Myoneurectomy for Adductor Spasmodic Dysphonia: Long-Term Outcomes, Complications, and Recurrence.

IF 2.2 3区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Laryngoscope Pub Date : 2024-11-14 DOI:10.1002/lary.31904

Domingos Hiroshi Tsuji, Adriana Hachiya, Rui Imamura, Luiz Ubirajara Sennes

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Abstract

Objective: To evaluate the long-term results of endoscopic myoneurectomy (EMN) of the thyroarytenoid (TA) muscle for the treatment of adductor spasmodic dysphonia (AdSD), with an emphasis on vocal outcomes, adverse effects, and recurrence.

Methods: A total of 48 patients underwent up to three EMNs of the TA muscle and were followed for at least 18 months to evaluate the efficacy, based on patient and examiner assessments, and safety of the procedure(s). Vocal outcomes were evaluated through the use of the 30-item Voice Handicap Index (VHI-30) questionnaire and subjective (patient-reported) assessment.

Results: In this group, 38 patients (79.2%) were considered successful. The median VHI-30 score at baseline was 97, decreasing to 26 after treatment, and the median subjective postprocedural improvement was 88.5%. The most common adverse effects were granulomas (in 18 cases), glottic insufficiency (in two), and dyspnea (in one).

Conclusions: Although up to three procedures can be needed to achieve a high success rate, EMN of the TA muscle can provide excellent benefits in terms of vocal function with a low rate of complications.

Level of evidence: 4 Laryngoscope, 2024.

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内收肌痉挛性发音障碍的肌腱切除术：长期疗效、并发症和复发。

目的评估内窥镜下甲状腺腱膜（TA）肌切除术（EMN）治疗内收肌痉挛性发音障碍（AdSD）的长期效果，重点关注发声效果、不良反应和复发情况：共有48名患者接受了最多3次TA肌EMN治疗，并接受了至少18个月的随访，以根据患者和检查者的评估来评价疗效和安全性。通过使用 30 项嗓音障碍指数（VHI-30）问卷和主观（患者报告）评估来评价发声效果：在这组患者中，38 名患者（79.2%）被认为是成功的。基线VHI-30评分的中位数为97分，治疗后降至26分，术后主观改善的中位数为88.5%。最常见的不良反应是肉芽肿（18 例）、声门功能不全（2 例）和呼吸困难（1 例）：尽管需要进行多达三次手术才能达到较高的成功率，但TA肌EMN可在发声功能方面带来极佳的疗效，且并发症发生率较低：4 《喉镜》，2024 年。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Laryngoscope 医学-耳鼻喉科学

CiteScore

6.50

自引率

7.70%

发文量

500

审稿时长

2-4 weeks

期刊介绍： The Laryngoscope has been the leading source of information on advances in the diagnosis and treatment of head and neck disorders since 1890. The Laryngoscope is the first choice among otolaryngologists for publication of their important findings and techniques. Each monthly issue of The Laryngoscope features peer-reviewed medical, clinical, and research contributions in general otolaryngology, allergy/rhinology, otology/neurotology, laryngology/bronchoesophagology, head and neck surgery, sleep medicine, pediatric otolaryngology, facial plastics and reconstructive surgery, oncology, and communicative disorders. Contributions include papers and posters presented at the Annual and Section Meetings of the Triological Society, as well as independent papers, "How I Do It", "Triological Best Practice" articles, and contemporary reviews. Theses authored by the Triological Society’s new Fellows as well as papers presented at meetings of the American Laryngological Association are published in The Laryngoscope. • Broncho-esophagology • Communicative disorders • Head and neck surgery • Plastic and reconstructive facial surgery • Oncology • Speech and hearing defects