Outcomes of type II thyroplasty for adductor spasmodic dysphonia: analysis of revision and unsatisfactory cases

Sanuki, Tetsuji; Isshiki, Nobuhiko

doi:10.3109/00016480802620639

Cited by 24 publications

(4 citation statements)

References 13 publications

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“…However, these BTX injections are usually required once every 3-4 months and may result in temporary dysphonia caused by incomplete glottic closure. The second option is surgical treatment, including recurrent laryngeal nerve (RLN) sectioning, 4 RLN denervation and reinnervation, 5 thyroarytenoid myectomy, 6,7 and type 2 thyroplasty (TP2), [8][9][10][11][12][13][14][15][16] with the objective of achieving permanent relief from voice symptoms such as a strained, strangled voice or intermittent voice breaks.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Botulinum Toxin Injections and Type 2 Thyroplasty for Adductor Spasmodic Dysphonia

Sanuki

Takemoto

2023

The Laryngoscope

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ObjectivesInjection of botulinum toxin type A (BTX) into intrinsic laryngeal muscles is the current gold standard therapy for adductor spasmodic dysphonia (AdSD). However, a surgical procedure could potentially offer more stable and long‐lasting voice quality to AdSD patients. Here, we report the long‐term results of type 2 thyroplasty (TP2) with TITANBRIDGE® (Nobelpharma, Tokyo, Japan) compared with those of BTX injections.MethodsIn total, 73 AdSD patients visited our hospital between August 2018 and February 2022. Patients were provided the option of BTX injections or TP2. They were assessed via the Voice Handicap Index (VHI)‐10 before treatments and at scheduled clinical follow‐ups at 2, 4, 8, and 12 weeks for BTX and at 4, 12, 26, and 52 weeks for TP2.ResultsOverall, 52 patients selected the BTX injection and had a pre‐injection mean VHI‐10 score of 27.3 ± 8.8. Following injections, the scores significantly improved to 21.0 ± 11.1, 18.6 ± 11.5, and 19.4 ± 11.7 at 2, 4, and 8 weeks, respectively. There were no significant differences between the pre‐injection scores and the 12‐week scores (21.5 ± 10.7). Alternately, 32 patients opted to be treated with TP2 and had a pre‐treatment mean VHI‐10 score of 27.7. All patients reported an improvement in their symptoms. Additionally, the mean VHI‐10 score significantly improved to 9.9 ± 7.4 at 52 weeks following treatment. There was a significant difference between the two treatment groups at 12 weeks. Some patients received both treatments.ConclusionThese preliminary results provide important insights into the value of TP2 as a potential permanent treatment for AdSD patients.Level of EvidenceIII Laryngoscope, 2023

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Section: Introductionmentioning

confidence: 99%

Comparison of Botulinum Toxin Injections and Type 2 Thyroplasty for Adductor Spasmodic Dysphonia

Sanuki

Takemoto

2023

The Laryngoscope

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“…In relation to thyroplasty, the results of this treatment were analyzed in more than one article showing the concern of a surgical team in improving the surgical procedures initially proposed. In general, the researchers discussed the indication and contraindication of this surgery, presented modifications to the surgical technique, and pointed to the patient's own satisfaction in his/her voice quality [16][17][18] . The use of the Remacle modified radiofrequency thyroarytenoid myothermy was reported on in one study.…”

Section: Injection Of Btmentioning

confidence: 99%

“…During speech, the edges of the cartilage are separated from 2 to 6 mm, average 4 mm, to verify any voice change 16,17 . A variety of material has been described for securing the edges of cartilage, such as pieces of silicon or cartilage, and titanium plates and bridges above and below the anterior commissure [16][17][18] .…”

Section: Thyroplastymentioning

confidence: 99%

Tratamento médico e fonoaudiológico da disfonia espasmódica: uma revisão bibliográfica

Fabron

Marino

Nobile³

et al. 2013

Rev. CEFAC

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A disfonia espasmódica (DE) é um distúrbio vocal caracterizado por voz tensa-estrangulada, com quebras de sonoridade e que compromete a comunicação do indivíduo. O objetivo deste estudo é apresentar uma revisão bibliográfica dos tratamentos médico e fonoaudiológico proposto para a DE no período entre 2006 e 2010. Os tratamentos descritos foram: injeção de toxina botulínica (TB), miectomia, neurectomia, denervação e reinervação laríngea seletiva adutora, tireoplastia, miotermia tiroaritenóidea com radiofrequência, injeção de lidocaína, homeopatia e tratamento fonoaudiológico (fonoterapia). O uso de injeção de TB mostrou resultados que indicaram a satisfação dos pacientes tratados, embora alguns dos artigos apontassem a necessidade de reaplicação da toxina frequentemente, como desvantagem. Os procedimentos cirúrgicos foram considerados duradouros e indicados para os pacientes que não quiseram se submeter às aplicações de TB. Tais estudos, no entanto, apresentaram contingência de pacientes restrita e os resultados foram baseados, na maioria das investigações, no julgamento dos próprios pacientes sobre a sua qualidade vocal. Os tratamentos, com uso de lidocaína e homeopatia, mostraram resultados positivos em relação à qualidade vocal dos pacientes e foram sugeridos como uma opção, também, para aqueles que não gostariam de ser submetidos ao tratamento cirúrgico ou à aplicação de TB. Os poucos estudos que reportam fonoterapia assinalaram bons resultados quando a mesma foi associada à injeção de TB, mostrando a escassez de informações nesta área. Futuras pesquisas envolvendo a fonoterapia no tratamento da DE são necessárias.

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“…In Japan, laryngologists have focused on surgical treatment, particularly because botulinum toxin is not state approved in the treatment of SD. Nowadays, thyroid cartilage relaxation surgeries are being attempted (31)(32)(33).…”

Section: Treatmentmentioning

confidence: 99%

Spasmodic Dysphonia

Paltura¹,

Develioğlu²,

Oğuz³

2017

JAREM

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Spasmodic dysphonia (SD) is focal dystonia involving intrinsic laryngeal muscles. It occurs because of a disorder in laryngeal motor neuron control during speech. Voluntary speech is affected, while involuntary actions such as loughing, crying, or coughing are not affected. An irregularity in organization in the central nervous system is observed in the pathophysiology of the disease. Some genetic mutations are found be responsible, and the disease is inherited in an autosomal dominant manner. There are two types of the dissease: adductor and abductor. The adductor type is more frequent. The diagnosis is usually delayed because of lack of exact objective criteria. Laryngeal electromyography (EMG) is the test that provides the most valuable diagnostic results. Injecting botulinium toxin into the densest muscle is the treatment of choice.

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Outcomes of type II thyroplasty for adductor spasmodic dysphonia: analysis of revision and unsatisfactory cases

Cited by 24 publications

References 13 publications

Comparison of Botulinum Toxin Injections and Type 2 Thyroplasty for Adductor Spasmodic Dysphonia

Comparison of Botulinum Toxin Injections and Type 2 Thyroplasty for Adductor Spasmodic Dysphonia

Tratamento médico e fonoaudiológico da disfonia espasmódica: uma revisão bibliográfica

Spasmodic Dysphonia

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