dysphonia (ADSD) is a focal laryngeal dystonia characterized by spasms of laryngeal muscles during speech. Botulinum toxin injection in the Thyroarytenoid muscle remains the gold-standard treatment for ADSD. However, as Botulinum toxin injections need to be repeated periodically, the voice quality fluctuates over a longer period. A Microlaryngoscopic Transoral approach to CO2 laser Thyroarytenoid myoneurectomy (TAM) has been reported as an effective technique for treatment of ADSD. It provides sustained improvement in the voice over a longer duration. Methods : Trans oral Microlaryngoscopic CO2 laser TAM was performed in 14 patients (5 females and 9 males), aged between 19 and 64 years who were diagnosed with ADSD. Data was collected from over 3 years starting from Jan 2014 – Dec 2016. GRBAS scale along with Multidimensional voice programme (MDVP) analysis of the voice and Video laryngo-stroboscopic (VLS) samples at the end of 3 and 12 months of surgery would be compared with the pre-operative readings. Results: A total of 9 (64.2%) patients showed an improvement in grade after 3 months as well as 12 months after the surgery. While 12 (85.7%) patients showed an improvement in strain after 12 months of surgery. The spasms on VLS showed an improvement in 9 (64.3%) out of 14 cases after 3 months of surgery which was proven to be statistically significant. Conclusion : This innovative surgical technique is a good alternative treatment for ADSD patients who seek a definite improvement of their condition.