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首页> 外文期刊>Journal of voice: official journal of the Voice Foundation >Endoscopic laser thyroarytenoid myoneurectomy in patients with adductor spasmodic dysphonia: A pilot study on long-term outcome on voice quality
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Endoscopic laser thyroarytenoid myoneurectomy in patients with adductor spasmodic dysphonia: A pilot study on long-term outcome on voice quality

机译：内镜激光甲状腺甲状腺样体肌神经切除术治疗内收肌痉挛性肌张力障碍：语音质量长期预后的初步研究

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Objectives: Adductor spasmodic dysphonia (ADSD) is a focal laryngeal dystonia, which compromises greatly the quality of life of the patients involved. It is a severe vocal disorder characterized by spasms of laryngeal muscles during speech, producing phonatory breaks, forced, strained and strangled voice. Its symptoms result from involuntary and intermittent contractions of thyroarytenoid muscle during speech, which causes vocal fold to strain, pressing each vocal fold against the other and increasing glottic resistance. Botulinum toxin injection remains the gold-standard treatment. However, as injections should be repeated periodically leading to voice quality instability, a more definitive procedure would be desirable. In this pilot study we report the long-term vocal quality results of endoscopic laser thyroarytenoid myoneurectomy. Study Design: Prospective study. Methods: Surgery was performed in 15 patients (11 females and four males), aged between 29 and 73 years, diagnosed with ADSD. Voice Handicap Index (VHI) was obtained before and after surgery (median 31 months postoperatively). Results: A significant improvement in VHI was observed after surgery, as compared with baseline values (P = 0.001). The median and interquartile range for preoperative VHI was 99 and 13, respectively and 24 and 42, for postoperative VHI. Subjective improvement of voice as assessed by the patients showed median improvement of 80%. Conclusions: Because long-term follow-up showed significant improvement of voice quality, this innovative surgical technique seems a satisfactory alternative treatment of ADSD patients who seek a definite improvement of their condition.
机译：目的：内收肌痉挛性肌张力障碍（ADSD）是一种局灶性喉肌张力障碍，极大地降低了所涉患者的生活质量。它是一种严重的声音障碍，其特征是在讲话过程中喉部肌肉痉挛，产生发声中断，被迫，紧张和勒死的声音。它的症状是由于说话过程中甲状腺素类肌肉的不自主和间歇性收缩引起的，这会导致声带拉紧，使每个声带相互抵触并增加声门阻力。肉毒杆菌毒素注射仍然是金标准治疗。但是，由于应该定期重复进行注入操作，从而导致语音质量不稳定，因此需要更加确定的过程。在这项前瞻性研究中，我们报告了内窥镜激光甲状腺甲状腺髓样神经切除术的长期声音质量结果。研究设计：前瞻性研究。方法：对15例年龄在29至73岁，被诊断为ADSD的患者进行手术（11名女性和4名男性）。在手术前后（术后31个月中位数）获得语音障碍指数（VHI）。结果：与基线值相比，术后VHI明显改善（P = 0.001）。术前VHI的中位和四分位间距分别为99和13、24和42。患者评估的主观声音改善显示中位数改善80％。结论：由于长期随访显示语音质量显着改善，因此这种创新的手术技术似乎是寻求明确改善其病情的ADSD患者的一种令人满意的替代疗法。

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