Surgical Treatment for the Patient of Adductor Spasmodic Dysphonia

概要

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The injection of botulinum toxin into the thyroarytenoid muscle (BT injection) is the standard therapy used around the world in the treatment of adductor-type spasmodic dysphonia (ADSD) ; however, in Japan BT injection is not approved at all institutions. Thyroarytenoid muscle myectomy-Muta method (TAM) and type 2 thyroplasty (TP2) are the main surgical procedures currently undertaken for treatment of ADSD. The choice between the two procedures is difficult.We reviewed the operative methods of surgical treatment of ADSD. The voice was evaluated preoperatively and postoperatively using the Mora method. The spasmodic ratios (%) were calculated based on the Mora score and then compared. Both operative methods yielded satisfactory results in terms of treatment outcome and satisfaction level of the patients. In surgical therapy for ADSD, TAM and TP2 yield approximately equivalent treatment outcomes. When selecting between the two operative methods, the merits and demerits of each method for each individual patient should be considered.