Laryngeal Nerve Crush for Spastic Dysphonia

Biller, Hugh F.; Som, Max L.; Lawson, William

doi:10.1177/000348947908800415

Cited by 35 publications

(7 citation statements)

References 2 publications

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“…Thirteen studies had low validity scores and thus were excluded. 3,6,[9][10][11][21][22][23][24][25][26][27] The article published by Mendelsohn and Berke 6 analyzed the effect of botulinum toxin and SLAD-R, and study assessment was performed for both treatment arms separately. When the validity of the SLAD-R treatment arm was examined, a high risk of bias was found and therefore excluded for evaluation.…”

Section: Study Assessmentmentioning

confidence: 99%

“…Alternative treatment options for AdSD include surgical treatments, such as thyroarytenoid myotomy/myectomy, thyroplasty, selective laryngeal adductor denervationreinnervation (SLAD-R), laryngeal nerve crush, and recurrent laryngeal nerve resection. 6,[9][10][11][12] So far, no randomized controlled trials have compared the effect of botulinum toxin injections and surgical treatment. Nonetheless, it is important for the outcomes of different treatment modalities to delineate the optimal treatment options.…”

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confidence: 99%

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Effect of Botulinum Toxin and Surgery among Spasmodic Dysphonia Patients: A Systematic Review

Esch

Wegner

Stegeman

et al. 2016

Otolaryngol.--head neck surg.

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Objective The effect of botulinum toxin among patients with adductor spasmodic dysphonia (AdSD) is temporary. To optimize long-term treatment outcome, other therapy options should be evaluated. Alternative treatment options for AdSD comprise several surgical treatments, such as thyroarytenoid myotomy, thyroplasty, selective laryngeal adductor denervation-reinnervation, laryngeal nerve crush, and recurrent laryngeal nerve resection. Here, we present the first systematic review comparing the effect of botulinum toxin with surgical treatment among patients diagnosed with AdSD. Data Sources MEDLINE (PubMed), EMBASE, and the Cochrane Library. Methods Articles were reviewed by 2 independent authors, and data were compiled in tables for analysis of the objective outcome (voice expert evaluation after voice recording), the subjective outcome (patient self-assessment scores), and voice-related quality of life (Voice Health Index scores). Results No clinical trials comparing both treatment modalities were identified. Single-armed studies evaluated either the effect of botulinum toxin or surgical treatment. Thirteen studies reported outcomes after botulinum toxin treatment (n = 419), and 9 studies reported outcomes after surgical treatment (n = 585 patients). A positive effect of bilateral botulinum toxin injections was found for the objective voice outcome, subjective voice outcome, and quality of life. The duration of the beneficial effect ranged from 15 to 18 weeks. Surgical treatment had an overall positive effect on objective voice improvement, subjective voice improvement, and quality of live. Conclusion No preference for one treatment could be demonstrated. Prospective clinical trials comparing treatment modalities are recommended to delineate the optimal outcomes by direct comparison.

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Section: Study Assessmentmentioning

confidence: 99%

mentioning

confidence: 99%

Effect of Botulinum Toxin and Surgery among Spasmodic Dysphonia Patients: A Systematic Review

Esch

Wegner

Stegeman

et al. 2016

Otolaryngol.--head neck surg.

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“…Attempts to control the disorder with recurrent laryngeal nerve section resulted in inconsistent, often temporary improvement, with recurrence in up to 80 percent of cases. [294][295][296][297] A single, retrospective study of laryngeal dystonia patients treated with bilateral division of the adductor branch of the recurrent laryngeal nerve followed by ansa cervicalis reinnervation demonstrated resolution of symptoms in 19 of 21 patients followed for at least 12 months. 298 Evidence profile for Statement 9: Surgery…”

Section: Supporting Textmentioning

confidence: 99%

Clinical Practice Guideline: Hoarseness (Dysphonia)

Schwartz

Cohen

Dailey

et al. 2009

Otolaryngol.--head neck surg.

359

241

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This clinical practice guideline is not intended as a sole source of guidance in managing hoarseness (dysphonia). Rather, it is designed to assist clinicians by providing an evidence-based framework for decision-making strategies. The guideline is not intended to replace clinical judgment or establish a protocol for all individuals with this condition, and may not provide the only appropriate approach to diagnosing and managing this problem.

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“…In 1976, Dedo [6] published a study first using a test dose of a local anesthetic agent to cause a motor blockade of the recurrent laryngeal nerve, followed by a nerve section in those patients with a positive result. Others followed with nerve crush and nerve avulsion or resection [7–9]. All of these procedure had initial good results, with many long term failures [10–12].…”

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confidence: 99%

Spasmodic dysphonia and botulinum toxin: experience from the largest treatment series

Blitzer

2010

Euro J of Neurology

126

157

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Spasmodic dysphonia is a focal laryngeal dystonia, with adductor, abductor, mixed, respiratory and singer's types. Our series over 24 years includes 1300 patients. 82% are of the adductor type; 63% were female; 12% had a positive family history and 82.4% had a focal distribution. All of the patients were managed with varying degrees of success with individualised dosing of botulinum neurotoxin A injected into the laryngeal musculature under EMG guidance.

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Laryngeal Nerve Crush for Spastic Dysphonia

Cited by 35 publications

References 2 publications

Effect of Botulinum Toxin and Surgery among Spasmodic Dysphonia Patients: A Systematic Review

Effect of Botulinum Toxin and Surgery among Spasmodic Dysphonia Patients: A Systematic Review

Clinical Practice Guideline: Hoarseness (Dysphonia)

Spasmodic dysphonia and botulinum toxin: experience from the largest treatment series

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