Autologous replacement of the vocal fold: a new surgical approach for adduction-type spasmodic dysphonia

Abstract

Many surgical approaches have been developed for the treatment of adduction-type spasmodic dysphonia (SPD). We developed and performed a new type of surgical approach (autologous replacement of the vocal fold). Our new surgical technique increases the advantages and decreases the disadvantages of previous surgical procedures in three ways: (1) It has similar effects to the previous procedures in that it prevents contraction of the thyroarytenoid muscle. (2) It decreases vocal-fold tension, as in framework surgery. (3) It reduces glottal incompetence, as does fibrinogen-glue injection, but it is more suitable because it is autologous. Furthermore, it produces increases in the mass and volume of the vocal-fold body and is also safe because the replacement tissue is autologous. The short-term results appear encouraging in preventing spastic voice while also avoiding vocal-fold atrophy. Long-term follow up will be necessary to determine the actual efficacy. However, this is clearly a possible choice as a surgical approach for treating adduction-type SPD.

Overall Evaluation of Effectiveness of Type II Thyroplasty for Adductor Spasmodic Dysphonia

“…A major drawback of this therapy is that the effect is only temporary, lasting 3 to 6 months, and requires frequent injections. Various treatments for adductor SD (AdSD) have been reported 4,6–14 . In 2000, we reported an entirely new surgical treatment for AdSD, type II thyroplasty 11 .…”

Autologous Transplantation of Fascia into the Vocal Fold: Long‐Term Result of Type‐1 Transplantation and the Future

“…Finally, we consider the future of ATFV as a phonosurgical technique. The technique of ATFV as a phono‐ultramicrosurgery proved useful as a new surgical approach for a case of adduction‐type spasmodic dysphonia 70 . In a case of pseudo vocal‐cord paralysis caused by a fish bone, 71 we reported a successful result using an ATFV technique for medialization surgery without a neck incision 72 .…”

Surgical treatment for adductor spasmodic dysphonia – efficacy of bilateral thyroarytenoid myectomy under microlaryngoscopy

“…No patients were dissatisfied with the breathy voice, because the spasmodic voice improved immediately. There is a report that a material for filling after the operation is temporalis fascia [18].…”