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Treatment of spastic dysphonia by recurrent laryngeal nerve section
Author(s) -
Barton Richard Thomas
Publication year - 1979
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1288/00005537-197902000-00007
Subject(s) - spastic , medicine , recurrent laryngeal nerve , superior laryngeal nerve , surgery , anesthesia , larynx , physical medicine and rehabilitation , thyroid , cerebral palsy
The problem of management of patients with spastic dysphonia has been complicated by a general resistance to speech therapy, psychotherapy, hypnotherapy, and drug therapy. Dedo introduced the concept of recurrent laryngeal nerve section in an attempt to eliminate the hyperfunction and excessive adduction of the vocal folds. Eleven patients were treated by RLN section with satisfactory results in 8 and some improvement in the other 3. The operation was found to be generally uncomplicated and required on average 4 days of hospitalization. Dedo's theory that spastic dysphonia is caused by a neurotropic viral‐induced proprioceptive nerve deficit represents a new search for organic cause. His most recent report of finding unmyelinated fibres in one‐third of the resected recurrent laryngeal nerves is of questionable significance. The evidence of deep emotional conflict and/or compulsive lifestyle is found in the majority of the patients, but the syndrome is not typical of an hysterical or conversion neurosis. Regardless of etiologic theory, RLN section is an effective treatment in selected, longstanding, and resistant instances of spastic dysphonia.